Shivaji University, Kolhapur: (Online Application Form For Post of System Analyst)

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Shivaji University,Kolhapur

(Online Application form for Post of System Analyst)

To,
The Registrar,
Shivaji University,
Kolhapur-416004

Sir,

I have submitted the online application form .The details are as follows.

Online Application No. : 22 Post Code : SA

Name of Applicant : PATIL SMITA PRADIP

Birth Date : 27-Sep-1986 Gender : Female Maritial Status : Married

Category : OPEN Mother Tounge : Marathi Knowledge of Marathi : Yes

Nationality : Indian Physically Handicaped : No

Telephone : 02164242022 Mobile : 9890944280 E-Mail : [email protected]

Present Position and Pay : visiting lecturer in gce and gpk karad. 20000/-

Expected Basic Pay : 20000/- Qualified M.phil and pursuing Ph.D.

Fee Details :

Fee Amt. DD/Chalan No. DD Date Bank Name

500 296994 15/03/2016 Bank of Maharastra

Qualification Details
Examination Subject with Passing Month/ Name of College and
Passed Specialization Year Percent Grade Board/University

M.Phil Computer application June-2014 oGrade Shivaji University Kolhapur


Shivaji University, Kolhapur

B.C.A. Computer application April-2006 71.75 1st with Y.M.I.M.Malkapur Karad


distinction Shivaji University, Kolhapur

H.S.C. science February-2003 56.33 2nd Y.C.College of Science Karad


Maharashtra State Board of Secondary & Higher
Secondary Education, Pune,

S.S.C. Marathi March-2001 75.46 1st with Premalatai Chavan Kanyashala


distinction Maharashtra State Board of Secondary & Higher
Secondary Education, Pune,

M.C.A. Computer application April-2009 74.59 1st with Y.M.I.M.Malkapur Karad


distinction Bharati Vidyapeeth, Pune

Certificate Course Complit with Hardware August-2006 A Shupra Computers Karad


and Networking Pune University, Pune

MSCIT Information Technology September-200 71.00 Sunbeam Computing Technology K


3 Maharastra State Board Technical Education
Mumbai
Work Experience Details ,pay and allowances etc.

Designation & Period Name and Address of Employer Pay and Allowances
Appointment Nature (From-To)
Teaching 1/Jul/2007 Shupra Computers, Shaniwar peth Karad 4000/-

to
( Temporary ) 31/Dec/2008

Trainee Software Engineer 31/Dec/2008 Sunbeam Computing Technologis, Karad 5000/-

to
( Temporary ) 30/Jun/2009

Teaching 1/Aug/2009 Power Sol Institute,Pune 11000/-

to
( Temporary ) 20/Dec/2011

Teaching 1/Jan/2012 Government Polytechnic Karad 9000/-

to
( Part Time ) 30/Oct/2015

Teaching 30/Jun/2014 Government College of Engineering Karad 9000/-

to
( Part Time ) 20/Oct/2015
-Prof.P.C.Shetiye. HOD of MCA Department, Government College of
1st Reference Person : -
Engineering, Karad

2nd Reference Person : - -Mr R.V.Mundhe,Government Polytechnic Karad

-Dr Milind Joshi. Internet Cell, Shivaji University Kolhapur.


3hrd Reference Person : -
Notice Period for Joining : - -4 months

Full Address : - -Deepali blog. Backside of Ganesh Mangal Karyalaya, A/P-Malkapur, Tal
-Karad

District : - -Satara

PinCode : - -415539

Telegraphic Address
-
if any,: -

DECLARATION
I hereby declare that, the information in application is true,correct and complete to the best of my knowledge
and belief and nothing has been concealed/distorted.If at any time,I am found to have concealed/distorted any
material information,my appointment shall be liable to be summarily terminated without notice/compensation.
This is to declare that I have never been found/held guilty convicted for any administrative misconduct or any
offence by the concerned appropriate authority/by the Court.Also no case is pending against me in any court of
Law,University or any educational authorities / Institutuion at the time of application (If yes documents to be
enclosed)

Yours Faithfully
Place : -

Date : -
(Signature of the Applicant)

(Name _____________________________________)

Forwarding remarks of the Institution :)

Seal & Signature of Competent Authority

Date : -
Declaration
FORM "A"
(See Rule - 04)

I Shri/ Smt/ Sau ___________________________________________________


Son/Daughter/Husband/Wife of Shri. ______________________________________
aged_______________ years, resident at ___________________________________
______________________________________________________________________
____________________ ______do hereby declare as follows:
1. That I have filled my application for the post of __________________________.
2. I have ____________ (Number) living children as on today, out of which no of children born after
28th March 2005 is _________ (Mention dates of Birth, if any).
3. I am aware that if any total number of living children are more than two due to the children born
after 28th March 2006, I am liable to be disqualified for the same post.

Place :
Date : Signature of Applicant

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