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    Application Form: Subject: - Post Applied: - SR - No. - Advt. No.

    Uploaded by

    Saurabh Singh
    The document is an application form for the Society for Applied Microwave Electronics Engineering & Research. It requests information such as the applicant's name, date of birth, nationality, contact details, education history, employment history, and whether the applicant has passed certain exams. The applicant is asked to declare that the information provided is true and provide a signature.

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    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Application Form: Subject: - Post Applied: - SR - No. - Advt. No.

    Uploaded by

    Saurabh Singh
    30 views4 pages
    The document is an application form for the Society for Applied Microwave Electronics Engineering & Research. It requests information such as the applicant's name, date of birth, nationality, contact details, education history, employment history, and whether the applicant has passed certain exams. The applicant is asked to declare that the information provided is true and provide a signature.

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    Appln-rev

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    The document is an application form for the Society for Applied Microwave Electronics Engineering & Research. It requests information such as the applicant's name, date of birth, nationality, contact details, education history, employment history, and whether the applicant has passed certain exams. The applicant is asked to declare that the information provided is true and provide a signature.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    30 views4 pages

    Application Form: Subject: - Post Applied: - SR - No. - Advt. No.

    Uploaded by

    Saurabh Singh
    The document is an application form for the Society for Applied Microwave Electronics Engineering & Research. It requests information such as the applicant's name, date of birth, nationality, contact details, education history, employment history, and whether the applicant has passed certain exams. The applicant is asked to declare that the information provided is true and provide a signature.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
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    You are on page 1of 4

    Society for Applied Microwave

    Electronics Engineering & Research

    APPLICATION FORM
    (TO BE FILLED IN BLOCK LETTERS ONLY)

    Affix Recent
    Subject : ________ Post Applied :__________________ Sr.No.______ Passport
    Advt. No.:______ Size Photograph

    1. Name in full(Shri/Smt/Km) :_________________________________________________

    ------------------------------------------------------------------------------------------------------------------------

    2. a) Father’s name: __________________________ b) Mother’s name: _________________________________

    3. a) Date of Birth: ___________________19 _______


    (in Christian era in figures) Date Month Year

    b) Age as on closing date mentioned in Advt.: _________Years _________Months _________ Days

    4. a) Sex (Male/Female) : _________________ b) Marital Status : ________________________________

    5. Nationality: _____________________________

    6. Reservation Category (SC/ ST): _____________________6 (a) Religion :_______________________________


    (attach certificates if applicable)

    7. Type of Present Employment, if employed (Central / State Govt / PSU’s/Others): _________________________

    8. Address for correspondence(with Pin Code) _____________________________________________________

    (Tele No., Mob. No., Fax & e-mail, if any) _____________________________________________________

    9.Permanent Address (with Pin Code) _____________________________________________________

    (Tele No., Mob. No., Fax & e-mail, if any) _____________________________________________________

    10.Nearest Railway Station _____________________________________________________

    11.Educational Qualifications #:
    -----------------------------------------------------------------------------------------------------------------------------------------------------------
    *Exam University/ Date of Date of Subject Specialisation **Percentage Division Rank/Position
    passed Institution/ Joining Passing in which as reqd. in of Marks in the Univ.
    Board degree is advt. (if any)
    awarded
    -----------------------------------------------------------------------------------------------------------------------------------------------------------

    -----------------------------------------------------------------------------------------------------------------------------------------------------------
    * In chronological order from X Standard (SSLC/HS/HSC) onwards, ** In case of CGPA/CPI, please give marks in
    percentage also along with the conversion formula, # Specify the gap with reasons in Education career, if any.
    12. Whether receiving Scholarship / Fellowship from any agency? If yes, indicate:-
    i) Name of Agency, ii) Amount of Fellowship/ Scholarship, iii) Duration (since when)

    13. Have you qualified GATE/NET(JRF)/NET : Yes / No/N.A


    (a) If yes, give name of Test & year (with percentile for GATE):
    (b) If registered for a higher degree, please indicate Title of Degree, University, date of registration and likely date
    of completion

    14. Professional Training:


    ---------------------------------------------------------------------------------------------------------------------------------------------------------
    Period
    Organisation From To Details of Training
    ---------------------------------------------------------------------------------------------------------------------------------------------------------

    ---------------------------------------------------------------------------------------------------------------------------------------------------------

    15.(a) Title of Project / Desertation / Thesis,(b) No.of Papers Published(Separate sheet may be used)

    16. Areas of Specialisation/ Research :

    17. Employment Record* (Attach separate sheet in following format, if necessary):-


    ---------------------------------------------------------------------------------------------------------------------------------------------------------
    Name & Period of Designation Scale of Detailed Reason for leaving
    address of service of the post pay of description
    employer/ From To held each post of work
    Orgn/Institution
    --------------------------------------------------------------------------------------------------------------------------------------------------------

    --------------------------------------------------------------------------------------------------------------------------------------------------------
    * Specify the gap, if any

    18. Present Basic pay: Total Emoluments :

    19. Are you under any contractual obligations to serve Central/State Govt/Any other Public Sector Undertaking
    or Autonomous body and if so, give details :
    (attach NOC if applicable)
    20. Have you been interviewed for any recruitment/selection by SAMEER during the past one year?
    If yes, give particulars:
    -------------------------------------------------------------------------------------------------------------------------------------------------------
    Sr Particulars Name of Posts & Date of Result
    No. (eg. Date of Advt, Advt. No.) Discipline Interview
    -------------------------------------------------------------------------------------------------------------------------------------------------------

    -------------------------------------------------------------------------------------------------------------------------------------------------------
    21. Details of relatives already employed in SAMEER:
    -------------------------------------------------------------------------------------------------------------------------------------------------------
    Name of the Relative Relationship Lab/Estt in which employed Post Held
    -------------------------------------------------------------------------------------------------------------------------------------------------------

    -------------------------------------------------------------------------------------------------------------------------------------------------------

    22. Give two referees name & address and attach certificate from them: ________________________________
    (Not related to the candidates) (Gazetted Officers/Professors of
    reputed academic Institutions/Public Sector Executives etc) ________________________________

    ________________________________

    ________________________________

    ________________________________

    23. Any other information you may wish to add, including extra curricular activities (use separate sheet if necessary).

    24. Declaration

    I declare 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 summary termination without notice. If offered appointment, I will join
    on specified date and subsequently, take up duty in the discharge of SAMEER assignments anywhere in India as
    and when required.

    Place: --------------------------------
    Date:
    Signature of Candidate
    (important : use only a4 size paper for application and other testimonials)
    SUMMARY
    (Use Separate Sheet)

    Advt. No. : Subject: Post :

    Sr. No.

    Name : DOB: Nationality:

    Month Year
    Category: SC
    Gen ST Age as on Closing Date:

    Central/State Govt./Armed Forces/ PSU’s/Others:

    Exam University Subject Month Year %age Div/Gde University Rank


    Essential Qualification (EQ)

    Highest Qualification (HQ)

    Qualified : GATE NET(JRF) NET Year: Score:

    Postal Address:

    City: PIN:

    Tele. No. Mobile: FAX:


    (with STD code)

    E.Mail :

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