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Candidate’s name in full
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PIN :
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PIN :
Telephone No. (with STD Code)
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Mobile No.
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Fax No. (with STD code)
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E-mail address
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Date of Birth
:
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Nationality
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Category(SC/ST/Physically
and icapped (PH)/ Gen.)
:
Designation & complete postal
address of current employer
:
Educational Qualifications:
Examination
University/ Board
Year of
Passing/
Award
Division
% age of
marks/
grade
Subjects
Matric /SSC/
10th Class
10+2 or
equivalent
*Graduation or
equivalent
* Post Graduation
or equivalent
M. Phil
** Title of Ph.D. Thesis
Ph. D. **
Any other
*
Indicate Degree Awarded
Field of specialization
:
Experience (Please start with the latest):
Name of the institution
/organization
Post held
Pay scale From To
Period
Nature of
work
Last basic
pay
(in Rs.)
Reasons for
leaving
(wherever
applicable)
Date of submission of
Ph.D. Thesis
:
Date
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February
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October
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December
Year
1927
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Month & year of passing
of NET or similar test
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Date
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January
February
March
April
May
June
July
August
September
October
November
December
Year
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1928
1929
1930
1931
1932
1933
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2000
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2004
2005
2006
Roll No.
:
Teaching/ Research Experience
:
Total teaching experience
(UG & PG both)
:
Year
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
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1981
1982
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1984
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1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
Month
January
February
March
April
May
June
July
August
September
October
November
December
Guidance/supervision of
Ph.D. Thesis
:
No. of candidates registered
for supervision at present
:
No. of candidates who
have successfully completed Ph.D.
:
No. of candidates who
have successfully completed M. Phil
:
Research
Number of years
:
Name of the institution(s)
where work done
:
Number of publications (Please attach one copy each of three publications which
you consider most important along with complete list of publications)
Publications
Capacity
Published
Accepted
for
Publication
Under
Preparation
(a) Books
Independently
Jointly
(b) Papers/
Articles
Independently
Jointly
(c)Abstracts
Independently
Jointly
(d) Patents
Independently
Jointly
Language(s) Known
(Please tick)
Read
Write
Speak
(i) Hindi
(ii) English
Present Basic Pay: Rs.
in the Pay Scale of Rs.
Basic Pay acceptable:
Rs.
Period required for joining, if selected:
Any other relevant information you wish to give in support of your candidature:
Name and address of two persons (other than relatives) to who references can be made:
1.
2.
Certified that the information given by me in this application form is complete and correct to the best of my knowledge & belief and nothing has been concealed there from. I also understand that in case any information is found to be false, my services shall be liable to be terminated without notice.
I have read the instructions and guidelines issued for the candidates.
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