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EACE ApplicationFormat

This document is an application form for a post at the Indian Academy of Sciences, requiring personal details, educational qualifications, employment history, and references. It includes sections for the applicant's name, date of birth, contact information, current and previous employment, educational background, and professional training. The applicant must also declare the accuracy of the information provided and sign the form.

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itshardesttolive
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4 views4 pages

EACE ApplicationFormat

This document is an application form for a post at the Indian Academy of Sciences, requiring personal details, educational qualifications, employment history, and references. It includes sections for the applicant's name, date of birth, contact information, current and previous employment, educational background, and professional training. The applicant must also declare the accuracy of the information provided and sign the form.

Uploaded by

itshardesttolive
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Annexure 1

INDIAN ACADEMY OF SCIENCES


(A professional body under the Department of Science & Technology, GoI)
PB 8005, RRI Campus, Sadashivanagar,
[Link] Avenue, Bengaluru 560 080.
-----------------------------------------------------------------------------------------------------------
Application for the Post of ----------------------
Affix coloured
latest
Passport Size
Photograph

1 Name in full (starting with :


. last name) in BLOCK
LETTERS (leaving one space
blank between two parts of
name
2 a) Date of Birth : : DATE MONTH YEAR
.

b) Age in completed years :

c) Nationality :

3 (i) Address for


. correspondence
(in BLOCK LETTERS)

Pin Code:
(ii) Telephone No.: :
(a) Office:
(b) Residence:
(iii) Mobile No. (mandatory) :
:.
(iv) E-mail ID (mandatory): :

4 Permanent Address :
. (in BLOCK LETTERS)

Pin Code:
Telephone Number:
5. Details of the Post being held presently

Name and date of the Nature of duties Name, designation, Any other relevant details
present post being address and contact of service
held numbers (including
mobile no. and e-mail
ID) of the superior
officers / authorities
to whom currently
reporting and the
previous supervisor, if
any.

6. Previous employment record


(Details in chronological order, starting with the first job. Attach a separate sheet)
Name and address Nature of Period Total Gross Pay Nature of duties
of the employer / employme worked period of
institution nt (ad hoc / employme
regular / nt in years,
temp. etc) months
and days
Fro To
m Date
Dat
e

[Link] Qualifications
(In chronological order from matriculation onwards. Enclose a separate sheet, duly authenticated
with your signature, if the space below is insufficient. Copies of certificates must be attached)
SL. EXAMS PASSED UNIVERSITY / YEAR OF SPECIALISAT DIV. / CLASS AND
No. INSTITUTION / PASSING I ON % OF MARKS
BOARD SUBJECT, IF
ANY
8. Professional Training/Certificate courses undergone:

SL. Name of the PERIOD Name of the Organiser


No Programme/Course
From To

9. Please justify your suitability for the position applied, in not more than 150 words:

10. Give below the names of three references (they must not be related to you) who are in a
position to testify from their personal knowledge regarding your suitability for the proposed
appointment. They could be persons under whom you have worked or studied. (One of the
referees should be your immediate supervisor at your work place). Name (s) with full address and
contact number, (Including mobile no. and e-mail address)

1.

2.

3.

[Link] information, if any:

[Link] of Enclosures:

(Attach a list) DECLARATION:

I certify that the foregoing information is correct and complete to the best of my knowledge and
belief and nothing has been concealed / distorted. If at any time I am found to have concealed /
distorted any material, information, my appointment shall be liable to be summarily terminated
without any notice.
Place:

Date:

Signature of the Candidate

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