1

BIRLA INSTITUTE OF TECHNOLOGY MESRA RANCHI

APPLICATION FORM (FOR FACULTY POSITION)

Post Applied for: Assistant Professor
Department / Extension Center Management/Jaipur
If applied earlier against Advt. No. GO / Rectt / 2013-14/2173, dated. June 10, 2013, please mention the following:
Name of Department and post applied earlier:
D.D.No.:_____________________ Date______________ Amount____________
Name of issuing bank_____________________ Branch Name: _______________


To
Deputy Registrar (P&A)
Birla Institute of Technology Mesra
Ranchi 835 215, Jharkhand







1. Name in full (in capital
letters) (Underline
Surname)
LAVISHA DHINGRA
2. Name of Father / Husband
Shri Jogendra Pratap
3. a. Marital Status Unmarried b. Male / Female : Female
a. Permanent address
56/23, Rajat Path, Mansarovar
Jaipur(Rajasthan)
Pin code- 302020
b. Address for correspondence
56/23, Rajat Path, Mansarovar
Jaipur(Rajasthan)
Pin code- 302020
4.
Phone No.
(with STD code)
0141-2785156 E-mail ID dhingra.lavisha@gmail.com
5. Details of the post applied for:
a) Post applied for Assistant Professor
b) Advertisement No. and Date GO/Rectt/2014-15 /2331;24
th
June 2014
c) Department
Management
d) Field of specialisation
Human resource
If you wish to apply for more than one Department, please send separate applications for each Department.
6. Date of birth (please attach true copy of
certificate )
30
th
December 1988



Photograph

2

7. Are you a citizen of India by birth or
by domicile?
By birth
8.
Please state your category (SC/ST/OBC/PD/General) General
9. If the appointment is offered, how
much time would you need before
joining the post?
Immediate
10. If you are employed, please state your
present scale of pay, basic pay and
AGP/GP
Not applicable
(Please attach true copy of certificate in case of SC/ST/OBC/PD)

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5

Research & Development, Training, Project, Publication etc.:
(a) Please attach a list of your Research & Development / Industrial/Training experience
(b) Please state the following in the format below:
No. of Ph.D. thesis guided Projects involved with amount
(separate sheet may be used)
No. of PG
projects guided
Completed On-going Sponsored Consultancy
No. of
Patents

(c) Please state no. of publications (Published/Accepted) in the format below:
In Journals (refereed) In Conferences
Refereed Un-refereed
National

International
National International National International

Technical
Reports

(d) Citation of your published papers:


(e) Please list most recent / important research publications (last two / three years) in the format below :
Name of the journal
Month & year of
publication
Title of the research
paper
Single or with Co-
author(s)

(f) Books published:

(g) Book chapters written:
13.
(For each of the above items, please give full details in separate sheets)
(a) Teaching experience No. of years: No. of different courses taught:
Please give a list of courses taught on a separate sheet with course titles, level (UG/PG) and number of
times taught
(b) Areas of specialization
14.
(c) Title of your Ph. D. Thesis

6

(d) Name of your Ph.D. Supervisor
(e) Please describe your Ph.D. work briefly on a separate sheet [1 page font size 10 (Font: Times New
Roman)]. Also detail the areas of interest with work done in each case (if any). Please attach additional sheets
wherever necessary

(f) Laboratory Experience : Please describe, in brief on a separate sheet, your experience in (i) Setting up
teaching and research laboratories (ii) Conducting laboratory courses & (iii) Using different types of
instruments, systems, computers etc.
(a) Awards and honours:

(b) Fellow of professional body:
(c) Member of professional body:


(d) Editorial board memberships:


15.
(e) Seminars/conferences organized:


16. Did you previously apply for any
post in this Institute? If so, give
particulars and approximate
date:
Not Applied
17. Additional Remarks:
(Applicants may mention here any
special qualifications or
experience, e.g. in organisations
which have not been included
under the heads given above)


Professional diploma in Aviation and hospitality Management




7

18.
Name, Designation and
Address (along with
phone no/ email) of three
referees who are
acquainted with your
research work.

Please request them to
send the reference letters
to the Registrar, BIT
Mesra by email to
registrar@bitmesra.ac.in
and hard copy by post









1.







2.






3.






19.
Your future research
plan at BIT
I have already enrolled myself in Ph.D programme at Jaipur Campus. I will
surely work hard to gain further knowledge and expertise in management
discipline and would also publish research paper so that I can explore new
areas.
20. Details of enclosures
sent with the
application
Mark sheets (X,XII), Degree (Graduation), Provisional Certificate(Post
Graduation), Fee Receipt(Ph.D), Resume, List of Subjects taught,
Experience Certificate


21. Details of Application
Fee (the applicant who have
already sent the fee against
previous Advt. GO / Rectt /
2013-14 /2173, dated. June 10,
2013, need not send the
application fee)
D.D.No.:_____________________ Date______________
Amount____________/ Name of issuing
bank____________________________________________ Branch Name:
_________________________________
I hereby declare that I have carefully read and understood the instructions and particulars supplied to me
and that all the entries in this form are true to the best of my knowledge and belief.





________________________
Date: ................................ Signature of the Candidate

8


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/
M
.
A
.



B
o
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k
(
s
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(
s
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:

P
h
o
n
e

a
n
d

M
o
b
i
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e

N
u
m
b
e
r
:


0
1
4
1
-
2
7
8
5
1
5
6
,

9
7
8
5
8
2
1
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7

P
h
.
D
.


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s
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.
:


C
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a
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E
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D
h
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a
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G
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3
0
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1
2
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1
9
8
8

A
s
s
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P
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S
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R
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1
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e
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1

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1
0

m
o
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s

2
.

3
.

4
.

5
.


A
w
a
r
d
(
s
)
:





_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_

D
a
t
e
:

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
























































































































S
i
g
n
a
t
u
r
e

o
f

t
h
e

C
a
n
d
i
d
a
t
e