Apply For Non Teaching Staff

Post Applied for *

Discipline *

1. Applicant Details

Title *

Name in Block letters *

Date of Birth *

Place of Birth

Nationality

Gender *

Blood Group

Identification Marks

PAN No

Driving License No

Passport No

Aadhar Card No

Bank Account No (HDFC Bank Only) *

IFSC Code (HDFC Bank Only) *

2. Present Postal Address ( in block letters)

Country *

State *

District *

City *

Address Line 1 *

Address Line 2

Pincode *

Email Address *

Mobile Number *

Alternate Mobile Number

Is Permanent Address Same As Address For Communication?

YesNo

Permanent Home Address (in block letters)

Country *

State *

District

City *

Address Line 1 *

Address Line 2

Pincode

Email Address *

Mobile Number *

Alternate Mobile Number

3. Other Details

Father's Name *

Mother's Name *

Name of Husband/wife (if married)

Details of Family

4.

5.

Present designation & name of employer (if employed)

Grade and consolidated salary being drawn

6.

Have you ever been prosecuted, kept under detention, fined, convicted by a Court of Law for any offence or debarred/disqualified by any University, Public Service Commission from appearing at its examinations/selection? Is any case pending against you in any Court of law at the time of filling up of this application form? If the answer is ‘Yes’ full particulars of the case, detention, fine conviction, sentence etc. should be given.

7. Educational Qualification:

Matric

Institute Name *

Board / University *

Year of Passing *

% age of Marks *

Class / Division *

Regular/Correspondence/Part time *

12th / Diploma Academic Details

Institute Name *

Board / University *

Year of Passing *

% age of Marks *

Class / Division *

Regular/Correspondence/Part time *

Graduation Details

B.A./B.Sc./ B.Com./B.Tech. (Branch) *

Institute Name *

Board / University *

Year of Passing *

% age of Marks *

Class / Division *

Regular/Correspondence/Part time *

Post Graduation Details

M.A./M.Sc./M.Com/MBA/MCA/M.Tech. (Branch) *

Institute Name *

Board / University *

Year of Passing *

% age of Marks *

Class / Division *

Regular/Correspondence/Part time *

Higher Degree Details

Ph.D.

Institute Name

Board / University

Year of Passing

% age of Marks

Class / Division

Regular/Correspondence/Part time

M.Phil

Institute Name

Board / University

Year of Passing

% age of Marks

Class / Division

Regular/Correspondence/Part time

Any other Exam

Detail of Exam

Institute Name

Board / University

Year of Passing

% age of Marks

Class / Division

Regular/Correspondence/Part time

8.

Topic of M. Tech./ M.Phil Dissertation

9.

Topic of research for Ph.D

Field of specialization

Please upload the copies of certificates duplicate

Recent Passport Size Photograph *

10th Marksheet *

12th/Diploma Marksheet *

Graduation Marksheet *

Post Graduation Marksheet *

Higher Graduation Marksheet *

Upload Your Resume *

10. Experience:

Experience A: Academic

Employers Name & Address

Institute/Industry

Duration

From

Total Period

Nature of Duties

Emoluments & Scale etc.

Reason For Leaving

Total Experience

11.

Any other achievement you would like to mention:

12.

Have you ever been connected with any political party? If so give details

Do you have any contract/ bond with your present employer? If yes, give details

Do you consume liquor?

Are you used to gambling?

Do you have any relative working in PIET or any relation with any member of the Managing Committee (if yes, furnish details)

Please state whether you are pursuing any course of studies at present? If yes, give details

Please note that:

(a) You will not be allowed to undertake any further studies during your employment without prior written permission of the competent authority. You will not undertake any part-time job including coaching/tuition etc.

If selected, when can you join?

Salary Acceptable

Name & Addresses of two references, not relatives:

Name

Address

I declare that the information given above is true and correct to the best of my knowledge and belief & nothing has been concealed therein. I am aware that any false or incorrect information given by me may result in termination of my services ipsofacto.

Place *

Date *

(APPLICANT’S SIGNATURE) *