Application No.:
GENBA SOPANRAO MOZE COLLEGE OF ENGINEERING
 SURVEY NO 25/1/3/, BALEWADI, TAL : HAVELI, PUNE - 411045
Telephone : 020 - 27290500
E-mail gsmoze@yahoo.co.in, Website : www.gsmozecoe.com
APPLICATION FOR EMPLOYMENT IN THE INSTITUTION
(Please enclose Xerox copies of all educational qualifications, experience & other achievements)

    Name of Candidate :

            (in block letters as in mark sheet of qualifying exam)
    Sex : Male Female                                 Category :
    Date of Birth :

    Post applied for :

 Name of Post :
  Department :   

    Address for Correspondence with PIN:

 

    Telephone No :

STD Code :  Phone No. :
 Mobile No :

    Email ID :

    Academic Qualifications (Fully completed examinations only) :

PLease Select the Checkbox Which is Applicable
Qualification Branch/Specilisation
as applicable 		Name of
Board/University 		Year of passing Percentage obtained Grade/Class/CGPA
SSC
HSC
Diploma
Degree
Post Graduation
Ph.D.
Attach Xerox copies of all qualifications.(Candidates need not give qualifications which are irrelevant to the post applied)

    Academic Qualifications (Appeared/in progress) :

PLease Select the Checkbox Which is Applicable
  Qualification Name of
Board/University 		Expected Year
of completion 		Percentage obtained
So far 		Grade/Class expected

    Experience (In chronological order) (Candidates may attach separate sheets if required) :
       (Teaching experience at Degree level and other than CHB only should be mentioned. )

PLease Select the Checkbox Which is Applicable
  Name of Organisation Nature of post held
(Teaching/Industrial) 		Period served Percentage
obtained So far 		Number of
years 		Last pay
drawn(Total) 		Reason for
leaving
From To

    Total years of teaching experience   :    
           (Total years of industrial experience) :  

Any other achievements
I hereby declare that all the information given above is true. I have enclosed the Xerox copies of all certificates/documents
wherever required. I shall produce the originals of these documents at the time of interview. I understand that no TA/DA is
admissible for the interview and I shall make my own arrangements for my travel/stay.