National Innovation Foundation- India Autonomous Body of Department of Science and Technology, Govt. of India Grambharti, Amrapur, Gandhinagar - Mahudi Road, Gandhinagar -382650, INDIA

FORMAT OF APPLICATION

Affix recent colored Passport Size Photograph

1.

Advertisement No.

: .......................................................................

2.

Post for which applied

: ........................................................................

3.

Name in full (in BLOCK LETTERS)

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........................................................................ ........................................................................ ........................................................................

4.

Father’s/Guardian’s/ Husband’s Name

:

........................................................................

5.

Mother’s Maiden Name

:

........................................................................

6.

Date of Birth

:

DATE ………

7.

Nationality

:

........................................................................

8.

Religion

:

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9.

Whether you belong to (please tick : and if yes, attach certificate)

SC !.....!

MONTH …………

ST !.....!

OBC !.....!

YEAR ………

Handicapped !.....!

1

10. Educational Qualifications: (In chronological order from latest. Enclose a separate sheet, duly authenticated by your signature, if the space below is insufficient) Sl. No.

Exams. Passed

University / institution / board

Year of passing

Subject(s) of specialisation

Div. / class & % of marks

11. Employment Record : (Details in chronological order, starting with the latest) (Enclose a separate sheet, duly authenticated by your signature, if the space below is insufficient) Sl. No.

Name & Address of Employer

Designation

Period From

To

Total period in years & months

12.

Total experience in years after Essential Qualification

:

13.

Details of work / experience, if any (Annexure, if any, should not exceed 200 words)

:

14.

Suitability for the post (Enclose a separate sheet, if the space below is insufficient)

Scale of pay

Nature of duties

Reason for leaving

:

2

15.

16.

(i) Address for correspondence (in BLOCK LETTERS)

: ....................................................................... ........................................................................

Pin Code (ii) Contact Number (iii) Email ID

........................................................................... ........................................................................ : ....................................................................... : ...................................................................... : ……………………………………………

(i) Permanent Address (in BLOCK LETTERS) Pin Code (ii) Contact Number (iii) Email ID

: ....................................................................... ........................................................................ ........................................................................ ......................................................................... :........................................................................ : ...................................................................... : ……………………………………………

17. Give below the names of two references (they must not be related to you) who are in a position to testify from their personal knowledge as to your fitness for the proposed appointment. (a) Name with full address (b) Name with full address

18.

: ............................................................ ............................................................. : ............................................................ ..............................................................

Any other information you may wish to add [Like list of publications, Membership of learned societies, awards and recognition, voluntary work in a reputed organizations etc. (in brief)]

: : :

19.

Details of Enclosures

:

20.

DECLARATION:

:

I certify 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 be summarily terminated without notice / compensation. Place: Date:

Signature of the candidate

3

National Innovation Foundation Gujarat Recruitment 2018 ...

Autonomous Body of Department of Science and Technology, Govt. of India. Grambharti .... Any other information you may wish to add : [Like list of ... National Innovation Foundation Gujarat Recruitment 2018 Application [email protected].pdf.

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