Shikshana Prasaraka Mandali’s
SIR PARASHURAMBHAU COLLEGE (AUTONOMOUS), PUNE
Tilak Road, Pune 30.
To,
Photograph
The Principal,
(Passport Size
S.P.College, 35mm x 35mm)
Tilak Road, Pune 30.
Application for the post of Assistant Professor in Senior College on Clock Hour Basis in
Department of --------------------------- .
Sir,
I hereby submit my application for the post mentioned above, with following details:
1.
Name in Full (in Block Letters)
Dr./ Shri / Smt Surname First Name Father’s / Husband’s Name
2. Postal Address in Full (in Block Letters)
Pincode
3. Date of Birth 4. Sex
5. (a)Nationality (b) Mother Tongue
6. Marital Status 7. E-mail
8. Telephone No. Mobile No
9. Category
S.C. S.T. D.T.(A) N.T.(B) N.T.(C) N.T.(D) S.B.C. O.B.C. E.S.B.C. S.B.C.-A OPEN
10. Educational Qualifications
Examination Board/ University Month & Percentage (%) or Subject
Year of Class/ Division/ Offered
Passing Grade Awarded
H.S.C.
Bachelor’s
Degree
Master’s
Degree
M. Phil
Doctorate
Degree
o SET o
NET
Other *
11. Experience:
a) Teaching
Institution Position Held Subject Exp. In Reason for leaving
Years
b) Industry
Institution Position Held Exp. In Years Reason for leaving
12. Any other information
13.* Other Relevant Experience
14.* Research Work Done
15.* No. of Publications (if any)
Published Communicated Under Preparation
Books
Articles
Journals
Reviews
16.* Patents
17. Whether Recognised Teacher of University?
If yes, give details: Approval Recognition Name of University:
18. (A) Present Position: University Ref No.:
(B) Name of the
Institution where employed:
(C) Date of Appointment:
(D) Signature of present employer & seal:
19.* Following Documents are enclosed
i) Attested/ Certified/ True Copies of Degree/ Diploma and other Certificates of Education
ii) Attested/ Certified/ True Copies of HSC or equivalent certificates in support of age
iii) Last Pay Certificate (if any)
iv) Any other (please specify)
* Separate sheet may be attached if required
I hereby declare that all information submitted in this application and in its accompaniments is true,
complete and correct to the best of my knowledge and belief. I accept that in the event of any information
found false, incomplete, or fraudulent or incorrect, it will be my sole responsibility and my candidature/
appointment is liable to be cancelled / terminated.
Place:
Date: Signature of the Applicant
