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    Nimhans Appli

    Uploaded by

    Jeshi
    This document is an application form for the post of [blank] at the National Institute of Mental Health & Neuro Sciences. The summary includes: 1) The application requests information such as personal details, education history, work experience, languages known, and publications. References and enclosures are also required. 2) Instructions state the application must be handwritten or typed by the applicant, incomplete applications will be rejected, and separate applications are needed for each post. Canvassing is prohibited. 3) For current government employees, the application must be routed through proper channels and a no objection certificate is required from the present employer if selected.

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    Nimhans Appli

    Uploaded by

    Jeshi
    49 views9 pages
    This document is an application form for the post of [blank] at the National Institute of Mental Health & Neuro Sciences. The summary includes: 1) The application requests information such as personal details, education history, work experience, languages known, and publications. References and enclosures are also required. 2) Instructions state the application must be handwritten or typed by the applicant, incomplete applications will be rejected, and separate applications are needed for each post. Canvassing is prohibited. 3) For current government employees, the application must be routed through proper channels and a no objection certificate is required from the present employer if selected.

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    This document is an application form for the post of [blank] at the National Institute of Mental Health & Neuro Sciences. The summary includes: 1) The application requests information such as personal details, education history, work experience, languages known, and publications. References and enclosures are also required. 2) Instructions state the application must be handwritten or typed by the applicant, incomplete applications will be rejected, and separate applications are needed for each post. Canvassing is prohibited. 3) For current government employees, the application must be routed through proper channels and a no objection certificate is required from the present employer if selected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    49 views9 pages

    Nimhans Appli

    Uploaded by

    Jeshi
    This document is an application form for the post of [blank] at the National Institute of Mental Health & Neuro Sciences. The summary includes: 1) The application requests information such as personal details, education history, work experience, languages known, and publications. References and enclosures are also required. 2) Instructions state the application must be handwritten or typed by the applicant, incomplete applications will be rejected, and separate applications are needed for each post. Canvassing is prohibited. 3) For current government employees, the application must be routed through proper channels and a no objection certificate is required from the present employer if selected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 9

    Application No:

    Affix recent
    passport size
    photograph duly
    signed by the
    candidate

    APPLICATION FOR THE POST OF


    (in Block letters)
    Advertisement No.& Date
    (Name of newspaper & date in which appeared)

    TO BE SUBMITTED TO:
    The Director
    National Institute of Mental Health & Neuro Sciences
    Hosur Road, Bangalore - 560 029
    Application fee particulars :
    (Name & address of branch,
    Challan No. date & amount
    etc.)

    Challan No. & Date

    Amount

    Name of the Bank &


    Address

    INSTRUCTIONS TO CANDIDATES:
    a) The application form should be filled in by the candidate's own handwriting or typed
    b) All the columns should be filled in and incomplete application will be rejected
    c) Separate application should be sent for each post
    d) Candidates who are in government service should apply through proper channel
    e) Canvassing in any form will be a disqualification
    f) Attested copies of educational certificates, experience certificates, age proof, caste/community
    certificates and testimonials/references should be attached with the application.
    g) If the space provided for furnishing particulars against Sl.No.1 to 27 is insufficient, full particulars may be
    furnished in a separate sheet of paper and enclose with the application, inserting reference to that effect.

    1. Full Name (in block letters)

    2. Father's / Husbands Name


    Address & Occupation

    Contd..2

    2
    3. Mother's Name
    & Occupation
    4. Address for correspondence

    (Contact Telephone/Mobile/Fax/E-Mail ID/


    number with STD code)

    5. Present Residential address

    6. Permanent address

    7. Date of Birth :
    a) Age as on last date of submission of application

    Years

    Months

    Days

    8. Sex (Male/Female)
    9. Marital Status
    (Unmarried/Married/Widower/Widow/Divorce)
    10. Nationality (by birth or by domicile)

    11. Name of the State to which you belong

    12. Religion
    13. Whether belongs to SC/ST/OBC, if so specify
    the category/community
    14. Whether coming under Persons with Disability
    category, if so whether :(i) Visually disabled
    (ii) Orthopaedically disabled
    (iii) Hearing disabled
    Contd..3

    3
    15. Whether Ex-serviceman, if so, particulars of
    service.

    16. Are you in-service candidate, if yes give


    particulars of Dept/Designation/Date of
    joining (Central/State/Autonomous organisation/
    PSU/etc.)

    17. Details of School/College/University studied


    (Starting from SSLC/10th standard & onwards)
    Name & address of the School/College

    Date of
    joining

    Date of
    leaving

    Examination
    passed

    18. Educational/Technical Qualifications


    (Starting from SSLC/10th standard & onwards)

    Examination
    Passed

    Name of Institution/
    Board / University

    Duration
    of course

    Date/month/
    Class /
    year of passing Percentage

    Subjects studied

    Contd..4

    4
    19. Details of work experience (after possessing minimum required qualification for the post) :

    Designation

    From

    20. Languages known to speak, read & write

    To

    Organization

    Speak

    Place

    Read

    Nature of work

    Write

    21. Knowledge of Hindi language


    (Examinations passed)
    22. Have you been a candidate for any post
    advertised by this Institute, if so give
    particulars and dates as to which post
    you applied
    23. References/Testimonials:
    (from two responsible persons)
    i) a) Name
    b) Occupation
    c) Address

    ii) a) Name
    b) Occupation
    c) Address

    24 . Have you been in abroad, if so give full


    particulars:
    a) Country/countries visited
    b) Period of Stay
    c) Date of return to India
    d) Purpose of visit
    Contd..5

    5
    25. Have you done any post graduate work or
    published any papers & papers presented
    at conferences, if so give full particulars.
    a) Publications :
    (Journals / Papers / Chapters in Books / Books)

    (Please mention the numbers in figures )


    National
    (i) Peer reviewed :
    (ii) Non peer reviewed :
    (iii) Others :
    International
    (i) Peer reviewed :
    (ii) Non peer reviewed :
    (iii) Others :
    b) Papers presented: (at conferences)
    National :
    International :
    (Please see the Annexure)
    c) Honours & Medals :

    26. Any other relevant information

    27. List of enclosures

    i) I, hereby declare that, all the above particulars furnished by me is true to the best of my knowledge & belief.
    ii) I am aware that, my application is liable to be rejected if the particulars given is incomplete or found to be
    incorrect.

    Signature of the candidate


    Place:
    Date :

    Contd..6

    NO OBJECTION CERTIFICATE FROM THE PRESENT EMPLOYER


    Ref. No: ..

    Date:

    Certified that Shri./Smt./Kum.________________________________________________

    is a permanent / temporary employee of this Institute / Organisation / PSU / Govt. Office in the

    capacity of ___________________________________________since _______________(Date) .

    His/her application is recommended and forwarded for the post. This Institute / Organisation /

    PSU / Government Office has no objection for applying/attending any interview to the post and

    he/she would be relieved in the event of selection.

    Signature

    Designation

    (Head of the Organisation with office seal)

    Place:
    Date :

    ANNEXURE
    NAME OF THE CANDIDATE:
    POST FOR WHICH APPLIED:
    DETAILS OF PUBLICATIONS:
    1. Peer reviewed journals:
    a) International

    No.:

    Author

    Name of the article

    Name of the journal

    Year of Publication

    b) National

    No.:

    Author

    Name of the article

    Name of the journal

    Year of publication
    Cond..2/-

    -:2:-

    2. Chapters in Books

    Name of the article:

    Name of the editor

    Name of the book

    Name of the Publisher

    Year of Publication

    3. Books

    Name of the author

    Name of the book

    Cond..3/-

    -:3:-

    Name of the publisher

    Year of publication

    Signature of the candidate

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