Dr.
Jivraj Mehta Institute of Technology
(An Institute approved by AICTE, New Delhi & Affiliated to
Gujarat Technological University, Ahmedabad)
Managed by: Charuttar Education & Navrachana Trust
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APPLICATION FORM (Teaching Post)
Please affix
recent Passport
Post applied for :________________________________ size
Photograph
Specialization in : ________________________________
Advertisment reference : ________________________________
1. Full Name (in block letters) : __________________________________________________________
2. Date of Birth : __________________________ Age (as on date): _______________
3. Nationality : __________________________
4. Sex : _____________________ Marital Status : _____________________
5. Mobile No : ____________________________ (2) : _________________________
6. Phone No. : ___________________E-Mail: ________________________________
7. Present Address : __________________________________________________________
___________________________________________________________
8. Permanent Address : ___________________________________________________________
___________________________________________________________
9. Academic Qualification (Begin with the recent) :
Sr. Examination / Board / Year of % Class/ Main Subject
No. Degree University Passing /(CPI)/CGPA Devision
10. Experience : (Years & Months)
Academics Research Industry Others Total
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DJMIT College Campus, NH-8, Village : Mogar, Dist : Anand,Gujarat-388 340.●Tel.:02692 221000
● Email: [email protected]/[email protected] ●Website: www.djmit.ac.in/www.centanand.org
Dr. Jivraj Mehta Institute of Technology
(An Institute approved by AICTE, New Delhi & Affiliated to
Gujarat Technological University, Ahmedabad)
Managed by: Charuttar Education & Navrachana Trust
=========================================================================
11. Details of Experience : (Begin with the recent)
Sr. Organization Period (From-To) Designation Salary Reason For
No. (DD-MM-YY) (Gross) Leaving
12. Numbers of paper published in journal:
National (SCI) International (SCI) National (Non-SCI) International (Non-SCI)
13. Numbers of paper presented in conference:
National (SCI) International National (Non- International
(SCI) SCI) (Non-SCI)
14. Details of Books/Book Chapters Published:
Title of the Name of Author(s) Name of the ISBN No. Year of Reprint
Book Publisher Publication No./
Edition No.
15. Details of Patent:
Name of Patent Awarding Organization Registration No. Date & Year Submitted if
of Award any
16. Seminar/STTP/Workshop/Conference attended: (Begin with the recent)
Sr. Title Held at : (Name of the Month & year Remarks
No. Institute)
17. Subjects Taught: (Begin with the recent)
Sr. Subject Discipline Semester/Year
No.
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DJMIT College Campus, NH-8, Village : Mogar, Dist : Anand,Gujarat-388 340.●Tel.:02692 221000
● Email: [email protected]/[email protected] ●Website: www.djmit.ac.in/www.centanand.org
Dr. Jivraj Mehta Institute of Technology
(An Institute approved by AICTE, New Delhi & Affiliated to
Gujarat Technological University, Ahmedabad)
Managed by: Charuttar Education & Navrachana Trust
=========================================================================
18. No. of Research & consultancy Project (If any) :
19. No. of Collaborative / Sponsored Research Projects (If any) :
20. Academic Administrative Experience and your Contributions (If any) :
21. Professional Membership (If any) :
22. Other Achievements (If any) :
23. Extra/Co-Curricular Activities (ECE/CCA) (If any) :
24. Present Employment Details :
Post Held : _______________________________
Name & Address : ___________________________________________________
____________________________________________________
25. Present Salary (per month) : __________________ Expected Salary : __________________
26. References:
Name:____________________________ Name:____________________________
Designation:_______________________ Designation:_______________________
Organization:_______________________ Organization:_______________________
Contact. No.:_______________________ Contact. No.:_______________________
Email : ____________________________ Email : ____________________________
DECLARATION
I hereby, solemnly declare that the information furnished in this application are true and correct to the best
of my knowledge and belief. If at any time I am found to have concealed/ suppressed any material/
information or given any false details, my appointment shall be liable to be summarily terminated without
notice of compensation.
Place : ____________________
Date : (Signature of Applicant)
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DJMIT College Campus, NH-8, Village : Mogar, Dist : Anand,Gujarat-388 340.●Tel.:02692 221000
● Email: [email protected]/[email protected] ●Website: www.djmit.ac.in/www.centanand.org
Dr. Jivraj Mehta Institute of Technology
(An Institute approved by AICTE, New Delhi & Affiliated to
Gujarat Technological University, Ahmedabad)
Managed by: Charuttar Education & Navrachana Trust
=========================================================================
INSTRUCTIONS TO THE CANDIDATES
1. Separate application should be submitted for each post.
2. Copies of certificates, mark sheets, photograph, testi monials etc. should be attached with
the application (attested by the applicant himself) and the originals must be produced at the
time of interview and at the time of joining, if selected.
3. Documents to be enclosed with the application form may securely be tagged to avoid loss in
handling, photographs may be properly attached.
4. Applying for the post does not entitle that the candidates should be called for an interview.
5. Wrong information and Misleading information may lead to summarily rejection of application /
appointment, if found subsequently.
6. The Institute reserves the right to fill up or not to fill up any of the post(s) advertised.
7. Applications not as per the prescribed format or received after the last date or without
complete information will not be considered.
8. No TA DA will be paid for the journeys made for the interview / screening test etc.
9. Fresher Staff may be appointed on Ad hoc basis and fixed salary.
10. Experienced staff will be appointed at appropriate grade or higher grade depending on
their credentials. Pay scale and other benefits will be same as per AICTE /GTU norms.
11. For points 14 through 25 as "Attach separate sheet, if required"
Note-Following documents (only as applicable) should be a tt ac h d by t h e candidae to th e online
application
1. HSC School Leaving Certificate
2. For identity–
PAN Cardcopy / License / AadharCard / Passport (any One Photo id Compulsory).
3. Photo of applicant shall be scanned and attached with application in JPG format not more than
50kb size.
4. Degree Certificate(s).
5. Last Two semester’s marksheet.
6. All experience letters (ifapplicable).
7. Last pay certificate or letter from concerned institute where candidate is working or has worked at last
before date of application.
8. Govt. Gazette Copy/ Marriage Certificate for confirmation of candidate name. (if applicable).
9. Other University Endorsement Letter (if applicable).
10. UGC approval letter for the degree awarding universities out
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DJMIT College Campus, NH-8, Village : Mogar, Dist : Anand,Gujarat-388 340.●Tel.:02692 221000
● Email: [email protected]/[email protected] ●Website: www.djmit.ac.in/www.centanand.org
