BIRLA INSTITUTE OF TECHNOLOGY MESRA RANCHI

APPLICATION FORM (FOR FACULTY POSITION)

Post Applied for: Assistant Professor
Department / Extension Center Management/Jaipur
If applied earlier against Advt. No. GO / Rectt / 2013-14/213! "#te"$ %&'e 10! 2013, please mention te follo!ing:
Name of Department and post applied earlier:
D.D.No.:""""""""""""""""""""" Date"""""""""""""" Amount""""""""""""
Name of issuing #an$""""""""""""""""""""" %ran& Name: """""""""""""""
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)e*&t+ Re,-.t/#/ (P0A)
B-/1# I'.t-t&te (2 Tec3'(1(,+ Me./#
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(A)I*+A D+IN,-A
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*ri Jogendra Pratap
/. a. Marital *tatus 0nmarried #. Male / 1emale : 1emale
2. a. Permanent address
34/./, -a5at Pat, Mansarovar
Jaipur6-a5astan7
Pin &ode8 /9.9.9
#. Address for &orresponden&e
34/./, -a5at Pat, Mansarovar
Jaipur6-a5astan7
Pin &ode8 /9.9.9
Pone No.
6!it *:D &ode7
9'2'8.;<3'34 E8mail ID dingra.lavisa=gmail.&om
4. )et#-1. (2 t3e *(.t #**1-e" 2(/:
a7 Post applied for Assistant Professor
#7 Advertisement No. and Date GO/Rectt/2014-15 /2331>.2
t
June .9'2
&7 Department
Management
d7 1ield of spe&ialisation
+uman resour&e
If ?ou !is to appl? for more tan one Department, please send separate appli&ations for ea& Department.
1
Potograp
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&ertifi&ate 7
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(Please attach true copy of certificate in case of SC/S/O!C/P"#
''. )et#-1. (2 e"&c#t-('#1 ?&#1-2-c#t-('.: Please give parti&ulars of all examinations passed and degrees o#tained &ommen&ing !it te +ig *&ool (eaving Examination
6'9
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standard / Matri&ulation7. 1or P.D., please give details, even if it is not &omplete. Please atta& true &opies of &ertifi&ates and mar$ seets dul? attested.
*l.
No.
*&ool / College / Institute Date of
entr?
Date of
leaving
Name of te %oard
/ 0niversit? / Institution
Examination
/ Degree /
Diploma passed
Distin&tio
n
/ Class /
Division
*u#5e&ts 6Please mention
field of spe&ialiAation,
onours, et&, !ere
appli&a#le7
Per&entage
of mar$s or
C.P.I.
Bear of
passing
' Central A&adem?, 0daipur '8928
.99/
./8938
.992
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. -?an International *&ool,
Jaipur
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and te&nolog?
'489;8
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%I:*, -an&i P.D6Persuin
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Management
'.. )et#-1. (2 e8*1(+8e't.: Please give parti&ulars of ?our present and past emplo?ments in &ronologi&al order, starting !it te present one :
*l.
No.
Erganisation / Institute Position eld Nature of duties / !or$
:ea&ing / -esear& / Industr? /An?
oter
Date of
5oining
Date of
leaving
(ast Pa? F *&ale
of pa?
Additional remar$s
a#out experien&e, if
an?.@
' Poornima ,roup of Colleges Assistant
Professor
Developing te &ontent, ta$ing
sessions of engineering and
management students, Erganising
Cultural programs and &oordination in
events
9;8948
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'.8928
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'<999/8 per
mont6'34998/@'997
3
'/. Re.e#/c3 0 )eAe1(*8e't! T/#-'-',! P/(>ect! P&91-c#t-(' etc$:
6a7 Please atta& a list of ?our -esear& F Development / Industrial/:raining experien&e
6#7 Please state te follo!ing in te format #elo!:
No. of P,
pro5e&ts guided
No. of P.D. tesis guided Pro5e&ts involved !it amount
6separate seet ma? #e used7
No. of Patents
Completed En8going *ponsored Consultan&?
6&7 Please state no. of pu#li&ations 6Pu#lised/A&&epted7 in te format #elo!:
In Journals 6refereed7 In Conferen&es
:e&ni&al
-eports
National International
-efereed 0n8refereed
National International National International
6d7 Citation of ?our pu#lised papers:
6e7 Please list most re&ent / important resear& pu#li&ations 6last t!o / tree ?ears7 in te format #elo! :
Name of te 5ournal
Mont F ?ear of
pu#li&ation
:itle of te resear&
paper
*ingle or !it Co8
autor6s7
6f7 %oo$s pu#lised:
6g7 %oo$ &apters !ritten:
6F(/ e#c3 (2 t3e #9(Ae -te8.! *1e#.e ,-Ae 2&11 "et#-1. -' .e*#/#te .3eet.7
/9. (#) Te#c3-', eB*e/-e'ce No. of ?ears: No. of different &ourses taugt:
Please give a list of &ourses taugt on a separate seet !it &ourse titles, level 60,/P,7 and num#er of
times taugt
6#7 Areas of spe&ialiAation
6&7 :itle of ?our P. D. :esis
5
6d7 Name of ?our P.D. *upervisor
6e7 Please des&ri#e ?our P.D. !or$ #riefl? on a separate seet G' page H font siAe '9 61ont: :imes Ne!
-oman7I. Also detail te areas of interest !it !or$ done in ea& &ase 6if an?7. Please attach a$$itional sheets
%here&er necessary
6f7 (a#orator? Experien&e : Please des&ri#e, in #rief on a separate seet, ?our experien&e in 6i7 *etting up
tea&ing and resear& la#oratories 6ii7 Condu&ting la#orator? &ourses F 6iii7 0sing different t?pes of
instruments, s?stems, &omputers et&.
/;.
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6Appli&ants ma? mention ere an?
spe&ial Jualifi&ations or
experien&e, e.g. in organisations
!i& ave not #een in&luded
under te eads given a#ove7
P/(2e..-('#1 "-*1(8# -' AA-#t-(' #'" 3(.*-t#1-t+ M#'#,e8e't
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#c?&#-'te" =-t3 +(&/
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Please request them to
send the reference letters
to the Registrar, BIT
Mesra by email to
[email protected]
and hard copy by post
'.
..
/.
23.
Y(&/ 2&t&/e /e.e#/c3
*1#' #t BIT
I ave alread? enrolled m?self in P.D programme at Jaipur Campus. I !ill
surel? !or$ ard to gain furter $no!ledge and expertise in management
dis&ipline and !ould also pu#lis resear& paper so tat I &an explore ne!
areas.
24. )et#-1. (2 e'c1(.&/e.
.e't =-t3 t3e
#**1-c#t-('
Mar$ seets 6K,KII7, Degree 6,raduation7, Provisional Certifi&ate6Post
,raduation7, 1ee -e&eipt6P.D7, -esume, (ist of *u#5e&ts taugt,
Experien&e Certifi&ate
2;. )et#-1. (2 A**1-c#t-('
Fee (the applicant who have
already sent the fee against
previous Advt. GO / Rectt /
2013-14 /2173, dated. June 10,
2013, need not send the
application fee
D.D.No.:""""""""""""""""""""" Date""""""""""""""
Amount""""""""""""/ Name of issuing
#an$"""""""""""""""""""""""""""""""""""""""""""" %ran& Name:
"""""""""""""""""""""""""""""""""
I ere#? de&lare tat I ave &arefull? read and understood te instru&tions and parti&ulars supplied to me
and tat all te entries in tis form are true to te #est of m? $no!ledge and #elief.
""""""""""""""""""""""""
Date: ................................ S-,'#t&/e (2 t3e C#'"-"#te
(
BIRLA INSTITUTE OF TECHNOLOGY! MESRA! RANCHI
)ATA SHEET FOR THE APPLICANT FOR FACULTY POSITION
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ate$ ................................ 9ignature &/ t,e .andidate
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