ONLINE APPLICATION FORM FOR
PROGRAM MANAGER- LEADERSHIP DEVELOPMENT for REACH TO TEACH

Position Code: PM-LD-RTT Location(s) of Vacancies: Ahmedabad/ Gandhinagar, Gujarat

1. Personal Details:

Applicant's Name:
Father/Husband's Name: Date of Birth:
Gender: Mobile No.:
Email ID: Alternate Contact No.:

2. Address:

Current City of Residence: City of Domicile(State):
Correspondence/ Current Address with Pin Code: Permanent Address with Pin Code

3. Qualification Details:

Name of Degree/Diploma
Specialization & Principal Subjects
Name of University/ Institute (City)
Passing Year
Marks (in %)/ GPA

4. Employment Details. (Please start with current/ most recent experience. If you have worked in more than one area/ post within the same organization, please enter details of the same separately):

# Name of Organisation Designation/ Title Key Responsibilities From To Location (City, State)
Current Employment Details:
1.
Other Employment Details:

5. Areas of Specialisation. (Please note that your response to this part of the application form shall be scored and qualitatively assessed to confirm your suitability for the post. We urge you to carefully fill your response and provide adequate details.):

# Name of Organisation Details of Key Job Responsibilities, Duties, Tasks Handled and/or Accomplishments to Demonstrate Relevance of Experience in Requisite Areas Duration of Experience (in months) Location (City, State)
 
1 Experience in leading multi-stakeholder transformation projects, preferably focused on leadership development; Please also highlight experience in the education sector (Please fill details of your experience in the row below):
 
2 Experience in developing standards for measuring project performance and operationalizing systems for collecting feedback regularly, flagging risks in time and taking effective measures for mitigation (Please fill details of your experience in the row below):
 
3 Experience in addressing challenges and bottlenecks, arising during implementation of the project and strategizing long term interventions for leadership development (Please fill details of your experience in the row below):
 
4 Experience in developing and maintaining relationships with the government, other relevant stakeholders and ensuring coordination and coherence in the support provided to the respective departments (Please fill details of your experience in the row below):

6. Present Salary and Allowances in INR lacs per annum. (Please use this section to report your present gross salary):

a. Annual Salary: b. Annual Allowances* if any. (Excluding components already included in a.): c. Gross Annual Salary and Allowances:
*Please exclude travel/ per diems and/or other allowances that comprise reimbursement of expenses incurred by you.

7. Computer Skills:

Application
 
(1) Proficiency in use of MS Office
a. Excel
b. Word
c. Power Point

8. Language Proficiency:

Language Read Write Speak
English
Hindi
Gujarati
Ability and willingness to travel extensively , based on the needs of the job. Joining Time (in days):

9 . Referees. (Please list three supervisors to whom you have reported professionally in the recent past, whom we can immediately contact for reference checking. Please note that reference checking shall only be initiated in case the applicant has been found suitable pursuant to final interview ):

# Name Address Email Phone Organization Designation Your Professional Relationship With and Year of Reporting to Referee
 
1.
 
2.
 
3.

10. Upload CV:

Certification: I certify that to the best of my knowledge and belief, the details submitted by me correctly describe my qualification, experience and other information, as requested by SAMS.