JOB APPLICATION FORM (To be filled in Block Letters)

JOB APPLICATION FORM
Medi-Caps International School
(To be filled in Block Letters)
Near Medicaps College Campus, A.B Road, Rau, Indore - 453331
Mobile : +91-96446 00054, +91-96448 00054
email : [email protected], www.medicapsschool.com
Form No.
ACADEMIC EMPLOYMENT / NON ACADEMIC STAFF
INSTRUCTIONS (please read and follow these carefully)
1. Copies of Degree / Certificates / Testimonial should NOT be sent with this Application Form.
2. Applicants called for interview will have to bear their own traveling expenses unless otherwise agreed in advance.
3. Application should be delivered personally at the School office or sent by Registered Post/Courier.
APPLICATION FOR
Date
Non Academic
Acacemic
Post Applied For
Name of the Applicant
(First Name)
D
Date of Birth
D
M M
Y
(Middle Name / Initial)
Y
Y
Affix
Recent passport
Size Colored
photo
(Surname / Last Name)
Age as on last birthday
Y
Marital Status
Nationality
Father’s Name
Spouse Name
Occupation
Address for Correspondence
City
State
Country
-
Residential Phone No. (with STD Code) [1]
Pin/Zip Code
-
[2]
Personal Mobile No.
Fax
-
Spouse Mobile No.
Personal Email ID
Spouse Email ID
Number of Children (If any)
S.No.
Age
Caste Category
Gender (Male/Female)
General
SC
School Name with Grade / Class
ST
Major illness(es)
OBC
Gender
Male
Female
Physical handicap / disability
(b) Written
Knowledge of Indian Languages (a) Spoken
Education and Qualification (will be verified on appointment)
Exam / Degree / Diploma
X
Medium of Study
Year
Marks (%)
Institute / School / College
University / Board
Subject
th
XIIth
B.Sc. / B.Com. / BA / BBA
Others (Specify)
M.Sc. / M.Com. / MA / MBA
Others (Specify)
B.Ed / M.Ed
Mphil
PhD
City Office: 201, Pushpratna Paradise 9/5, New Palasia, Indore -452003 (M.P.) Ph.: 0731-4046321, 4041435 Fax: 0731-4028148
Employment Experience - Total Working Experience (No. of Years)
Academic (Teaching)
Name of the Institution with complete postal address
From
To
Period
Subject
Class taught
Non Academic (Non-Teaching)
Name of the Institution with complete postal address
From
To
Period
Proficiency in sports and activities
Seminars / Courses attended
S.No
Name of Seminars / Courses
Description
Duration
Do you have any substantial connection with any employee of MIS or its Units
Yes
No
If yes please specify
Current CTC (Rs. / Yearly)
Expected CTC (Rs. / Monthly)
Expected Joining Period Required
DECLARATION
I hereby declare that all the particulars stated in the application are true to the best of my knowledge and belief. I have not concealed any information likely to
impair my fitness for employment. If it is revealed later that I have given false / incorrect details or concealed material information, my services are liable to
summary terminated without any notice or compensation.
If selected, I shall produce :
n
Medical Certification from recognize Hospital / Clinic / Registered Medical Practitioner (indicating, In case of ladies, If they are pregnant)
n
Experience certificate from my last employer duly counter signed by the Zonal Educational Officer or the competent authority.
n
Original certificates for verification
Date
Signature
Place
FOR OFFICE USE ONLY
Selected
Yes
No
Application Received on
Form No.
Call for Interview on
.
Interview Panel Remark
.
.
City Office: 201, Pushpratna Paradise 9/5, New Palasia, Indore -452003 (M.P.) Ph.: 0731-4046321, 4041435 Fax: 0731-4028148