APPLICATION FORM FOR APPOINTMENT OF ACADEMIC STAFF

Note: 1. Please fill in the form completely. 2. 3. 4. Attach self attested copies of required Certificates and Testimonials as detailed in appendix. Original documents should be presented at the time of interview. Kindly sign at the bottom of every page to certify/validate the correctness of particulars filled in.

Recent pp size color photograph to be affixed

Position Applied for: __________________________________________ Specialization: _______________________________________________ I. Personal Details: (In Capital letters)
Title (Dr./ Mr./ Mrs./ Ms.) First Name: Middle Name: Last Name: Date of Birth (DD/MM/YYYY): Marital Status: Nationality: PAN No.: Category: Blood Group: General SC Married Unmarried Divorcee Widow

Name of the State to which you belong: EPF A/c No.: ST Height (Cm.): OBC Others__________________ Weight (Kg.):

______________________ (Signature of the Applicant) 1

II. Address:
Permanent Address: House No. Locality: City: State: Present Address: House No. Locality: City: State: Preferred address for correspondence: Pin Code: Country: Permanent / Present (Please Tick) Residence Contact No(s). Contact Phone Numbers: Mobile No(s).: Emergency No(s).: Email Id: Were you at any time declared Medically Unfit; asked to submit your resignation; discharged or dismissed from Service? (if yes, please provide details) Permanent: Present: 1. 2. 1. 2.
(STD code) - Number (STD code) - Number

Street:

Pin Code: Country:

Street

III. Family Details:

Relation Father Mother Husband/Wife Child 1 Child 2 Child 3 Name Age Education Occupation

______________________ (Signature of the Applicant) 2

IV. Educational Qualification

Name of Course/ Degree/ Diploma/ Certificate Name of Institute/ College Name of the Board/ University Year of Passing Dura -tion Full Time/ Part Time /
Correspondence

Level

/ Distance Learning

% or Specialization CGP /Subjects

A

Div.

X XII UG PG PG
(Additional, if any)

Any Other
(Please Specify)

V. Other Qualifications/ Certifications

Qualified JRF NET SET/ SLET GATE Any Other (Please Specify) (Yes/ No) Subject/ Specialization Year Score

VI. Research Degrees

Degree M.Phil. Ph.D./ D.Phil./ FPM D.Sc./ D.Litt. Title Date of Registra -tion Date of Subm -ission Date of Award of Degree Institute/ University Research Guide(s) Details Designation & Name Institute

______________________ (Signature of the Applicant)

VII. Details of Professional Training Programs (MDPs/FDPs/Workshops etc.)

Period S.No Name of Program Duration
From To

Training Organization with Location

Subject/ Area of Training

1 2 3 4 5

VIII. Employment Details (starting from your current organization)

Name of the Organization & its Location (City) Nature of Employment Designation
(Regular/ Part
Time/ Visiting/ Adhoc/ Contractual)

Period
From To No. of Years

Specialization/ Functional Area

Gross Salary
(Per Month)

______________________ (Signature of the Applicant) 4

IX. Present Salary Details (Monthly in INR)

Pay Scale Basic Pay AGP/ DP DA HRA Other Allowances Gross Total

X. Industrial/ Teaching Experience (Full-time) Industrial Experience (in years) Teaching Experience Research Experience excluding years spent in M.Phil/ Ph.D (in years)
P.G Classes (in years) U.G Classes (in years)

Area(s) of Specialization

XI. Courses Taught (Last Three Years)

S.No. Course Title University/ Institute Level (UG/PG/Doctoral) Year

XII. Academic Guidance (Last Two Years)

S.No. Thesis Title Level (UG/PG) Year

______________________ (Signature of the Applicant) 5

XIII. Number of Research Guidance

Qual. Ph.D M.Phil Completed Pursuing

XIV. Journal Publications (Last Three Years)

S. No. Journal Name Paper Title ISSN/ ISBN Number Type Whether Whether peer (National/ you were No. of Year of reviewed? International) the main Co-authors Publication Impact Factor author? (if any)

XV. Conference/ Seminar Presentations & Workshop Conducted (Last Three Years)
S. No. Name Paper Title Place Published (Yes/No) ISSN/ Type ISBN (National/ Number International) Whether you were the main author? No. of Coauthors Year

XVI. Sponsored/ Consultancy Projects Undertaken (Last Three Years)

S.No Title Duration Funding Agency Amount Funded Patent/ Technology Transfer/ Product/ Process

______________________ (Signature of the Applicant) 6

XVII. Book Publications

S.No. Name of the Book Chapter Name (if chapter of a book) Publisher Whether you were the main author? No. of Co-authors (if applicable) Year

XVIII. Scholarships, Honours and Awards

Award National/ International Date Organization Basis of Selection

XIX. Language Proficiency

(Please indicate languages and level of proficiency Good, Average or Nil)

Language HINDI ENGLISH FRENCH GERMAN OTHERS (Specify) .

Good

Writing Average

Nil

Good

Reading Average

Nil

Good

Speaking Average

Nil

XX. Other Details 1. ________________________________________________________

Membership of Professional Bodies/ Associations :

2. ________________________________________________________ 3. ________________________________________________________

Experience in administrative positions, Student Welfare, Curricular and Lab Development, Professional and Outreach Activities

1. ________________________________________________________ 2. ________________________________________________________ 3. ________________________________________________________

______________________ (Signature of the Applicant) 7

XXI. Computer Proficiency (Theoretical & Practical)

(Please indicate your overall competency level)

Microsoft Office S. No. Computer Skills 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 11. 12. 13. Word processing Spreadsheet (Excel) PowerPoint Microsoft Outlook C C++ Java Visual Basic PHP Oracle Dot Net ASP/ HTML Windows Linux

Very Good

Good

No Knowledge

Programming Languages

Operating Systems

Additional Information (if any)

XXIII.
Expected Date of Joining (If Selected)

XXIV.
Expected Emoluments (Monthly in INR)

XXV.
Past Employment/ Association/ Acquaintance with IMS / any other affiliate organization of the Unison Group: (If yes, please give details underneath) YES NO

______________________ (Signature of the Applicant) 8

XXVI.
a) Have you ever applied or been interviewed for a job at a Unison Group Institute earlier? (Please Tick) If Yes, Please give details: b) Do you have any acquaintances or relatives associated with Unison Group? (Please Tick) If Yes, Please give details: Yes No Yes No

XXVII. Any major Illness/ Physical Handicaps (if any)

(Please give details) a) Major Illness: (if any) b) Physical Handicaps: (if any)

XXVIII. Professional References (3 References with whom the candidate has worked including from the last Organization/
Institute Served)

Name

Current Position

Organization

Contact Details (Email ID, Mobile No., Phone No.) Email ID Mobile No. Phone No. Email ID Mobile No. Phone No. Email ID Mobile No. Phone No.

XXIX. Job Reference (kindly tick mark)

Newspaper IMS Website
(Name of newspaper)

Job Portals
(Name of Portal)

Employee Referral (Name of Referee)

Any other Source (Please specify)

______________________ (Signature of the Applicant) 9

Declaration by the Applicant I certify that the information presented in this Employment Application Form and details in annexure annexed with the Application Form are complete and honestly presented. I understand and agree that any inaccurate information, misleading information or omission will be cause for the rejection of any offer of employment or for disciplinary action or dismissal if discovered at a later date. I agree to honor IMSs Code of Ethics in letter and spirit.

I understand that employment is based strictly on merit and declare that I will not violate the rules against canvassing directly or indirectly to seek employment with Institute of Management Studies and/or to seek any undue/special favors outside the framework of rules in force from time to time. I agree to abide by the Rules and Regulations covering the employment with Institute of Management Studies presently in force or as amended from time to time.

I shall act responsibly, interact honestly and respectfully with all others, respect the resources made available to me and be accountable for my actions.

Place : Date : IMPORTANT INSTRUCTIONS 1. Experience less than 6 months in an organization will not be considered.

________________________ Signature of the Applicant

2. Experience obtained at (10+2) level teaching or below will not be considered. 3. Post-eligible qualification experience will only be considered. 4. Experience obtained in part-time/ visiting capacity will not be taken into account. 5. In case of published work, only number of publications already published is to be mentioned. The publications in press, in preparation etc. will not be taken into account. 6. Application Form incomplete in any respect will not be entertained.

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APPENDIX List of Documents to be attached with the Application Form: 1. Updated Resume 2. Educational Certificates & Marksheets (from class 10th till highest degree) 3. Appointment Letter of current organization/ Last served organization 4. Appointment Letters of all previous organizations as specified in Clause VIII: Employment Details 5. Latest Salary Slip/ Bank Statement 6. Address Proof & ID Proof 7. Two Passport Size Photographs (Recent) 8. Experience & Relieving Certificate from previously served organizations 9. Conferences/ Workshops Attended/ Conducted/ Organized and Presented Papers 10. Certificates of Training Courses/ Short-Term Refresher Courses 11. Documentary Proof of Sponsored/ Consultancy Projects undertaken 12. Publication Details 13. Awards & Recognition 14. JRF/NET/GATE/SLET/SET Qualified Certificate (If Applied & Cleared) 15. Any Other relevant document

Note: The candidates are required to carry all originals along with one set of self attested documents.

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