Application for the Post of Assistant Professor (Self Finance Course) in ... *

Salutation (Dr./Mr./Ms./Mrs.) *

First Name *

Middle Name *

Last Name *

Marital Status *

Mother Tongue *

Caste and Category

Domicile & Nationality *

Address for Correspondence *

Permanent Address *

Mobile No *

Email id *

Adhar Card No. *

Date of Birth (DD/MM/YYYY) *

Name of UG Degree passed - Year of Passing - Name of the University (Eg. B.Sc.-1997-RTM Nagpur University) *

% of Marks obtained and Division of Marks (Eg. 72%-I Division) *

Subject for Post Graduation Degree -Specilization (if any)- Year of passing - Name of University (Eg. M.Sc. Chemistry-Organic Chemistry-1999-SGB Amravati University) *

% of Marks obtained and Division of Marks (Eg. 72%-I Division) *

NET/SET/PhD - Year of Passing (Eg. NET-Dec 2011/SET-2012/PhD-2010) *

PhD Topic and Notification Date

Teaching Experience (Eg. From July 2009 to Dec 2014 as Assistant Professor at ABC College, Paratwada, From January 2015 to till date at XYZ College, Nagpur)

Are you presently employed? If yes NOC from the present employer is required. Format for NOC is available in the application form at www.jbsw.shikshamandal.org *

Date of advertisement and name of news paper in which it was advertised *

Postal Order No. and Amount (Eg. BM 41521 - Rs. 100 or MB 41521 Rs. 50 + MB 441522 Rs 50), Date *

Application Mode - By hand / By Post - Date of application (Eg. By Post - 28/02/2019) *

Have you attached all the requisite documents with the application ? [List of documents to be attached - 1. B.Sc. Marksheet, 2. B.Sc.Degree 3. M.Sc. Marksheet, 4. M.Sc. Degree, 5. NET/SET/PhD. Marksheet or degree 6. Experience Certificate (if any) 7. Copy of leaving certificate to confirm date of birth 8. Indian Postal order (Rs. 100/-) 9. Other relevant documents (if any)] *

All the information furnished by me is correct and I am aware that my candidature will be rejected at any stage if false/incorrect information detected during the selection process. *