Indian Institute of Management Sirmaur: Annexure - A for Deputation

Page 1 of 3 ANNEXURE - A Application for the post of SUPERINTENDING ENGINEER on Deputation 1 . Name and Address (in BLOCK LETTERS) 2. Date of Birth 3. Organization Name 4 . Date of retirement under Central/ State Government rules 5 . Educational Qualification 6 . Details of employment, in chronological order starting from the current job. Enclose a separate duly authenticated by your signature, of the space below is insufficient: Office/ Institution Post held From (DD/MMM/YYYY) To (DD/MMM/YYYY) Pay Scale and Basic Pay, Total Emoluments Nature of Duties (in detail) Page 2 of 3 7 . Number of years/ Period of Deputation so for held and name of organization, level, basic pay; if any 8 . Additional details about present employment. Please state whether working under (indicate the name of your employer against the relevant column): (i) Central Government (ii) State Government (iii) Autonomous Organization (iv) Public Sector Undertakings (v) Universities (vi) Others 9 . Additional information, if any, that you would like to provide in support of your suitability for the post.

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