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College*

Discipline:*

Post Applied*

Surname Name*

Name*

Upload passport size image*

Father's Name *

Mother's Name*

Gender :*
MaleFemale

Date of Birth*

Age:

Place of birth*

Marital Status:*
MarriedUnmarriedDivorcee

Nationality :*
IndianOther

Mobile No:*

Alternate Contact No:

Email:*

AADHAR No:*

Permanent Account No(PAN):

Same as Permanent Address

Permanent Address:*

Local Address:

Father's Occupation*

Mother's Occupation**

Languages Known :

Languages	Read	Write	Speak
English	yesNo	yesNo	yesNo
Hindi	yesNo	yesNo	yesNo
Gujarati	yesNo	yesNo	yesNo
	yesNo	yesNo	yesNo

Educational Qualification :

Branch/Subject	Percentage	Class	Uni./Board	Year
HSC
Diploma
UG
PG
Ph.D.

Academic Experience :

Academic Experience	Yrs. (upto 40)	Months (upto 11)	total
Lecturer
Assistant Professor
Associate Professor
Professor

Industrial Experience

Designation :*

Experience :*
yrs months

Research Experience

Designation**

Experience :*
yrsmonths

Number of books authored:

Reference - 1

Name:

Credentials:

contact number:

Reference - 2

Name:

Credentials:

Contact Number:

Current Total Emoluments (Rs.):*

Expected Monthly Emoluments (Rs.):*

Time required to join, if selected:*

Date of Application*

I, hereby declare that the information furnished by me is true and I understand and agree that my application will be rejected if the information is found wrong.

B.Tech

M.Tech

School of Diploma Studies

B.Sc

M.Sc

PG Diploma

Faculty of Humanities & Social Sciences

UG Program

PG Program

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