Performa for Faculty Recruitment in Cbpacs 2017

PERFORMA FOR FACULTY RECRUITMENT IN CBPACS 2017

CH. BRAHMPRAKASH AYURVED CHARAK SANSTHAN

Khera Dabar, Najafgarh, New Delhi -110073

Website:

Proforma for Direct Recruitment of Faculty CBPACS-2017

ADVT.NO.01/2017 POST APPLIED FOR ______

DEPARTMENT ______

GENERALINFORMATIONANDACADEMICBACKGROUND

1. Name(inBlockLetters):

2. Date ofBirth: Recent Passport Size

Attested photograph 3. Sex: to be affixed

4. Father’s Name:

5. Mother’s Name:

6. Marital Status:

7. Nationality:

8. Are you present Contractual Employee of CBPACS.:

9. Current Designation:

10. Date of Joining in CBPACS

11. Thecategory for which youbelongs to:SC/ST/OBC/Gen

12. The Post for which you applied for Comes Under:SC/ST/OBC/Gen

13. FEEDETAILS: AMOUNT (RS) …………..DRAFTNO …………..

DATE ………………. BANKNAME ………………………….

14. Addressfor Correspondence (withPIN Code):

MobileNo.: E-mail ID:

15.PermanentAddress(withPIN Code): …………………………………………………………… ………………………………………………………………

MobileNo.: E-mail

16. Academic Qualifications

Examination / Name of the Board/ University / Year of
passing / Percentage
Of Marks
obtained / Div./
Grade
High School/Metric
Intermediate/+2
B.A.M.S.
Post Graduation
Ph.D.
Other examinations/ Super Specialization, if any

17. Experience Details

Serial No. / Name of Employees / Duration
From To / Total Experience
Y/M/D / Designation
Total Experience Y/M/D

18.OTHER RELEVANTINFORMATION

Pleasegivedetailsof anyother credential, significantcontributions, and awardsreceivedetc.notmentioned earlier.

S.No / Details

(AttachdocumentaryproofinsupportoftheinformationprovidedbyyouinthisProforma)

List of Enclosures :( Please attach self-attested copies of certificates, papers etc. wherever necessary)

1Certificatefrompresentemployer

2. Self Attested copy of Secondary certificate/mark sheet

3. Self Attested copy of Higher Secondary certificate/mark sheet

4. Self Attested copies of B.A.M.S. Mark sheets (Should be enclosed as 4 A, B, C,etc.)

5. Self Attested Copy of B.A.M.S. Degree

6. Self Attested Copy of M.D./M.S. Degree

7. Self Attested Copy of Degree of Ph.D. if available

7. Self Attested copies of Experience Certificates (Should be enclosed as 7 A,B,C,etc.)

8. Self Attested Copy of Registration Certificate by State board.

9. Self Attested Copies of Published Articles if Any (Should be enclosed as 9 A,B,C,etc.)

10. Self Attested Copies of Cover pages of Published Books if Any (Should be enclosed as 10 A,B,C,etc.)

11. Self Attested copy of Administrative Experience Certificate if Any

12. Self Attested copy of certificate if claiming any kind of reservation.

13. Any other document…………….

I certify that the informationprovided by me is correct to the best of my knowledge. If found false at any stage, my candidature shall be stand cancelled. I also certify that no disciplinary action is going on against me and is not involved in any criminal activity. I also certify that I am fulfilling all the qualificationandexperiencesasper the advertisement.

Date:

Place:SignatureoftheApplicant

Certificate from present employer

Certified that ……………………………………………..has been working as …………………………………………………………in the Department of ………………………………since………………………………………………..The particulars given in this application have been checked and verified from office records.

Headof the institution