SAI VIDYA VIKASA SHIKSHANA SAMITHI (R)

SAI VIDYA INSTITUTE OF TECHNOLOGY (Affiliated to VTU, Belgaum, Recognized by Government of Karnataka, Approved by AICTE, New Delhi)

Rajanukunte, Bangalore-560064Tel: 080-2846 8196, Fax: 2846 8193 / 98, Web: www.saividya.ac.in

BIODATA

Application for the post of:

Personal Details( fill in Block letters)Title (Mr. / Mrs. / Ms./Dr.)

First name

Last nameFull nameNationality Religion

Caste Reservation Category

D.O.B(dd/mm/yy)/Age as on Date Place of BirthPassport Number Blood Group

PAN Number Driv. License Number

Gender:

Male Female

Marital Status: Married Unmarried

Family DetailsName of Father:Name of Mother:

Spouse Name :

Name of Child 1Name of Child 2Name of Child 3

Contact Details

Permanent Address

Prominent Landmark

Local Residential Address

Prominent LandmarkLand Line with STD codeMobile Number +91-Email AddressEmail Address(Alternate)

1

Exact period of stay (From)(DD/MM/YY)

(To)(DD/MM/YY)

Languages Known( Please tick appropriate box)Language Read Write Speak

1.

2.

3.

4.

5.

6.

Educational Record (Please ensure copy of degree certificate and mark sheet are attached)Qualification

(tick the appropriate qualification)

SSLC / ITI / DIP / PUC

BA / BSc / BCOM / BE / BTech

M.E / M.TECH / MCA/ MBA/ MSc / MCom /

specify, if othersPh.D

Name of the UniversityClass ObtainedYear of PassingReg No/USN

Specialization

Department

Professional Certifications,if any

1.

2.

3.Professional Experience Summary

Teaching(in yrs) Industry(in yrs) R & D(in yrs) Administration(in yrs) Total Years

Details of Research Experience (Use separate sheet, if required)

Name of the University/Institution

Area of ResearchPeriod

From To Total

Details of Number of Research Publications (National & International)

International Journal National International National Conference

2

Conference

Details of Publications (if any, Please attach separate sheet if required)

Title of the Paper National / International

Year and Month of Publication

Conference/Journal

Details of Teaching Experience (Total No. of Years):(Pls. fill in Reverse Chronological Order& attach certificates as annexures)

Name of the Organization

Position Held Period

From To

(DD/MM/YYYY) (DD/MM/YYYY)

Total

Years Month

Industrial Experience (Total No. of Years) Details of Industrial Experience(Pls. fill in Reverse Chronological Order and attach certificates as annexures)

Name of the Organization Position Held

Period

From To Total

(DD/MM/YYYY) (DD/MM/YYYY) Years Month

Employment HistoryDetails of CURRENT /PREVIOUS Employer

3

Organization/Institute Name:

Position Held:

Address (main office and branch where worked): Telephone:

Employment Period: START DATE(DD/MM/YYYY): END DATE(DD/MM/YYYY):Whether employment is of permanent or temporary nature:

Permanent Temporary

Responsibilities:1.

2.

3.

Reason for Leaving:

Reference Details

Reference 1

Name Designation

Phone No. Email ID

Reference 2

Name Designation

Phone No. Email ID

Declaration and Authorization

To whom so ever it may concern

I confirm that the above information is correct to the best of my knowledge and I understand that any misrepresentation of information on this application form may, in the event of my obtaining employment, result in action based on company policy.

Signature:Name in Block Letters:Date:

Note: Send the duly filled application to PRINCIPAL, SVIT through post with copies of all the testimonials OR email to careers@saividya.ac.in.

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