JAWAHARLAL NEHRU CENTRE FOR ADVANCED SCIENTIFIC RESEARCH Jakkur P.O., Bangalore 560 064
Application for the post of ......
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Date ......
Please affix your signature on the photograph
(b) Father's / Husband's Name:
(c) Age & Date of Birth:
(d) Married / Single : / (e) Nationality
(f) Do you belong to SC/ST/OBC (Attach
Caste/Tribe certificate) State the sub-caste/tribe / Yes / No
2. Address(in block letters)
(a) permanent address / (b) Current Address
(c) Contact Details Email Address : Mobile Number : Landline Number :
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3. Educational career (Beginning with SSLC/X Standard/Equivalent): The details should be in the order given below:
a. Name of School/College with University
b. Year of stay in School/College (From – To)
c. Main Subjects
d. Year of passing examination
e. Marks obtained
f. Class/Division
(Attach attested xerox copy of certificates/marks cards)
4. Indicate any certificate course(s) or diplomas completed and/or training programme etc., undergone or currently undergoing. The details should be in the order given below:
a. Name of Institution
b. Name of the Course
c. Main Subjects
d. Training undergone
e. Year of passing examination
f. Marks obtained
g. Class/Division
(Attach attested xerox copy of certificates/marks cards)
5. Give your previous employment details in the sequence starting from the latest in the order given below:
a. Name of employer
b. Duration of employment
c. Designation
d. Nature of employment
e. Duties and Responsibilities
f. Pay last drawn & total emoluments
6. If the post is offered time required to join duty:
7. Salary expected (state the basic pay you expect in the grade):
8. Additional information if any,
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9. References (Give names and addresses of two or more persons who are intimately acquainted with your work but are not related to you)
Sl. No. / Name and address / Profession / Years Known10. List of enclosures to the application:
1.
2.
3.
4.
5.
6.
Only attested Xerox copy of testimonials/marks cards/certificates should be submitted. Original testimonial/marks cards/certificates should not be sent unless asked for.
NOTE: Enclose a separate detailed resume in respect of the qualifications, experience, nature of job
undertaken etc., along with the application form.
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DECLARAT IO N
I au thorise investig ation of all matters con tain ed in th is app lication and ag ree th at if, in the ju dg ement of the Cen tre an y misrepresen tation has been made by me herein or th e results of su ch investig ation are not satisfactory, any offer of employmen t mad e by the Centre may b e with drawn , or any employment with the Cen tre may be termin ated immediately, without an y oblig ation or liab ility to me other than for p ayment, at
th e remun eration agreed u pon for services actually ren dered , if i have been employed .
Place :
Date :
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Sig nature of the can didate
11. Candidate already in employment should forward the applications through the present employer.
Forwarding note:
Date:
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Sig natu re and Desig nation
W ith seal
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