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Appa Officers

This document contains an application form for the position of Group 'A' Officers at the Indian Institute of Technology, Bombay. The application requests information such as the applicant's name, address, date of birth, nationality, age, present and past employment details, academic qualifications, professional training received, membership of professional bodies, conferences attended, references, and a statement of objectives. The applicant is asked to declare that all information provided is true to the best of their knowledge.

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Tilak Kalbande
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20 views3 pages

Appa Officers

This document contains an application form for the position of Group 'A' Officers at the Indian Institute of Technology, Bombay. The application requests information such as the applicant's name, address, date of birth, nationality, age, present and past employment details, academic qualifications, professional training received, membership of professional bodies, conferences attended, references, and a statement of objectives. The applicant is asked to declare that all information provided is true to the best of their knowledge.

Uploaded by

Tilak Kalbande
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
Download as pdf or txt
Download as pdf or txt
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INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY POWAI MUMBAI 400076

Application for Appointment of : Group 'A' Officers


(Please type or write using BLOCK LETTERS) Advertisement No. Post applied for Amount of Bank Draft enclosed Name of Issuing Bank Bank Draft Number Bank Draft Date

1. Name in full (pl.underline Surname) Married 2. Address: Present Single Male Female [Please () tick]

Permanent

Fax Email Telephone Off: Res: 3. Date of Birth: Day Month Year

x x 4. Nationality:

x x

Age in completed years : _________Yrs. 5. Present employment: Designation Organization Date of Joining Scale of pay Rs. Pay Rs. Total Emoluments (per month) Rs. 6. Basic Pay expected at IIT-Bombay as per advertisement Rs.

7. (a) () Tick the appropriate box if you belong to reserved category (b) Attested copy of certificate enclosed : YES

: SC NO ST OBC

8.

Academic record starting with graduation: (Please attach photocopies of degree certificates) Degree College/University/Institute Year of Year of Percentage joining leaving

9 Employment (Particulars of your past position(s)) . Employer Designation

(Please attach photocopies of experience certificates) Total From To Years Months

Scale/PB/ Consolidated Salary

10. Professional Training Received Year Nature of Training

Duration

11. Membership of Professional Bodies Name of the Body

Status of Membership: Life/Annual

12. Important Conferences/Seminars attended Year Conferences/Seminars attended

Title of paper read (if any)

13. Names and addresses of three Referees (at least one of them should be familiar with your recent work) Name Occupation or Position Address

Telephone e_mail ID Fax 14. Statement of Objectives a. Please indicate as to why you wish to join IIT Bombay ? b. How in your opinion do you meet the job requirements as advertised?

(Use a separate sheet if necessary) 15. I hereby declare that I have carefully read and understood the Instructions and particularly supplied to me, and that all entries in this form as well as the attached sheets are true to the best of my knowledge and belief. There are attached sheets along with form

Date Place

: :

................................................................ (Signature of Applicant)

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