Application Form for Employment

Read the following instructions carefully before filling the form.

Paste one recent Passport size photograph

Post Applied For ______________________________ 1.

This application form, duly completed should be submitted to the Registrar, Khyber Medical University on or before the due date along-with the following documents: i. Attested photocopies of certificates, degrees, detailed marks certificates/transcripts, domicile, CNIC, experience certificates and other relevant testimonials. ii. Bank receipt or Bank Draft of the required application processing fee (as per advertisement) drawn in favour of Treasurer, Khyber Medical University (National Bank of Pakistan, Hayatabad Township Branch Peshawar). iii. Research Papers evaluation fee as per advertisement in addition to the application processing fee) for the post of Associate Professor and Professor should be deposited in the KMU A/C No. 1450-8 in National Bank Hayatabad Township Branch Peshawar. 2. Persons already in employment should submit their application forms through proper channel along-with NOC issued by the competent authority. 3. Incomplete application forms and those received after the due date will not be entertained. 4. Use additional sheets, if required. 5. Work experience of Government/Semi-Government/Autonomous bodies will only be considered. 6. Fill all the columns. Write N/A if not applicable

1. 2. 3.

NAME (in block letters) Mr. /Miss. /Mrs. _____________________________________________ FATHERS NAME ___________________________________________________________

ADDRESS AND OTHER PARTICULARS: For correspondence (interview Call) ................................................................................... .. Mobile Ph. No . ......

(i)

(ii) (iii) (iv) (v) (vi) (vii) (viii) (ix) (x)

4. S#

Permanent Home Address: .................................................................................................. Ph. No. ......... E-Mail Address: ... Gender: ..... Province of Domicile: .. Nationality: .................................... Marital Status: .. Date of Birth: (Day). (Month) ... (Year) ..... Age on closing date: (Days) (Months) (Years) Amount deposited Rs:. Bank... Receipt/Draft No.. Dated .. EDUCATION: Certificate/ Degree Commencing from the Matriculation or Equivalent Examination. Name of Board/ University Exam. with year of passing Obtained / Total Marks % Marks/ CGPA
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1. 2. 3. 4.

Matric Intermediate

5. S#
1. 2. 3.

HIGHER QUALIFICATION: Degree M.Phil/MS PhD Post Doctorate ADDITIONAL RELEVANT QUALIFICATION: Certificate/ Degree Name of Board/ University Exam. with year of passing Obtained / Total Marks % Marks Obtained / CGPA Name of University Subject with year of passing Obtained / Total Marks % Marks Obtained / CGPA

6. S#
1. 2. 3.

7.
S#

FORMAL TRAINING OR EDUCATION: Period Name of Institution Type of Training From - To Certificate or Diploma obtained

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8.

RESEARCH PROJECTS: Give particulars of all post-graduate research work done. Mention name of Institution and Professor under whose guidance research completed. Nature of Research Name of Institution Name of Professor

S.#

9.

RESEARCH PUBLICATIONS: Attach attested photocopy of title of journal with each research paper mentioning Impact Factor. Title of Research Paper Name of Journal Date of publication Principal/ Co-author with S.No. of author HEC/PM&DC recognized Yes/No Impact Factor of the Journal

S#

Attach additional sheet (if required).

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10.

EMPLOYMENT RECORD: Period Name of Institute / Organization Job Description (Teaching / Research / Admin) Nature of Job (Permanent/ Temporary) Status of Organization (Govt./Semi Govt./ Autonomous

S#

From

To

Designation

BPS

11.

Attach list of Miscellaneous Teaching or Administrative Experience, if any.

12. 13.
S#

Membership of Professional Organizations / Societies and other achievements in the University, Public or International Affairs, if any. COUNTRIES VISITED: Name of Country Duration Purpose of Visit

14. a.

References: _______________________________________________________ _______________________________________________________

b.

_______________________________________________________ _______________________________________________________
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15.

State any other relevant facts. (Attach additional sheet, if required).

... . ... . ... . ... . ... . ... . ... . ... .

16.
S.No.

Checklist of required documents attached. (Please mention the attached documents, other than enlisted below, at serial No. 16 & onwards)
Name of Document Attached
Please Tick (if attached)

Not Applicable Page No.

(Write page number on the top Please Tick (if not applicable) right corner of the attached documents)

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.

CNIC Domicile Certificate Matric Certificate Matric DMC/Transcript Intermediate Certificate Intermediate DMC/Transcript Bachelors/Graduation Degree Bachelors/Graduation DMC/Transcript (final year) Masters Degree Masters DMC/Transcript M.Phil/MS Degree M.Phil/MS DMC/Transcript Ph.D degree Post Doctorate Certificate Relevant experience Certificate

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* Attach additional sheet (if required). __________________________________________________________________________________ I hereby declare that all the entries made in this application form, all the above information and the additional particulars/documents furnished along-with it are true to the best of my knowledge and belief.

______________________ Signature of the Candidate

Dated: ______ /______ /_________

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