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SAI VIDYA VIKASA SHIKSHANA SAMITHI (R)

SAI VIDYA INSTITUTE OF TECHNOLOGY


(Affiliated to VTU, Belgaum, Recognized by Government of Karnataka, Approved by AICTE, New Delhi)

Rajanukunte, Bangalore-560064
Tel: 080-2846 8196, Fax: 2846 8193 / 98, Web: www.saividya.ac.in

BIODATA
Application for the post of:
Personal Details( fill in Block letters)
Title (Mr. / Mrs. / Ms./Dr.)
First name
Last name
Full name
Nationality

Religion
Reservation
Category
Place of Birth
Blood Group
Driv. License
Number

Caste
D.O.B(dd/mm/yy)/Age as on Date
Passport Number
PAN Number
Gender:
Marital Status:

Male
Female

Married

Unmarried

Family Details
Name of Father:
Name of Mother:
Spouse Name :
Name of Child 1
Name of Child 2
Name of Child 3

Contact Details
Permanent Address
Prominent Landmark
Local Residential
Address
Prominent Landmark
Land Line with STD
code
Mobile Number
Email Address

+911

Email Address(Alternate)
Exact period of stay

(From)

(To)

(DD/MM/YY)

(DD/MM/YY)

Language

Languages Known( Please tick appropriate box)


Read
Write

Speak

1.
2.
3.
4.
5.
6.
Educational Record (Please ensure copy of degree certificate and mark sheet are attached)
M.E / M.TECH / MCA/
Qualification
SSLC / ITI / DIP /
BA / BSc / BCOM / BE /
MBA/ MSc / MCom /
(tick the appropriate
PUC
BTech
qualification)
specify, if others
Name of the University
Class Obtained
Year of Passing
Reg No/USN

Ph.D

Specialization
Department
1.
Professional Certifications
,if any

2.
3.

Teaching(in yrs)

Professional Experience Summary


Industry(in yrs)
R & D(in yrs)
Administration(in yrs)

Total Years

Details of Research Experience (Use separate sheet, if required)


Period
Name of the
University/Instit
ution

Area of Research

From
Total

To

Details of Number of Research Publications (National & International)


2

International
Journal

National

Internationa
l Conference

National Conference

Details of Publications (if any, Please attach separate sheet if required)


Title of the Paper

National /
Internation
al

Year and
Month of
Publication

Conference/Journal

Details of Teaching Experience (Total No. of Years):(Pls. fill in Reverse


Chronological Order& attach certificates as annexures)
Name of
the
Organizati
on

Position
Held

Period
From
To

Total

(DD/MM/YYYY)
(DD/MM/YYYY)

Years
Month

Industrial Experience (Total No. of Years) Details of Industrial


Experience(Pls. fill in Reverse Chronological Order and attach certificates
as annexures)
Name of the
Organization

Position Held

Period
From
Total
(DD/MM/YYYY)
Month

To
(DD/MM/YYYY)

Years

Employment History
Details of CURRENT /PREVIOUS Employer
Organization/Institute
Name:

Position Held:

Address (main office and branch where worked):

Telephone:

Employment Period:
START DATE(DD/MM/YYYY):
END DATE(DD/MM/YYYY):
Whether employment is of permanent or temporary nature:
Permanent

Temporary

Responsibilities:
1.
2.
3.
Reason for Leaving:

Reference Details
Reference 1
Name

Designation

Phone No.

Email ID

Reference 2
Name

Designation

Phone No.

Email ID

Declaration and Authorization


To whom so ever it may concern

I confirm that the above information is correct to the best of my knowledge and I understand that any
misrepresentation of information on this application form may, in the event of my obtaining employment,
result in action based on company policy.
Signature:
Name in Block Letters:
Date:

Note: Send the duly filled application to PRINCIPAL, SVIT through post with copies of all the
testimonials OR email to careers@saividya.ac.in.