Application Form

1. Bhartiya Gramin Punnarrachana Sanstha’s
HITECH INSTITUTE OF TECHNOLOGY
ENGINEERING COLLGEE (APPROVED BY AICTE, DELHI)
P-119, Bajajnagar, Pune Road, Aurangabad - 431133. Photograph
(Maharashtra State) INDIA
Tel.: (0240) 2553495, 2553496 Fax: (0240) 2552240
Website: www.hitechengg.org E-mail: info@hitechengg.org
RECRUITMENT APPLICATION FORM
Certificates Attached [Office Use Only] Category [Office Use Only]
Passing Certificate Mark Statements OPEN DT-a
B.E. B.E. SC DT-b
M.E. M.E. ST DT-c
Ph.D. H.S.C. NT-a VJ
H.S.C. S.S.C. NT-b SBC
S.S.C. NT-c OBC
* If Applicable
*Caste Certificate Last Salary Certificate DD / Cash Details [Office Use Only]
*Caste Validity Experience Certificate Demand Draft No.
*Creamy Layer Demand Draft Date
Cash Receipt No.
1. Post Applied For (Designation): ______________________________________
2. Subject: ___________________________ Category: _____________________
3. Applicant’s Name: _________________________________________________
(Surname) (First Name) (Middle Name)
4. Date of Birth: DD______ MM ______ YY ______
5. Local Address: ____________________________________________________
___________________________________________________________________
Post: _____________________ Taluka: __________________
District:___________________ Pin Code: _______________
Tel. No. with STD code: _________ - ____________________
Mobile No.: _________________________________________
6. Permanent Address: _______________________________________________
___________________________________________________________________
Post: _____________________ Taluka: __________________
District: ___________________ Pin Code: _______________
Tel. No. with STD code: _________ - ____________________
Mobile No.: _________________________________________
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2. 7. Educational Qualifications: [Please Attach Attested Copies]
School / Month & Total
Exam Board / No. of Class /
Sr. College Year of Marks/Out %
Passed University Attempts Grade
Attended Passing of
01. S.S.C.
02. H.S.C.
03. B.E.
04. T.E.
05. S.E.
06. F.E.
Diploma
07. Final Yr.
08. M.E.
09. M.Tech
10. Ph.D.
11.
12.
13.
8. Elective Chosen at B.E.: ____________________________________________
9. Project undertaken at B.E.: __________________________________________
10. Specialization M.E. / M.Tech: _______________________________________
11. Ph.D. Thesis Topic: _______________________________________________
12. Extra Co-curricular Activity: ________________________________________
13. Reserved / Open Category: Please tick mark. Attach attested copies of Caste,
Caste Validity & Creamy Layer (if applicable) Certificate in case of reserved
category post.
Category & Certificate [Please √ only]
OPEN DT-a Caste Certificate
SC DT-b Caste Validity Certificate
ST DT-c Creamy Layer (if applicable)
NT-a VJ
NT-b SBC
NT-c OBC
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3. 14. Teaching Experience: [Please attach attested copies]
University to Designation &
Period Total
Sr. Name of the Institute which College last Salary Subject Taught
From-To Year
is Affiliated Drawn
01.
02.
03.
04.
15. Professional Experience: [Please attach attested copies]
Designation &
Period Total
Sr. Name of the Industry
From-To Year
Place last Salary Job entrusted
Drawn
01.
02.
03.
04.
16. Application Form Fee:
Demand Draft No.: ______________ Date: _____________ Amount: ____________
Bank: ____________________________________
For Cash Payment:
Receipt No.: ____________ Date: _____________
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4. To the best of my knowledge and belief the information given above is
correct and no part of the information is being suppressed by me. If any of the
Information given above if found incorrect, I shall be held responsible and liable
for its consequences.
Place: ________________ ________________________________
Date: _____________ [Name & Signature of the Applicant]
N.B.: 1. Certified copies of passing certificates & marks statements of educational qualifications
mentioned in table no. 07 must be attached along with the application. 2. Teaching Experience /
Professional Experience certified copies with last salary drawn certificate must be attached with
the application. 3. Proof of Birth Date must be attached along with the application 4. In case of
reserved post, Caste & Caste Validity Certificate must be attached along with application.
For OFFICE Use Only:
1. Application Verified.
2. Documents attached verified.
3. Remarks. Signature
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