Bansilal Ramnath Agarwal Charitable Trust’s

Vishwakarma Institute of Information Technology (VIIT)

Survey No 3 / 4, Kondhwa Budruk, Pune – 411048

Application for Employment

(STRICTLY CONFIDENTIAL) (Insert Softcopy or
Reference:
 An Advertisement in _____________________ Paste Recent
 An Introduction by ______________________ Passport Size Color
 Any Other source ________________________ Photograph)

Post Applied for: Assistant Professor / Associate Professor / Professor in the following [Retain Appropriate
option(s), strike out whichever not applicable.]
1. Computer Engineering
2. Information Technology
3. Artificial Intelligence and Data Science
4. Computer Science and Engineering (Artificial Intelligence)
5. Computer Science and Engineering (Artificial Intelligence and Machine Learning)

(I) PERSONAL DATA:

1. Full Name Dr./ Mr./Ms.______________________________________________________________________________________

Last name First name Middle name

2. Permanent Address : _________________________________________________________________________________________

___________________________________________________________________________________________
3.Present Address : _____________________________________________________________________________________________
_____________________________________________________________________________________________
4. Contact No : __________________________________ , 5.E-mail id : _________________________________________

6. Date of Birth (DD/MM/YY) ________________ ,Place of Birth : _________________, Age : ______ years (as on date________ ,

7. Nationality: _________________________ 8. Religion: ____________________ 9. Mother tongue: ____________________

8. Category (Attach Copy)

S.C S.T. D.T.(A) N.T.(B) N.T. (C ) N.T. (D ) O.B.C. S.B.C. Physically Open / General
Handicapped

9. Aadhar No. : ______________________________________ 10. PAN No.: _______________________________

11. IT Competencies:

Highly Proficient Fairly Proficient Not Proficient

MS WORD

MS EXCEL

MS POWERPOINT

SPSS/ Systat / SAS

ERP
 (II) ACADEMIC QUALIFICATIONS (ATTACH COPIES):

Degree/Diploma Post Name of Board/University Year of No of Class / Exact Special Subject

Graduate School/College passing Attempts Grade % / Offered
CGPA

Matriculation/
S.S.C./S.S.L.C.
Diploma/ Higher
Secondary/
Pre-University/
Intermediate
Bachelor’s Degree*
(B.E. or B. Tech.)

Master’s Degree*
(M.E. or M. Tech.)
Doctor’s Degree in
Engineering and
Technology (If
Completed)

Doctor’s Degree (If

Pursuing)
Date of Registration:
Current Stage / Status:

Post-Doctoral
Degree/Dip.

Others

(III) WORK EXPERIENCE:

(A) Teaching = Total ______ years ______ months.

(a) Under-Graduate Level: (Attach Copies)

Institution Position Held Course Nature of Subject Period of Appointment With
Appointment Dates

(Regular/ From To
Temporary)

(b) Post-Graduate Level : (Attach Copies)

Institution Position Held Course Nature of Subject Period of Appointment With
Appointment Dates

(Regular/ From To
Temporary)

(c) Post-Doctoral Research Experience: (Attach Copies)

Institution Associated As Nature of Subject / Area Period of Association
Association
From To
 (d) Teacher’s Approval: UG, PG Teacher, Guide Recognition: If Approved Teacher of this University and/or other
University? If so, give details (Attach Copies):

Name of the college / Approval Letter No. Approval Letter Date Post /Cadre Period of Recognition
Institute/ University (From – To)
DD/MM/YY

From To

(B) INDUSTRY EXPERIENCE (Attach Copies): Total ______ years ______ months
Name of Your Period (From – Duration Responsibilities No. Of Persons Subject Gross
Employer Designation To) DD/MM/YY (months) to your Supervision / Salary
Designation of
Immediate Superior

(IV) Research Work / Research Publications / Academic Content Developed:

a) By Self:

Published in Journals Presented in Conferences Under Preparation

Books

Articles

Papers

Book Reviews

b) Patents:
S. No. Name of the patent Classification Date of Filing / Registrations

c) Research / Projects Supervised:

No. of Students Awarded / Guided Registered In Process

PG Projects Guided NA NA

M.Phil. (if applicable)

Ph.D.

(V) MEMBERSHIP OF ACADEMIC BODY / PROFESSIONAL SOCIETIES:

Sr. Professional Body Type of Membership Period (From – To) Contribution till date
No.
 (VI) PROFESSIONAL ACTIVITY: Training Programme/ Workshops/ Seminars/ Conferences Organized
Sr. Title Dates Organization Level: Funded by Remarks
No University /
State /
National /
International

(VII) Training Programmes/ Workshops/ Seminars/ Conferences Attended:

Sr. Title Dates Organization Level: University / State / Remarks
No National / International

(VIII) Consultancy Activities:

Sr. No Year Organization Project Title Revenue Generated

(IX) SPONSORED PROJECTS: ( Attach Separate Sheet, If Required)

Sr. No Year Organization Project Title Amount Received

(X) Cost-To-Company:

Current Gross: Rs. Per month ______________________(For month & Year_______ )

Expected Salary (Gross) : Rs. Per Month_____________________ .

Minimum Notice Period required for joining ________________ Months.

(XI) HONOURS AND AWARDS :

Sr. Name of the Organization Category Year / Period Remarks

No

(XII) ANY OTHER INFORMATION (ATTACH SEPARATE SHEET, IF REQUIRED): _______________________

(XIII) OTHER INTERESTS

(1) ________________________________________________________________________________________________

(2) ________________________________________________________________________________________________
 (XIV) REFERENCES: Please give names of at least two persons (Other than relatives).

Sr. Name Contact No Email Occupation Period for which

No known

(XV) Is any of your relative or friend employed in Vishwakarma Institutes ? if so , please give her / his name

_______________________________________________Institute _______________________ relationship_____________________.

DECLARATION

I declare that the information given above is true . I understand and fully agree that any statement herein indicated found to be erroneous
and any omission, which tends to mislead the Institute will be sufficient cause to terminate my services from the Institute at any time
during my employment

Place: __________________________________ Applicant’s Signature :

Date: ____________________________________ Applicant’s Name :____________________________

Note
1) Please make sure that application is complete in all respects, including the certificates/documents to be enclosed/attached.
2) Incomplete applications will be rejected.
3) Please attach additional sheets wherever required.
4) Please do not delete the matter, put NA wherever not applicable.

Photocopies of the following documents are to be enclosed with the application:

(1) Original copy of the completely filled application duly signed, along with all self-attested documents, as below:
(2) Self-Attested copies of UG Degree, PG/Masters Degree, PhD Degree Certificate and any other certificates of education.
(3) Self-attested copies of the summary of publications, research papers, with DoI number.
(4) Self-Attested any of the copies of S.S.C./School Leaving / Birth Certificate or equivalent certificate in support of DoB /Age.
(5) Self-Attested copies of Caste Certificate & Caste Validity Certificate (if applicable).
(6) Self-Attested copies of Marriage Certificate/Affidavit/ Gazette for name change (applicable in case of married female
candidates).
(7) Self-Attested copies of Experience Certificates – Teaching and/or Industry, (wherever applicable).
(8) Self-Attested copies of Teacher’s Approval letters received from University/ PG Teacher/ Guide Recognition Letters.
(9) Self-Attested Last pay certificate / Latest Salary Slip of your current employment.
(10) Self-Attested copies of Aadhar, PAN and address proof.
(11) Any other Documents/ Certificates (Please specify).__________________________________________________________.