Himgiri Zee University

PO Sherpur, Chakrata Road, Dehradun, Pin-248197

Details of Faculty and Non-Teaching Staff

(Please write using BLOCK Letters)

Post Applied for Department

1. Name in Full

Married Single Male Female (Please tick)

2. Address:

Present

Permanent

Fax

Email

Telephone Office X X

Res X X

3. Date of Birth: 4. Nationality

Day Month Year

4. Present Employment:

Designation

Organization

Date of Joining

Scale of Pay Rs.

Pay Rs.

Total emoluments (per month) Rs.

5. Salary expected Rs.

6. (a) Tick mark the appropriate box if you belong to reserved category
SC ST OBC

(b) Attested copy of certificate enclosed

YES NO

7. Areas of Specialization:

8. Academic record starting with Graduation: (Please attach self attested photocopy)
Degree College/University/Institute Year of Percentage Class/
Passing Division

9. Employment: (Particulars of your past position(s) starting from the current)

Employer Position Held Date of Date of Pay with Scale of Pay
Joining Leaving

10. Important Conferences / Seminars attended:

(Please provide certificates at the time of employment)

11. Names and addresses of three References:

12. Statement of Objectives

a. Please indicate as to why you wish to join HIMGIRI ZEE UNIVERSITY, Dehradun.

b. How in your opinion do you meet the job requirements as advertised?

c. A short paragraph about the research/teaching/development projects you would like to undertake and the courses that you would like to
handle.

(Use a separate sheet if necessary)

Form to be returned to: The Registrar

Himigiri Zee University
PO Sherpur, Chakrata Road
Dehradun - 248197
Telephone: 0135-2102676 / 2110005