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Application Performa For Scientific Post

This document is an application form for the post of Scientist B at the Wadia Institute of Himalayan Geology. The form requests information such as personal details of the applicant, educational qualifications, work experience, publications, specializations, salary, and references. It also requires the applicant to declare that the information provided is true and gives consent to terminate employment if any information is found to be false. The form is to be forwarded and recommended by the head of the applicant's current institution or organization.

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MUKUL
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40 views7 pages

Application Performa For Scientific Post

This document is an application form for the post of Scientist B at the Wadia Institute of Himalayan Geology. The form requests information such as personal details of the applicant, educational qualifications, work experience, publications, specializations, salary, and references. It also requires the applicant to declare that the information provided is true and gives consent to terminate employment if any information is found to be false. The form is to be forwarded and recommended by the head of the applicant's current institution or organization.

Uploaded by

MUKUL
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 7

3rd DRAFT

WADIA INSTITUTE OF HIMALAYAN GEOLOGY


(An Autonomous Institution of Deptt. of Science & Technology, Government of India)
33, General Mahadev Singh Road
DEHRA DUN - 248 001

Application form for Scientific Post

1. Advertisement No. : General Recruit./WIHG/2019-20/Estt.,


dated 16.07.2019   Affix recent
passport size
2. Post applied: - colour
photograph duly
singed
(i) Name of Post: SCIENTIST ‘B’

(ii) Against Category: GEN SC ST OBC


(Please tick as per advertisement)

(iii) Against Essential Qualification:


A B
(Please tick in anyone)
(Note:- Please tick only one post in one application, failing which application will not be
considered for the post)

(iv) Details of Fee:-


Name of the BankDemand Draft No. Date Amount

3. Applicant Name (in Block letters) :


____________________________________________________

4. Father's/Husband's
Name:________________________________________________________

5. (a) Address For Correspondence (b) Permanent Address


(give phone/fax number also, if available) (give phone/fax number also, if available)

Telephone No(s) :
Fax No.(s) :
E-mail :

Page 1 of 7
6. Date of birth & Place of birth : ______________-
_______________________________________

Age as on the date of advertisement: …………...….Years………..…..….Months….


………....Days

7. a. Sex : Male / Female : ______________________________________

b. Marital Status : ______________________________________

c. Identification Mark : ______________________________________


______
_
8. Nationality : ______________________________________

9. (a) Do you belong to Scheduled Caste/Scheduled Tribe/OBC ? Yes / No

(b) If yes, please state category :


(Please enclosed attested copies of documentary evidences)

10. Academic Qualifications:


(Commencing with the High School or an equivalent examination).

Examination Subject/ Year Division % University Distinctions/


/ Degree Specialization Marks/ /College/ Scholarships
Grade Board

11. (a) Has there been any break in your academic career ?
(If so, give details thereof with reasons).

(b) Have you been punished during your studies at College/university?


Page 2 of 7
(If so, give details).
     

(a) Have you been punished during your services or convicted by a


court of Law?
(If so give details).

(b) Were you at anytime declared medically unfit or asked to submit


your resignation or
discharged or dismissed? (If yes, give details in a separate sheet).

12. Experience:
Sl. Name of Organization (Give Post held From To Nature of duties
No complete address)

13. Publication:
(Give names of author, title of paper, name of journal, year , volume, pagination
etc.)
(i) Research Papers in Referred Journals:

(ii) Papers in Conference/Symposia:

(iii) Books edited and chapters in books:

(iv) Popular articles:

(v) Others:

14. Number of Theses supervised:


Awarded Submitted In Progress

(i) Ph.D.

Page 3 of 7
(ii) M.Phil

(iii) M.Tech/M.Sc.

15. Sponsored Research/Consultancy Projects:


Completed In
Progress

(i) Number of Sponsored Research Projects:

(ii) Number of Consultancy Projects:

16. Prizes/ Medals / Awards / Honours:-

17. Extra-curricular activities - give details, if any, of proficiency acquired in


games, sports and part taken in other extra-curricular or social
activities such as NCC, public lectures debates and social service etc.

(i) As a Student

(ii) After entering into service.

18. Academic visits abroad:

Country Visited Purpose of Visit Duration

19. Special Training/Assignment/ Any other Relevant Particulars:

Page 4 of 7
20. Specialization :

(a) Research specialization:

21. Present Salary per month:


Scale of Pay Band/Level ` ___________________

Present Basic Pay/Band Pay ` ___________________

Grade Pay ` __________________

Present Dearness Allowance ` ___________________

Other allowances, if any, ` ___________________

Total Salary per month ` ___________________

Next increment due on : _______________

22. (a) Membership/Fellowship of Professional Societies :

(b) Knowledge of foreign language :

(c) Other Activities/Responsibilities:


(Applicant may mention any special qualification/experience which have not been
included under the heads given above).

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(d) Are you willing to accept the initial salary of the post?
(If no, state what is the minimum salary acceptable or expected, with justifications thereof)

(e) If appointed, what notice would you require before joining the post?

(f) Any other relevant information, not given above.

23. Give name, designation with address and Mobile No. of three referees
not related to you.
(Referees should be persons with or under whom you have worked, or who
have intimate knowledge of your work).

i.

ii.

iii.

24. List of enclosures (Education Qualification, Experience Certificates etc):


(failing which application will not be considered for the post)

25. Declaration to be signed by the candidate

I hereby declare that the entries in this form are true to the best of my
knowledge and belief. If at any time I am found to have concealed any material
information or given any false details, my appointment shall be liable to be
summarily terminated without notice or compensation.

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Dated :
Signature of applicant

26. Forwarded with the remarks that the Institute/Organization has no objection to
the candidature of the applicant being considered for the post applied for as
above.

Dated:
Signature
(Head of the Institution/Organization)
Designation
Address: 3rd DRAFT
               Telephone/Fax No.
    (with STD Code)

Page 7 of 7

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