Loreto College Recruitment

Form of Application for Post of Counsellor (part-time)

1. Personal Details

Name (Block Letters)*

Father / Mother Name*

Date of Birth*

Age (Years)*

Gender*

Nationality*

Category*

Mobile*

Email*

Address for Communication*

Permanent Address*

Photograph (JPG ≤ 200KB)*

Accepted format: JPG/JPEG only. Maximum size: 200KB

Signature (JPG ≤ 200KB)*

Accepted format: JPG/JPEG only. Maximum size: 200KB

Caste Certificate (PDF ≤ 500KB – SC/ST/OBC only)*

Accepted format: PDF only. Maximum size: 500KB

2. Educational Qualifications

(Minimum Qualification: M. Phil in Clinical Psychology and a valid registration number issued by the Rehabilitation Council of India.)

Educational qualifications (arranged chronologically, starting from Matriculation/S.F./H.S. or equivalent, Graduation, specifically mentioning Honours or Pass, Post-graduate Degrees etc. : (upload relevant documents)

Secondary

Examination Level

Institution

Board / University

Examination Passed

Year of Passing

Class / Division

% of Marks

Subjects Studied

Any other information

Upload Relevant Educational Documents (PDF ≤ 500KB)

Higher Secondary

Examination Level

Institution

Board / University

Examination Passed

Year of Passing

Class / Division

% of Marks

Subjects Studied

Any other information

Upload Relevant Educational Documents (PDF ≤ 500KB)

Bachelors

Examination Level

Institution

Board / University

Examination Passed

Year of Passing

Class / Division

% of Marks

Subjects Studied

Any other information

Upload Relevant Educational Documents (PDF ≤ 500KB)

Masters

Examination Level

Institution

Board / University

Examination Passed

Year of Passing

Class / Division

% of Marks

Subjects Studied

Any other information

Upload Relevant Educational Documents (PDF ≤ 500KB)

M.Phil

Examination Level

Institution

Board / University

Examination Passed

Year of Passing

Class / Division

% of Marks

Subjects Studied

Any other information

Upload Relevant Educational Documents (PDF ≤ 500KB)

Ph.D.

Examination Level

Institution*

Board / University*

Examination Passed*

Year of Passing*

Class / Division*

% of Marks*

Subjects Studied

Any other information

Upload Relevant Educational Documents (PDF ≤ 500KB)

Any other (if applicable)

Examination Level

Institution

Board / University

Examination Passed

Year of Passing

Class / Division

% of Marks

Subjects Studied

Any other information

Upload Relevant Educational Documents (PDF ≤ 500KB)

NET / SET Qualification

NET / SET Qualified*

Upload NET / SET Certificate (PDF ≤ 500KB)*

Accepted format: PDF only. Maximum size: 500KB

RCI License

Upload Relevant RCI License (PDF ≤ 500KB)

Publication in Journals (last 5 yrs) (if any) (Please upload cover page and 1st page of each article merged as one document in pdf within 500 kb)

Publications in Journals Last 5 Years

Title of Paper

International/National with ISSN

ISSN NUMBER

Name of the Journal with Volume No. and Issue No.

Year of Publication

No. of Authors (1st Author or Co-Author)

Merged Publication PDF (Cover + First Page ≤ 500KB)

Books / Book Chapters Last 5 Years (if any)

Book or Book Chapter

Title of the Book/Book Chapter

Name of Publisher

ISBN

Year of publication

Author/Editor/Co-editor

Merged Book / Chapter PDF (≤ 500KB)

Paper presentations in Conferences (1) (if any)

Paper Title

Organizer

Upload Presentation Certificates (PDF ≤ 500KB)

Paper presentations in Conferences (2) (if any)

Paper Title

Organizer

Upload Presentation Certificates (PDF ≤ 500KB)

Paper presentations in Conferences (3) (if any)

Paper Title

Organizer

Upload Presentation Certificates (PDF ≤ 500KB)

3. Professional Experience

Institution

Designation

Nature of Work

From

To Present

Scale of Pay and Pay drawn

Experience Certificate (PDF ≤ 500KB)

Research Experience: (if any)

Project Title

Funding Body

Funding Amount

Institution/Organization

Ongoing/Completed with year

Teaching Experience Full-Time (if any)

Institution

Designation

From

To Present

Scale of Pay and Pay drawn

Teaching Level UG / PG

Teaching Experience Certificate (PDF ≤ 500KB)

Teaching Experience Part-Time (if any)

Institution

Designation

From

To Present

Scale of Pay and Pay drawn

Teaching Level UG / PG

Teaching Experience Certificate (PDF ≤ 500KB)

If selected, time required before joining**

Approximate time required if you cannot join immediately *

Give the names of not more than two referees (with designation and full address, email and mobile number)

Reference-1*

Reference-2*

(One Hardcopy of all documents and testimonials to be brought on the day of the Final Interview). Kindly save the document once submitted and take a print out

Declaration

I certify that the above statements are true to the best of my knowledge and belief.
I accept that in case any information is found to be incorrect, or in case there is any suppression of fact, this application is liable to be rejected.

Submitting your application...

Form of Application for Post of Counsellor (part-time)