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Application Form
1
PERSONAL DETAILS
2
ACADEMIC RECORD
3
WORK EXPERIENCE
4
DECLARATION
Please read the INSTRUCTIONS below before filling up the form:
1. You are requested to fill all the required details.
2. The information provided by you in this application form will be used by us or an authorized representative to conduct inquiries as may be necessary at our discretion.
3. Any false statement or omission may render you liable to an action, which may include disqualification of your application. In case you are offered employment or are appointed, this may also lead to your appointment being withdrawn or to your dismissal.
4. All the credentials submitted must be attested or approved as the case may be from the issuing authority itself.
Personal Details
Name
*
(as per Aadhar Card)
Mr.
Mrs.
Ms.
Dr.
Prof.
Prefix
First
Middle
Last
Father’s Name
*
Mr.
Dr.
Prof.
Prefix
First
Middle
Last
Date of Birth
*
Date Format: DD dash MM dash YYYY
Age
Gender
*
Male
Female
Transgender
Latest Colored Passport Size Photograph
*
Accepted file types: jpg, jpeg, gif, png.
Maximum File Size is 2MB. Filetype only jpg, jpeg, gif, png is allowed.
Email
*
Mobile Number
*
Organisation
*
Bhawani Shanker Anangpuria Charitable Trust
B. S. Anangpuria Institute of Technology & Management
B. S. Anangpuria Institute of Pharmacy
B. S. Anangpuria Institute of Law
Employee Type
*
TEACHING
TEACHING-SUPPORTING
NON-TEACHING
Department
*
CSE
IT
ECE
ME
CE
BCA
BBA
MBA
Department
*
D-Pharma
B-Pharma
Department
*
BA.LLB
LLM
Department
*
ADMIN
ACCOUNTS
REGISTRATION & EXAMINATION
TRAINING & PLACEMENT
Post Applied For
*
GENERAL MANAGER
DEPUTY MANAGER
MANAGER (TRANSPORT)
Post Applied For
*
DIRECTOR
PRINCIPAL
PROFESSOR
ASSOCIATE PROFESSOR
ASSISTANT PROFESSOR
LECTURER
Post Applied For
*
CONSULTANT DOCTOR
DPE
LIBRARIAN
IT MANAGER
STORE INCHARGE
SR. LAB TECHNICIAN
LAB TECHNICIAN
ASSISTANT LIBRARIAN
LAB ASSISTANT
COMPUTER DATA OPERATOR
Post Applied For
*
SR. EXECUTIVE
SUPERINTENDENT
FRONT DESK OFFICER
CLERK
Post Applied For
*
MANAGER
ASSISTANT MANAGER
SR. EXECUTIVE
EXECUTIVE
Post Applied For
*
REGISTRAR
DEPUTY REGISTRAR
ASSISTANT REGISTRAR
SUPERINTENDENT
ASSISTANT
CLERK
Post Applied For
*
HOD
ASSOCIATE
PAN
*
Aadhar Card Number
*
Passport Number
Marital Status
*
Select Marital Status
Single
Married
Divorced
Widow/Widower
Seprated
Spouse Name
*
Mr.
Mrs.
Prefix
First
Middle
Last
Occupation
*
Address of Business Premises
*
Contact No.(s) of Spouse
*
Email ID of Spouse
*
For candidate residing in
*
Urban area
Rural area
Permanent Home Address
*
House / Apartment no.
Society / Street / Sector
City / Town / District
State / Province / Region
ZIP / Postal Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Permanent Home Address
*
House no.
Village / Tehsil
City / Town / District
State / Province / Region
Pin Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
If different from above, please give your current mailing address for all future correspondence.
Yes
Current Mailing Address
*
House / Apartment no.
Society / Street / Sector / Village/ Tehsil
City / Town / District
State / Province / Region
ZIP / Postal Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Demographics & Medical Information
Place of Birth
*
City / Town / District
State / Province
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Religion
*
Hinduism
Islam
Sikhism
Christianity
Buddhism
Jainism
Other
Mother Tongue
*
Blood Group
*
A+
A-
B+
B-
AB+
AB-
O+
O-
Languages known
*
Any Physical disability (medically diagnosed)
*
Yes
No
Suffering from any chronic disease
*
Yes
No
Suffering from any kind of depression
*
Yes
No
Undergone any major surgery
*
Yes
No
Any case of drug abuse or rehabilitation diagnoses
*
Yes
No
Suffering from any kind of allergy, etc.
*
Yes
No
Are you diabetic?
*
Yes
No
Are you still under medical prescription?
*
Yes
No
Academic Record
Provide details of educational qualifications completed or in progress.
*
EXAM TYPE
NAME OF SCHOOL/ INSTITUTE
NAME OF BOARD/ UNIVERSITY
YEAR OF COMPLETION
PERCENTAGE/ GRADE
SPECIALIZATION
Matric
*
EXAM TYPE
NAME OF SCHOOL/ INSTITUTE
NAME OF BOARD/ UNIVERSITY
YEAR OF COMPLETION
PERCENTAGE/ GRADE
SPECIALIZATION
10+2
Diploma
Graduation
Post-Graduation
Ph.D.
M.Phil
NET
GAPT
GATE
Others
(Click the + button to add a new row)
Other Details
Books Published
Authors
Title
Publisher
Year
Subject
(Click the + button to add a new row)
Papers Published
Authors
Title
Publisher
Year
Volume: Issue; Page No.
(Click the + button to add a new row)
Papers Presented in Workshops/ Seminars/ Conferences
Title of Paper
Title of Event
Year
Date
Place
(Click the + button to add a new row)
Workshops/ Seminars/ Conferences/ Faculty Development Programme Attended
Type of Activity
Title of Event
Year
Date
Place
(Click the + button to add a new row)
Research Projects (On-Going/ Completed)
Name of Investigator
Title of Project
Duration
Sanctioned Amount
Name of Funding Agency
(Click the + button to add a new row)
Consultancy Services
Name of Agency
Title of Work
Duration
Amount Received
(Click the + button to add a new row)
Patents Granted
Title
Patent Application No.
Name of the Inventors
Awarded By
(Click the + button to add a new row)
Work Experience
Please follow a chronological sequence, starting with the most recent employment. Also include project work, if any
*
Dates From - To
Organization Name & Address
Designation
Nature of Duties
Gross Salary
Reason(s) for leaving
(Click the + button to add a new row)
Activities & Achievements
Extracurricular:
Please list your principal extra-curricular, community, volunteer and hobbies in the order of their interest to you. Include specific events and/or major accomplishments such as musical instrument(s) played, varsity letters earned, etc. to allow us to focus on the highlights of your activities.
My favorite sports
My cultural activities
Musical instruments I play
My Hobbies
My achievements
I have represented my school/ college/institution in sports/ cultural / other activity at
Inter-school
Inter-college
Inter-university
District level
State level
National level
International level
Disciplinary History
Have you ever been found responsible for a disciplinary violation at any educational institution you have attended upto-now, whether related to academic misconduct or behavioral misconduct, which resulted in your probation, suspension, removal, dismissal, or expulsion from the institution?
*
Yes
No
Have you ever been convicted of a misdemeanor, felony, or other crime?
*
Yes
No
Is any judicial proceeding pending or still going on against you?
*
Yes
No
Applicant's Declaration
I hereby declare that all the above information given by me are true and correct to the best of my knowledge and belief. I also understand and agree that if any of the above information given by me is found false or incorrect in any of the events my services are liable to be terminated without any notice and without any full and final settlement.
Place
*
Signature:
*
Accepted file types: jpeg, jpg, gif, png.
Maximum File Size is 1MB. Filetype only jpeg, jpg, gif, png is allowed.
Resume / CV
*
Accepted file types: pdf.
Maximum File Size is 10MB. Filetype only pdf is allowed.
Date:
24/09/2023
Name
*
Comments
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*
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*
College (For Admission)
*
B. S. Anangpuria Institute of Technology and Management
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B. S. Anangpuria Institute of Law
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