Job Application Form Page 2

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14. Other qualification
(if
any)
15. Details of projects done( if any):
16.
Details
of publications
(if
any):
17. Are
you
employed in a Govt./Semi-Govt./ :
Public Sector Undertaking/Autonomous
body?
(If yes,
you are required to forward
your
application through proper channel)
18.
Are
you
under any contractual obligation :
to serve the Govt./Semi-Govt./Public Sector
Undertaking/Autonomous body?
If
yes, give
details.
19.
Experience/Details
of present and previous employment
(attach
photocopies of experience
certificates) :
Name of Employer
Designation of
Period
of
Service
Salary
the post held
From
To
20. Names and addresses of two referees
: 1)
2)
21. Have
you
at any time been called
:
for interview
in
the Centre?
If
so, give details:
I' hereby declare
that
the
statements
made in
this
application
are
true,
complete
and
correct to the
best of my knowledge
and
belief.
Place:
Date:
(Signature
of the candidate)
NOTE : Applications giving full details together with copies of relevant certificates/testimonials
in
the
above format and superscribing the post applied for & Serial Number of the post on the envelope
should
reach
Registrar,UM-DAE Centre
for
Excellence
in
Basic Sciences,lst Floor,
Health
Centre
Building,University of
Mumbai,Kalina
Campus,
Vidyanagari,
Santacruz
(East), Mumbai 400098.

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