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Post applied for :
Candidate’s name in full :
Father’s/ husband’s name :
Marital status : Sex :
Permanent residential address :
      PIN :
Address for correspondence :
      PIN :
Telephone No. (with STD Code) :
Mobile No. :
Fax No. (with STD code) :
E-mail address :
Date of Birth :
Nationality :
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
:
Month & year of passing
of NET or similar test
:
Roll No. :
Teaching/ Research Experience:
Total teaching experience
(UG & PG both)
:
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.