Format For Admission Forms

SARVAJANIK EDUCATION SOCIETY
Sarvajanik Centre for Training & Certificate Courses (SCTCC)

SARVAJANIK SCHOOL OF INTERIOR DESIGN (SSID)
c/o, SARVAJANIK COLLEGE OF ENGINEERING & TECHNOLOGY
Dr.R.K Desai Marg, Athwalines,Surat-395001
Website: www.scetarch.ac.in
EMPLOYMENT FORM FOR POST OF

ASSISTANT PROFESSOR
PERSONAL DATA :
(1) FULL NAME : ____________________________________________________
(2) DATE OF BIRTH : _________________ AGE ____________________________
(3) MARITAL STATUS : _________________ NO. OF DEPENDENDANTS____________
(4) BLOOD GROUP : __________ HEIGHT _____________ WEIGHT _____________
(5) NATIONALITY : ______________ RELIGION _______CASTE______________
(6) PERMANENT ADDRESS PRESENT ADDRESS
(7) PHONE NO : ____________________________________________________
(8) EMAIL : ____________________________________________________
(9) NAME, ADDRESS AND PHONE/FAX NO. OF THE NEAREST RELATIVE WHO CAN
BE CONTACTED IN CASE OF EMERGENCY.
ACADEMIC RECORDS :
(Percentage or credit earned upto the first place & Decimal)
Degrees Specialization University Year of Percentage Class

Award Obtained Awarded
Bachelor
Master
Doctorate
Other
PRESENT EMPLOYMENT DETAIL :

Present Position : Employed Since :
Address of the Employer: : Telephone No. :
Present Total Emoluments : Expected Salary :
PROFESSIONAL EXPERIENCE :
(In Chronological Order) start with your present/last employment)
Sr. Name of the Place of Designation Period Total Last salary
No. Employer Employment years/ drawn
months
From To
Total Teaching Experience ( Only Degree Level) : ______________ Years
CO-CURRICULAR ACTIVITY : (Attach copies of certificates)
Briefly describe activities undertaken during studies and prizes / awards won etc. (Attach separate sheet)
PROFESSIONAL TRAINING : (Attach copies of certificates)
Date Organization Type of Training (Give Details)

From To
MEDICAL HISTORY
Have you any Disabilities? Yes / No

If yes, Give Details :
Have you undergone any major surgery or illness in last five years? Yes / No
If yes, describe when and type of surgery / illness:
Are you suffering from any recurrent disease ? Yes / No

Are you on any Medication / Treatment Yes / No

Have you ever been arrested or convicted for any offence or crime ? Yes / No
if yes, Give brief details:
REFERENCES
Reference No. 1 Reference No. 2
Name& : Name & :

Address Address
Phone No. : Phone No. :
E.Mail : E.Mail :
I certify that information provided in this form is true and correct to the best of my knowledge
and belief. I am aware that if any of the above particulars are found to be false, I am liable to
be dismissed and any such actions as the management deem fit.
Date :
______________________________
Place : Signature of Applicant
Note:
(1) Please fill in the details in the attached sheet and for each item, attach the attested copies
of corresponding certificates.
(2) Person already serving in other Educational Institutes should apply through their
respective Institutional heads.
(SUPPLEMENTARY DATA)
(A) EDUCATIONAL EXPERIENCE :
Experience of Teaching/Research in the related College Faculty / Registered Institution of

Graduate Level (OR) Post Graduate Level. (A Lecturer who is recognized by University and
who is in full time service with University Pay Scale, that experience can be considered. The
Part time experience as Lecturer should be shown separately.
UNDER GRADUATE : Year ________ to ___________ Total ___________________ Yr/s

POST GRADUATE : Year ________ to ___________ Total ___________________ yr/s
(B) EXPERIENCE AS A PRINCIPAL OR HEAD OF THE UNIVERSITY DEPARTMENT :
Year ________ to ___________ Total ___________________ Yr/s

(C) EXPERIENCE IN AFFILIATED COLLEGE / RECOGNIZED INSTITUTIONS / UNIVERSITY
DEPARTMENT AS :-
-VICE PRINCIPAL : Year ________ to ___________ Total ___________________ Yr/s
-CHAIRMAN OF STUDENTS : Year ________ to ___________ Total ___________________ Yr/s

COUNCIL
-CHAIRMAN OF TIME-TABLE: Year ________ to ___________ Total ___________________ Yr/s
- CHAIRMAN OF INTERNAL : Year ________ to ___________ Total ___________________ Yr/s

EVALUATION COMMITTEE
- MEMBERSHIP ACQUIRED : Year ________ to ___________ Total ___________________ Yr/s
IN STATUTORY OF UNI.
TERM/PART:
- P.G. INCHARGE : Year ________ to ___________ Total ___________________ Yr/s
(D) FOR RESEARCH WORK :-
- The articles published in the category of National OR International Journal of the relevant
subject :
(a) Total Articles published in own Name : _______
(b) Total Articles published jointly with other Researchers :________
- Total no. of students who have acquired Ph.D Degree and Masters thesis : _______
Completed under your guidance for Ph.D / Master Degree.
- Total no. of students who have acquired M.Phil Degree and who have :_______
completed dissertation under your guidance.
I hereby declare that all statements made in this application are true and correct to the best of
my knowledge and belief.
PLACE :
_____________________________
DATE : SIGNATURE OF THE CANDIDATE

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SARVAJANIK EDUCATION SOCIETY

Sarvajanik Centre for Training & Certificate Courses (SCTCC)

EMPLOYMENT FORM FOR POST OF

(1) FULL NAME : ____________________________________________________

(2) DATE OF BIRTH : _________________ AGE ____________________________

(3) MARITAL STATUS : _________________ NO. OF DEPENDENDANTS____________

(4) BLOOD GROUP : __________ HEIGHT _____________ WEIGHT _____________

(5) NATIONALITY : ______________ RELIGION _______CASTE______________

(6) PERMANENT ADDRESS PRESENT ADDRESS

(7) PHONE NO : ____________________________________________________

(8) EMAIL : ____________________________________________________

Degrees Specialization University Year of Percentage Class

PRESENT EMPLOYMENT DETAIL :

Address of the Employer: : Telephone No. :

Present Total Emoluments : Expected Salary :

Total Teaching Experience ( Only Degree Level) : ______________ Years

CO-CURRICULAR ACTIVITY : (Attach copies of certificates)

PROFESSIONAL TRAINING : (Attach copies of certificates)

Date Organization Type of Training (Give Details)

Have you any Disabilities? Yes / No

Are you suffering from any recurrent disease ? Yes / No

Are you on any Medication / Treatment Yes / No

Name& : Name & :

Phone No. : Phone No. :

Experience of Teaching/Research in the related College Faculty / Registered Institution of

UNDER GRADUATE : Year ________ to ___________ Total ___________________ Yr/s

Year ________ to ___________ Total ___________________ Yr/s

-VICE PRINCIPAL : Year ________ to ___________ Total ___________________ Yr/s

-CHAIRMAN OF STUDENTS : Year ________ to ___________ Total ___________________ Yr/s

- CHAIRMAN OF INTERNAL : Year ________ to ___________ Total ___________________ Yr/s

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(2) DATE OF BIRTH : _ AGE ____________

(3) MARITAL STATUS : _____ NO. OF DEPENDENDANTS

(4) BLOOD GROUP : ____ HEIGHT _ WEIGHT _______

(5) NATIONALITY : __________ RELIGION _CASTE____________

UNDER GRADUATE : Year __ to _ Total _______________ Yr/s

Year __ to _ Total _______________ Yr/s

-VICE PRINCIPAL : Year __ to _ Total _______________ Yr/s

-CHAIRMAN OF STUDENTS : Year __ to _ Total _______________ Yr/s

- CHAIRMAN OF INTERNAL : Year __ to _ Total _______________ Yr/s