Prof. Ram Meghe Institute of Technology & Research, Badnera-AmravatiApplication Form for Recruitment 2013

(Filling Instructions: Delete Blank or Unwanted Data)

To,The Principal, PRMIT&R, Badnera

Photograph image format JPEG & size

less than 51 KB(Optional)

Application for the Post of Professor / Associate Professor / Assistant Professor

Name of the Department

1. Name in Full(First, Middle & Last Name )

2. Complete Postal Address

City Pin Code No.3. Mob. Email4. Male/Female Married/Unmarried Yes / No5. Age (yr) Birth Date (mm/dd/yyyy)

6. Category belong to SC/ST/SBC/General (State specific caste in accordance with authentic certificate)

7.Educational Qualification

Name of Examination University Year of award Subjectmarks obtained

( % )Class Division

awarded

U.G. Degree

P.G. Degree

Ph.D.

Other Degrees

Research Work

8. Experience in Chronological Order

Name of Institution / Company Designation Subject No. of Years

Total Teaching Experience Yrs Total Industrial Exp. Yrs

9. Other Proficiencies / Achievements

Sr. No. Details Year

I hereby declare that all the statements made in this application are true and correct to the best of my knowledge and belief.

Sent from (email id) Signature of Candidate image

format JPEG & size less than 51 KB

(Optional)

Date (DD/MM/YYYY)

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