CANDIDATE INFORMATION FORM

Personal & Confidential

Please affix
a passport
Date: ____/____/____
size
photograph
Post Applied for:______________________ Subject/ Department:____________________
here.

1. PERSONAL DETAILS
Name
Date of Birth

Email ID

Husband / Fathers
Name

Mothers
Name

Religion/ Caste

Category

SC/ST/OBC/Gen./Others

Marital
Status

Married [ ] Unmarried [ ]
Separated { }

Male [ ]
]

Gender

Female [

2. CONTACT DETAILS
Present Address

Permanent Address

Pin Code:

Pin Code:

Land Line No:

Land Line No:

Mobile No:

Mobile No:

3. ACADEMIC/ PROFESSIONAL QUALIFICATIONS

Name of
Degree
Certificate

Mode
(Reg/
PT/
Corres/
O)*

Institution

Year of
Passing

High school
Intermediat
e
Graduation
Post
Graduation
PhD
Other
* Reg = Regular, PT = Part- time, Corre = Correspondence, O = Online

University

Major
subject/
Ph.D Topic

%ag
CGP
GP

4. ADDITIONAL / TECHNICAL QUALIFICATIONS

Test

Percentile

Year

GATE
NET
UGC- CSIR
Others

5. EXPERIENCE DETAILS (From recent to last organization worked) :

Nature of
S.
Organizatio
Start
Job (Reg /
Designation
No.
n
Date
PT)*
Teaching Experience
1.

End Date

CTC / Take
Home

2.
3.
4.
Industry Experience
1.
2.
3.
Research Experience/ Guidance
1.
2.
* Reg = Regular, PT = Part- time

6. OTHER DETAILS:

Current CTC
Expected CTC
Notice Period

7. DETAILS OF PARTICIPATION: Please attach extra sheets of paper, if required:

Activity

Numbers Attended/ Presented/ Organized

Publications (Books / Papers/

Articles
Conferences
MDP/ FDP/ other Training
Courses
Workshops/ Seminars
Administrative Responsibilities
in Academic Institution (Please
describe briefly)

8. Subject Details
a. List of subjects
taught
b. Name of Programs/
Courses dealt with

9. REFERENCES (3 professional references from last or current organization other than friends &
family members):
Contact
Name
Designation
Organization
Email ID
Number

10.

FAMILY MEMBER DETAILS:

Name

Relationship

Date of
Birth

Occupation/ Business

Declaration: I declare that the foregoing information is correct and complete to the best of my
knowledge and belief and nothing has been concealed/ distorted. If I am found to have
concealed/distorted any material information, my appointment shall be liable to summarily
termination without any notice. If offered appointment, I will join on specified date and subsequently
take up RNB Global Universitys assignment anywhere as and when required

Place: ___________________
______________________
Signature of the
candidate
Date : ___________________