CHAITANYA BHARATHI INSTITUTE OF TECHNOLOGY

(Autonomous)
(8 U.G. & 3 P.G. Engg., Programmes Accredited by NBA & Accredited by UGC - NAAC -
with "A" Grade and NIRF Ranked Institute)
Chaitanya Bharathi P.O., Kokapet (V), Gandipet (M), Hyderabad - 500 075, Telangana State.
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EMPLOYMENT APPLICATION FORM Affix your latest

passport size
APPLICATION FOR THE POST OF : ___________________________________ photograph & get
it attested by a
Gazetted Officer
with seal
DEPARTMENT : ___________________________________
PART - A : GENERAL & ACADEMIC INFORMATION

1. Name in full with Surname : ___________________________________

2. Father’s / Husband Name : ___________________________________

3. Date of Birth & Age (in Christian era) : ___________________________________

4. Place of Birth : ___________________________________

5. Postal Address for Communication : ___________________________________

___________________________________

___________________________________

6. Email ID : ___________________________________

7. Mobile No. : ___________________________________

8. State whether you belong to OC/SC/ST/BC/PH: __________________________________

(Attach a Certificate from the Authority prescribed under Government Rules)
9. Give particulars of all Examinations passed Degree / Diploma obtained (commencing with the
Matriculation or equivalent Examination). Where a Degree / Diploma has been obtained by Private
appearances that should be specifically mentioned in Brackets in Column (2) of the Table.
- (Copies of Certificates to be enclosed)

S. Examination or Name of the College and Year of Class & Subjects taken
No. Degree University passing Percentage for Specialization

Page 1 of 5
10. EMPLOYMENT DETAILS:
a) Teaching Experience: ________ Yrs. (Give in reverse chronological order)
- (Copies of Appointment Orders and Service Certificates to be enclosed)

Scale of Duration of Basic Pay Reasons

S. Name & Address of pay / Employment last Drawn / for
Designation Consoli-
No. the Organization Consolidated leaving
dated From To
Total
Salary Rs. (Yrs) salary the Post

1.

2.

Courses taught: _______________________________________________________________________

_______________________________________________________________________

b) Administrative Experience: ________ Yrs. (Give in reverse chronological order)

- (Copies of Appointment Orders and Service Certificates to be enclosed)
Duration of Pay Band /
Employment Grade Pay
Designati
S. No. Organization To and Total
on
From Salary in
Hand
1.
2.

c) Industrial / Research Experience: ________ Yrs. (Give in reverse chronological order)

- (Copies of Appointment Orders and Service Certificates to be enclosed)

Duration of Basic Pay Reasons

S. Position Nature of Employment last Drawn / for
Employer
No. Held Duties Total
Consolidated leaving
From To salary the Post
(Yrs)

1.

2.

Page 2 of 5
 PART – B : RESEARCH PUBLICATIONS & OTHER INFORMATION

1) RESEARCH:

a) Papers published in International Journals

(List of Publication details to be attached)
Complete reference details Publishing group [(like
Number of Page
Sl. No. of the paper (names, paper ISSN/ISBN/DOI Elsevier, Springer, IEEE
Authors Nos.
title, issue etc.) etc)]
1.

2.

b) Papers published in Conferences (National or International)

(List of conference papers to be enclosed)
Complete reference details of ISSN/
Name of the Conference Page
Sl. No. the paper (names, paper title, ISBN Date
Conference organized by Nos.
issue etc.) /DOI
1.

2.

c) Books and Monographs

(Enclose the proof of Books and Monographs)
Reference details Name of the Number
Page
S. No. Name of the Authors of publisher & of
Nos.
book / monograph ISSN/ISBN authors
1.
2.

d) Book Chapters
(Enclose the proof of Book chapters)
Reference details of
Name of the
book chapter and the Page
S. No. Name of Authors publisher &
book in Nos.
ISSN/ISBN
which this appears
1.
2.

e) Research Projects
(Enclose the proof of document)

Month & year of sanction Name of the Expected Page

S. No. Current Status
of project and duration Sponsoring Agency Outcome Nos.
1.
2.

Page 3 of 5
f) Consultancy Works
(Enclose the proof of document)
Month & year of sanction Expected Page
S. No. Name of the Current Status
of project and duration Outcome Nos.
consultancy work
1.
2.

g) Patents
(Enclose the proof of document)
Filed /
File No. & Design Published / Page
S. No. Authors Title Date Process Granted with Nos.
date
1.
2.

2) Awards/Fellowship (Enclose the proof of document)

Name of the award / International / Page
S. No. Name of awarding Date
fellowship National Nos.
body
1.
2.

3) THESIS (M. Phil. / Ph.D.) Supervision (At all organization that you have worked with):

Year of
Co-guides (if
S. No. Name Title of Thesis Completi
any)
on
1.
2.

4) Membership of Professional Bodies: (Enclose the proof of document)

______________________________________________________

______________________________________________________

5) Other Information, if any : ________________________________________

6) Details of Enclosures:

(i) (ii)
(iii) (iv)
(v) (vi)
Page 4 of 5
7) If any of your Relatives / Friends are working in the
Institute mentions their Names with Relationship. :
_______________________________________

8) Names of two Persons with their Address / Designation

(Including Email ID & Mobile Number) to whom reference
can be made about the Candidate :

i) ____________________________________________

ii) ____________________________________________

9) If selected and appointed please specify the time you require for joining duty: ____________________

Place:
Date: Signature of the Candidate
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DECLARATION TO BE SIGNED BY THE CANDIDATE

I hereby declare that the particulars furnished in this Application are true to the best of my knowledge.

Date: Signature of the Candidate

================================================================================

ONLY FOR CANDIDATES ALREADY WORKING IN ORGANIZATION / INSTITUTIONS

a. Forwarded to the Principal, CBIT, Gandipet, Hyderabad – 500 075.

b. The Applicant is a Permanent / Temporary Employee and His / Her Conduct and Character are __________
c. Certified that the above Particulars are correct as per our Records.
d. The Organization / Institution has No Objection to relieve Him / Her, if He / She is selected for the Post.

FULL SIGNATURE:
DESIGNATION:
Date: (Office Seal)

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