JANSONS INSTITUTE OF TECHNOLOGY

APPLICATION FOR THE POST OF __________________

The information revealed should be accurate. False information would
affect the chances of selection.
The decision of the Institute will be final on all matters relating to
appointment and binding on the applicant. No correspondence will be
entertained from the applicant regarding non-selection.

Paste your recent

passport size
photograph

Personal Information
1. Name : (as in H.Sc / Pre-degree Certificate)

2. Address for Communication :

City :

Pin Code :

State :

Country :

Telephone No. STD Code :

Office

Residence

Fax

Email

Mobile :

3. Community Group :
4. Sex :

OC BC MBC SC ST

Male

Female

(As per Tamil Nadu Government norms)

5. Nationality :

6. Date of Birth :
(Date)

(Month)

(Year)

7. Family Details :
Name
Father / Guardian
Mother
Siblings if any

Qualification

Occupation

8. Marital Status :

Single

Married

If married provide the following details of your spouse:

Name :

Occupation :

Contact Address :

9.
Details of Medical history if any & blood group :

10. Academic Performance: (Please enclose attested copies of all mark sheets and degree certificate received.)
Stage

Name of
Examination

Year of
Passing

No. of
Attempts

Branch / Major
Sepcialisation

Examining /
Certifying
Authority

Educational
Institution

Percentage /
Grade

Division

SSC /
Equivalent
HSC /
Equivalent
U. G.
Degree
P.G.Degree
Other
Qualifications
(if any) (a)
(b)

Please account for breaks in your academic career, if any :

11. Major Extra Curricular Activities :

No.

Activity

Role

Year
From

To

Honours
(if any)

1
2
3
4
5
12. Meritorious Achievements : Academic/Professional Awards/Medals/Prizes/Scholarship/Certificates, etc.,
No.
1

Name of Award

Awarding
Institution

Level

Basis of Award

Year

2
3
4
5
13.Work Experience : (Please furnish a certificate from the last employer)
No.

Name of
Orgn.

Annual
Salary (Rs.
Lakhs)

Size of
Orgn (No. Category
Designation
of
(F.P.O)*
Employees)

1
2
3
4
5
* F : Full Time

P : Part Time

O : Other (Please Specify)

14. State your career objectives and goals. (Use additional sheet (A4 Paper))
15. Describe your role model. (Use additional sheet (A4 Paper))
16. (a) What are your hobbies ?
(b) What are your strength ?
(c) What are your weaknesses ?
17. What is the reason for choosing JIT?

18. Please Furnish Two References (Should not be close relatives)

JIT may contact the referees, if necessary

Nature
of
Duties

Period
From To
(in month)

Total
(monthly)
Salary

(1)
Name

(2)

.........................................................

Name .....................................................................

Occupation ........................................................

Occupation .............................................................

Address .............................................................

Address ...................................................................

...........................................................................

.................................................................................

Phone ................................................................

Phone ......................................................................

e-mail ................................................................

e-mail ......................................................................

19. Checklist: Attach photocopies of the following certificates and tick the appropriate boxes
1

H.Sc / Pre-degree Marks Sheet

Ph.D Certificate, if any

UG Degree or Provisional Certificate

Work Experience Certificate, if any

PG Degree or Provisional Certificate

20. Declaration:
I have carefully read the instructions and agree to abide by the decision of the Institute regarding
my selection. I certify that the particulars given by me in this application form are true to the best
of my knowledge and belief.

Place :
Date :

Signature of Applicant

Please send to

Principal
JANSONS INSTITUTE OF TECHNOLOGY
Karumathampatti, Coimbatore 641 659. Tamil Nadu.
Tel. No. 0421 2264900 (100Lines)
E-mail: principal@jit.ac.in