fdp registration form.pdf - Jrnrvu

FACULTY OF MANAGEMENT STUDIES
JRNRVU, UDAIPUR
FACULTY DEVELOPMENT PROGRAMME
ON ENTREPRENEURSHIP & skill dEVELOPMENT-2013
JANUARY07-JANUARY13
APPLICATION FORM
LAST DATE FOR RECEIVING APPLICATION FORM-24 DECEMBER2012
A.PERSONAL INFORMATION:
PASTE A RECENT
PASSPORT SIZE PHOTO
HERE, DO NOT STAPLE
OR CROSS SIGN
FULL NAME
DATE OF BIRTH
E MAIL
PHONE WITH STD CODE
PRESENT ADDRESS
PERMANENT ADDRESS
EMERGENCY CONTACT
B.EDUCATIONAL AND PROFESSIONAL INFORMATION:
NAME OF THE
DEGREE
PERIOD
FROM TO INSTITUTION
% MARKS
/ CGPA
MAJOR
SUBJECTS
GRADUATION
POST
GRADUATION
M.PHIL

EMPLOYEE DETAILS (STARTING FROM THE RECENT, ATTACH SEPARATE SHEET IF
NEEDED)
DESIGNATION ORGANIZATION RESPONSIBILITIES PERIOD
FROM TO
TEACHING
INTERESTS
RESEARCH
INTERESTS
C.PROFESSIONAL EXPERIENCE:
TOTAL DURATION OF TEACHING
EXPERIENCE
TOTAL DURATION OF NON
TEACHING EXPERIENCE
TOTAL EXPERIENCE
I , …………………………………………………………………………..,hereby declare & certify that,
1. All the information provided above is true to the best of my knowledge and i am liable
to produce proof of such information on demand.
2. I have read & understood the programme brochure. I agree to abide by the
programme and institute rules.
3. I am medically fit to take part in the programme and do not suffer from any medical
illness or condition.
DATE…………………………..PLACE……………………………….SIGNATURE………………………………