[PDF] Employment Application Form (For Non Teaching Staff)





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Annexure 1 APPLICATION FORM Personal Details [IN CAPITAL

APPLICATION FORM. Advertisement No. Please affix. Recent Passport size photo. Name of the Department / Speciality. Applied for. Name of the Post.

BITS, PILANI - K.K. BIRLA GOA CAMPUS

Application Form (For Non-teaching Staff)

To,

The Director

BITS, Pilani K.K. Birla Goa Campus

Zuarinagar-403726

Goa. Advertisement Date: __________________________________

A: POST APPLIED FOR:

What is your expected salary per month?

* Rs.

What is your current salary per month?

* Rs.

B: PERSONAL PARTICULARS

Full Name (Prefix Dr. / Mr. / Mrs. / Ms.) Surname Middle Name First Name

Maiden Name (if applicable)

Date of Birth (dd / mm / yyyy)

Marital Status

Married / Unmarried

Contact Address

City State

Pin Code

Primary Contact No.

Alternate Contact No.

E-mail

C: LANGUAGE SKILLS (Tick as appropriate)

Name of the Language

English

Hindi

Konkani

Marathi

Any other

Speaking

Writing

Reading

D: CO-CURRICULAR

ACTIVITIES

Paste your

photograph here E: EDUCATIONAL QUALIFICATIONS (in chronological order) (Please attach photocopies of certificates) Sr. No.

Qualification*

Year of

Passing*

University / Institute

/ Board * % of Marks* * Indicates mandatory field

F: TECHNICAL / PROFESSIONAL QUALIFICATIONS

(Please provide details starting with the highest qualification. Attach photocopies of certificates) Sr. No.

Qualification*

Year of

Passing*

University / Institute

/ Board * % of Marks* * Indicates mandatory field

G: COMPUTER SKILLS

Applications known

Programming languages

known

Computer Courses

Completed

Course

University / Institute

Year H: PROFESSIONAL EXPERIENCE (in chronological order) Sr. No. From (mm / yyyy) To (mm / yyyy)

Organization,

Location

Designation

held

Brief description of duties (in not more

than 3-4 lines) *

Reasons for

leaving the job * Additional sheets may be attached only for brief description of duties I: NOTICE PERIOD REQUIRED FOR JOINING, IF SELECTED: _____________________________

J: PROFESSIONAL REFEREES

(Referees must not be related to you by blood or marriage. Referees should be contacts out of your professional experience with them )

Name of 1st Referee

No. of years known & how

Occupation

Address

Contact no. with STD code

E-mail

Name of 1st Referee

No. of years known & how

Occupation

Address

Contact no. with STD code

E-mail

H: DECLARATION

I hereby declare that the information furnished by me is correct and complete. I hereby agree that any false

statement I make in this application shall result in cancellation of my candidature. I have attached Xerox copies

of certificates as proof of my qualification and work experience.

Place: _____________________ Signature: ______________________

Date: _____________________ Name: _________________________

(Please forward e-copy of the application to hroffice@goa.bits-pilani.ac.in. Application in any format

other than the above will not be accepted)quotesdbs_dbs19.pdfusesText_25
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