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CHAITANYA BHARATHI INSTITUTE OF TECHNOLOGYChaitanyaBharathi P.o., Gandipet, Hyderabad-75(AffiliatedtoOsmaniaUniversity)

APPLICATION FOR RECRUITMENTTO THE POST:

Affix your latestpassport sizephotograph & get itattested by aGazetted Officerwith seal.Department:Note: Please see annexure before filling up this form.1. Name in full with surname

(BLOCK LETTERS)2.3.

Father's Name

4.Date of Birth (in Christian era) .Place of Birth

5. Postal address to which communicationsshould be sent with Telephone No.

6.7.

State whether you belong to SC/STIBCGive particulars of all examinations passed Degree/Diploma obtained (commencing with -the matriculation or equivalent examination). Where a Degree/Diploma has been obtainedby private appearances this should be specifically mentioned in brackets in column (2) ofthe table.

Contd.2..

Examination or Name of the College and Year of Class / Subjects takenDegree University passmg Grade for specialization1 2 3 4 5

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8.

9.

:: 2::Have you published any papers if so, give particulars (if space here is insufficient for thispurpose, please give full particulars on a sheet of paper and attach it to the applicationinserting here a reference to the sheet) (attached). (To be filled in for teaching posts only).

Give in chronological order details of your employment:

10. Give below details of the experience gained during your employment:a) Teaching:

i) in CollegelUniversityii) to Post-graduate classesiii) Guiding Research

b) Industrial Experience11. If selected and appointed please specify the time you require for joining duty:

12. Additional remarks if any (Applicant may mention here any special qualification orexperience not covered above) (Separate sheet to be enclosed if necessary).

Contd..3..

Name & BasiC.Address of Designation Scale of Pay last Reasons forInstitution/Firm Pay From To Drawn/ leaving theor Office. Consolidated postSalarv

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:: 3::13. Details of enclosures:

1)(2)

. 3)4)5)6)

14. Names of two persons with their address/designationto whom reference can be made about the candidate

Place:Date: Signature of Candidate

DECLARATION TO BE SIGNED BY THE CANDIDATEI hereby declare that the particulars furnished in this application are true to the best of myknowledge.

Date: Signature of the applicantONLY FOR CANDIDATES ALREADY WORKING IN ORGANISATION/INSTITUTION

Endt. No. Date:1) Forwarded to the Principal, Chaitanya Bharathi Institute of Technology, Gandipet, Hyderabad.2) The applicant is a permanent / temporary employee and his / her conduct and character are

3) Certified that the above particulars are correct as per our records.4) The Organization/Institution has no objection to relieve him/her, if he/she is selected for thepost.

FULL SIGNATURE

DESIGNATION