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The document is an application form for a teaching position at the Sardar Vallabhbhai Patel Institute of Nursing, requiring personal details, educational qualifications, work experience, and research publications. It includes sections for the applicant's salary expectations, references, and additional relevant information. Applicants must submit supporting documents and a declaration of the accuracy of their information.

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5 views

svpnursing apply

The document is an application form for a teaching position at the Sardar Vallabhbhai Patel Institute of Nursing, requiring personal details, educational qualifications, work experience, and research publications. It includes sections for the applicant's salary expectations, references, and additional relevant information. Applicants must submit supporting documents and a declaration of the accuracy of their information.

Uploaded by

allinone3855
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Sardar Vallabhbhai Patel Institute of Nursing – Vasad

SUMMARY SHEET (To be written legibly or typed)

Name : Date of Birth:


Category:
Post applied for: Department:
Qualifications: Degree Class/Grade Year University

UG
PG
PhD
Others
Total Experience: Years Post Ph.D. Experience: Years

Teaching:
Position Basic Pay AGP From To
Professor
Associate Professor
Assistant Professor
Tutor
Industry: Years
Research: Years
Present Employer (if applicable) and monthly emoluments:
No. of Publications National International
Journal Papers
Papers in Conference Proceedings
Books
Chapters in Books
Patents
M.E. thesis Guided
Ph.D. thesis Guided
Total value (Rs. in Lakhs)
Projects
 2 Lakhs 2 to 5 Lakhs 5 to 30 Lakhs > 30 Lakhs
Research
Consultancy
Awards / Distinctions, if any:

Place :

Date: Signature of the Applicant


Sardar Vallabhbhai Patel Institute of Nursing – Vasad
B/h. S.T. Bus Depo, Vasad – 388 306, Dist: Anand
Phone No: 9510782981, 82,83 & 84
Mail: [email protected]
Recent passport size
color photograph to
be affixed

APPLICATION FOR THE POST OF _______________________ in ________________


(Department)
SPECIALIZATION _________________________________________________________
1 Name in Full: Gender:
2 Nationality: Place of Birth:
Date of Birth: Age:
3 Category: Marital Status:
4 Particulars of Educational Qualifications:
Sr. Degree Obtained & Name of the Year of % of Class/
No. Branch / Specialization University/Institute Passing Marks/ Division
(specify) CGPA
1 Bachelor’s Degree
2 Master’s Degree
3 Ph.D. Degree
4 Others (if any)

5 Title of PG/Ph.D. Thesis with name of Ph.D. Guide.


Degree Title of Thesis Guide University
i) P.G.

ii) Ph.D.

6 Details of Experience:
i) Teaching Experience : years Post Ph.D. Experience years

Sr. Name of the organization Designation Date of Date of Last Pay Band and
No. where employed Joining leaving Grade Pay*
1.
2.
3.
4.
ii) Research Experience: years

Sr. Name of the organization Designation Date of Date of Last Pay Band and
No. where employed Joining leaving Grade Pay*
1.
2.
3.
4.
iii) Industrial Experience: years

Sr. Name of Industry Designation Date of Date of Salary Drawn


No. Joining leaving
1.
2.
3.

7 i) Total Research Publications / Presentations


Sr. Nature Published Accepted
No.
1. Books
2. Chapters
National
3. Refereed
Journals International

National
4. Presentations
(Proceedings) International

ii) No. of PG dissertations / Ph.D. thesis guided: P.G. Ph.D.

8 a) Minimum monthly Salary expected: Rs………………………………………


b) Present monthly salary. ………………………………………………. (Attach copy of latest salary slip)
c) Time required to join the Institute, if selected: _________________________
9 Honors / Awards / Distinctions received, if any:
10 Names and addresses of two professional referees (who are not related to the applicant) who
are in a position to testify from their personal knowledge as to the fitness of the applicant for
the post applied for:
Name:
Designation:
Address:

Email: Mob.No.

I) Name:
Designation:
Address:

Email: Mob.No.
11 I) Address for correspondence:

Email: Mob. No.

II) Permanent Address:

12 Any other information relevant to the Post applied for, such as:
i) Memberships/Fellowship and position of responsibility in Professional Societies:
a)
b)
ii) Attainments in sports and extra-curricular activities (including N.C.C.)
a)
b)
13 Candidate should submit BIO-DATA separately.
14 Copies of documents enclosed:
O School Leaving Certificate
O PG degree Certificate
O PG Last Two Semester’s Marksheet
O UG Last Two Semester’s Marksheet
O Ph.D. degree Certificate
O Experience Certificates
O Other University Endorsement Letter for the post of Director/Principal, Professor,
Associate Professor/HOD to consider teaching experience.
O UGC approval letter for the degree awarding private/deemed universities outside of
Gujarat.
O Latest Salary Slip
 Caste Certificate, if applicable.
 PAN
 AADHAR

Declaration:
I hereby solemnly declare that the information furnished above is true and correct and I am responsible
for the veracity of the same.
Place:
Date: Signature of the Applicant
Important Note:-
1. Every application must be accompanied by self-attested photo copies of documents in
support of claims made by the candidate.
2. Applicant in service must forward application through the employer.
3. Incomplete application/s will be rejected.
4. Applicants called for Interview will have to come at their own cost.

(To be filled in by the present employer)


No Objection Certificate

Place: Signature of the Forwarding Authority:


Date: Designation:

Office Seal:

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