HAZARA UNIVERSITY, MANSEHRA PAKISTAN

Ph: 0997-414163, Fax 0997-530046

Post applied for: - Attach

attested
recent
Bank Draft/University Receipt No. passport size
Bank Name:
Dated: - - photograph
Instructions: -
(1) Please fill each row and column in this performa very carefully.
(2) If a row or a column is not relevant, write Not Applicable or "NA.
(3) Wherever necessary, use additional sheets for additional information.
(4) Incomplete performa/application will not be entertained.
1. Name (in block letters):
2. Fathers Name:
(b)
3. (a) Date of birth: Domicile:
4. (a) Phone: (b) Mobile:
5. (a) CNIC: (b) Email:
6. (i) Address (for Test, Interview call,

etc: (ii) Permanent Home Address:

7. Educational Record:
Institution Date of Academic
Name of Division
Level Examination or Board obtaining Marks or % age/ Major
of Education Passed or certificate Obt. Total Grade CGPA Subjects
University degree
Matriculation
Intermediate
Bachelors
Masters
Doctorate
Any other
Note: Attach certificates of distinction
8. EMPLOYMENT RECORD:
Please indicate various appointments in chronological
order. (Use additional sheets if needed)
Name & address Major Duties
Scale of Pay Dates of &
Designation responsibilitie
(if applicable) From To employer s
1/2
9. Other Formal Training or Education:
1* Please mention %age marks along with CGPA and attach certificate for
distinction.
Duratio
Name & Type of n Certificate or Division or
Place Training
From To Diploma obtained Grade / %age

10. PUBLICATIONS ______________________________________________________________________

(Use additional sheets, if needed)
11. Details of documents etc. attached.

a. b. c. d.

e. f. g. h.

i. j. k. l.

12. Declaration
I hereby declare that all the entries in this performa and all the additional particulars (if any) furnished
along with it are true to the best of my knowledge and belief. I understand that any
misrepresentation/concealment of facts in it shall result in the rejection of my application, and even after
my selection as_______________ shall lead to dismissal/termination from service.

Dated:
________________________
Signature of Candidate
-----------------------------------------------------------------------------------------------------------------------
---------

FOR OFFICE USE ONLY

RECOMMENDATIONS OF THE SCRUTINY COMMITTEE
Please tick the relevant

The candidate is Eligible OR Not Eligible

If the candidate is Not Eligible please state the reasons:

1. ______________________________________________________________________________
2. ______________________________________________________________________________
3. ______________________________________________________________________________
Name of evaluator: 1._________________________ Signature__________________________
2. _________________________ Signature__________________________
3. _________________________Signature__________________________
Concerned Dean: ______________________________________
2/2