Post Applied for GUEST FACULTY Category (please ) GEN / OBC / SC / ST/EWS
Branch/Discipline …………………………………………………………………
1. Name (in Block letters)
2. Date of Birth (DD/MM/YY)
3. Father's /Husband’s Name
4. Address for correspondence Pincode
5. Nationality 6. Married/Unmarried
7. Whether belong to SC/ST or OBC Category of U.P., attach latest certificate on proforma prescribed by U.P. Govt
8. Permanent address Pincode
9. Phone Nos./Mobile No
10. E-mail address (essentially required)
11. Educational Qualifications: (High School or equivalent onwards. Attested copies of certificates, degrees and marks-sheets must be attached)
S.No. Examinations School/ College/ University Year of Passing Subject(s) Division And Marks (%) Distinction/ Gold Medal/ Rank, if any Upload Attachment
1 High School
2 Intermediate
3 B.A./B.Sc./B.Tech.
/B.E. B.Com.
4 M.A./M.Sc./M.Com./
5 Ph.D.
6 Others (M–Phil/NET etc.)
Sr. No Name of Post Date of joining Date of leaving Pay Scale Basic pay Name of Employer Experience(Yr)
13. Publications: Give the number of technical publications of which you are an author in each of the following categories:
I. Papers A
In Press
International Journal
14. Details of any past, current involvement in any Cognizable/Criminal Offence and nature of punishment
15. List of enclosures:
1 2
3 4
5 6
I here by declare that the entries made in the form are true to the best of my knowledge and belief and, if found incorrect/wrong later, I shall be liable to loose the employment at whatever stage it is noticed. I also under take to abide by the terms and conditions as prescribed in advertisement for the applied post and as enforced by Institute from time to time.