Shree Chanakya Education Society’s
Indira College of Engineering and Management
(Affiliated to the University of Pune, recognized by Govt of Mah. & approved by AICTE.)
[Link]. 64, 65, Gat No. 276, At Post – Parandwadi, Tal. Maval, Dist. Pune Pin – 410506 (India)
I. D. No. PU/PN/Engg/282(2007)
Tel: 02114 – 661500 Fax No. 02114 – 661700
Website: - [Link] E-mail:info@[Link]
For Office use only
Qualifications: Ph. D M. Tech M. E. M.B.A [Link]. M.C.A B. E. B. Tech [Link]
Category: OPEN OBC SBC VJ DT/NT ST SC
1. Post Applied For (Designation):………………………………………… Photograph
2. Subject: ……………………………………………………………………
3. Category: OPEN / OBC / SBC / VJ / DT / NT / ST / SC
4. Applicant’s Name: ……………………………………………………………………………….......
5. Date of Birth: DD……… MM…………..YY……………… Nationality:………………………..
6. Address: ………………………………………………………………………………………............
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…………………………… Pin Code: ………………….. Tel. No. (………)……………..
Mobile: ………………………… E-mail ID:………………………………………………
7. Educational Qualifications:
Sr. Examination Board / Month & Yr Total Marks Class /
%
No. Passed University of Passing / Out of Grade
B.E. / B. Sc
1.
M. Tech / M.E.
2.
/ M. Sc.
3. M.B.A. /
M.C.A.
Ph. D.
4.
5.
8. Teaching Experience:
Sr. Name of the Institute Period University Designation & Subject
No. Approval Last Salary taught
From To No. & date drawn
1.
2.
3.
4.
5.
9. Industrial Experience:
Sr. Name of the Industry Period Place Designation & Job
No. Last Salary entrusted
From To drawn
1.
2.
3.
4.
5.
10. Membership of Professional bodies:
Sr. Name of the Type of Membership Validity
No. Professional body membership No.
1.
2.
3.
4.
5.
11. Publications *:
Sr. Conference / Journals No of Papers Remarks
No.
1. National Conference
2. National Journals
3. International Conference
4. International Journals
5.
* Please attach a list of publications separately giving details of conference / title, co – authors and page numbers
12. Projects and consultancy assignments (if any): …………………………………………………
.………………………………………………………………………………………………………….
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13. Extra curricular activities (if any):……………………………………………………………….
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14. References:
Sr. Name Tel. / Mobile E-Mail ID
No.
1.
2.
13. Present Salary:………………………………………………………………………………………
14. Expected Salary: ……………………………………………………………………………………
To the best of my knowledge and belief the information given above is correct and no part of the
information is being suppressed by me. If any of the information given above is found incorrect, I
shall be held responsible and liable for its consequences.
Place:……………………..
Date: / /200
________________________________
(Name & Signature of the applicant)
Note: 1. Incomplete application with insufficient data will be summarily rejected.
2. Do not attach the copies of testimonials.