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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.: _________________________________________



                                                   1
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




                                                 2
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: _____________




                                            3
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




                                              4

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Application formstaffhit

  • 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.: _________________________________________ 1
  • 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 2
  • 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: _____________ 3
  • 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 4