JSS MAHAVIDYAPEETHA
JSS ACADEMY OF TECHNICAL EDUCATION
C-20/1, Sector-62, Noida-201301 (U.P.) Ph: 0120-2400115, 2400104, Fax:0120-2400097
Serial No.:___________
Application for the post of_____________________________________________
1. (a) Name in full___________________________________________________
(In block letters)
(b) Name of Father________________________________________________
2. (a) Permanent Address___________________________________________________________
______________________________________________________________________________
(b) Present Address_____________________________________________________________
Tel No.________________________________e-mail__________________________________
3. Date of Birth ____________________________Age___________________________________
Place of Birth___________________________
4. (a) Nationality________________
(b) Region & Caste___________________
(c) Sex______________________
(d) Marital Status ____________________
(e) Languages Known:
Speak
Read
Write
5. Academic Qualification commencing from Matriculation or Equivalent Examination:
Courses
Name of the institution in
which studied
Univ/Board
institution
Candidates with M.Tech, please indicate if it is Full time
Year of
passing
Class/Grade
if any with
% of Markes
Part time
Specification
if any
Distance learning
6. Have you published any papers? If so, give full particulars in a separate sheet of paper.
______________________________________________________________________________
7. Membership of Professional bodies.
______________________________________________________________________________
8. List of the Sports, Games and other Extra curricular activities in which you have participated.
______________________________________________________________________________
9. Give a list of honors/distinction/Prizes in studies or sports, if any
______________________________________________________________________________
10. Details of Past Employment(Experience)
______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
11. (a) Are you in service presently:
If the answer to (a) above is yes, give
Yes/No
Name of the Employer________________________________________________________
Designation_________________________________________________________________
Basic Pay & Gross Salary Drawn ________________________________________________
Scale of pay________________________________________________________________
Total service in the present Cadre_______________________________________________
12. Joining time required if selected __________________________________________________
13. Additional information the applicant wishes to furnish, if any
14. List of enclosures:
1.
2.
3.
4.
5.
I hereby declare that the statements made in this application are true and correct to the best of my
knowledge and belief.
Date
Signature of the Candidate
Place....
NOTE: submit the application along with
(a) Copies of degree certificate and marks-cards for all Semesters/years of the qualifying
examination, Experience certificate, and age proof certificate etc,.
(b) Candidate already employed should enclose a certificate of last salary drawn.
