Professional Documents
Culture Documents
Department: ………………………………………………………………..
PASTE HERE A
PAYMENT DETAILS SIGNED COPY OF
Name of the Bank Transaction Date Amount YOUR RECENT
Number PASSPORT SIZE
PHOTOGRAPH
A. General Information:
1. Name in Full ((IN BLOCK LETTERS)…………………………………………………………………….
5. Age (as on the last date fixed for the receipt of application by the University)..….years..….months
6. Nationality …………………………………………….
7. Religion ………………………………………………….
…………………………………………………………………………………………
………………………………………………………………………………………
1
To be supported by appropriate document if yes
B. Educational Qualification:2
Higher Secondary/
Intermediate(10+2)
Bechelor’s dergree
Master’s Degree
M.Phil
Date of award:
DD/MM/YYYY Title of the dissertation
Technical
Qualifications
(if any)
Please attach separate sheet if the space is insufficient for this column
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2
To be supported by copies of appropriate documents.
2. M.Phil Full Time Part Time NA
3. Ph.D Full Time Part Time NA
(Ph.D Course work Marksheet/Certificate to be enclosed)
(4 below is to be responded by applicants seeking exemption from NET/SLET/SET)
4. Was the Ph. D degree awarded is in accordance with the UGC’s minimum standards and procedures for
award of M. Phil/Ph. D degree regulations 2009 2016 ? Yes No
5. In case the Ph. D degree has been obtained from a foreign university/institution was the university/
institution ranked at any point of time amongst the top 500 in the World University Ranking by any one
of the following:
(i) Quacquarelli Symonds (QS)
(ii) the Times Higher Education (THE) or
(iii) the Academic Ranking of World Universities (ARWU) of the Shanghai Jiao Tong University?
Yes No
C. Area of specialization:
D. Teaching/Administrative/Technical/Research Experience 1
Designation Name of the Scale of Pay Nature of Period of Service
organization Appointment
PB GP From To Duration (in months)
Please attach separate sheet if the space is insufficient for this column
E. Whether information as per Table 1 of Part B is attached and provided with the application form :
Yes No
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F. Total number of publications in peer-reviewed or UGC-listed journals:
Name of Title of the Ph.D Status of Ph.D Year of award Department and
the Scholar thesis (ongoing/awarded) (if awarded) University/institution
Please attach separate sheet if the space is insufficient for this column
State whether you have been at any time (a) dismissed, removed or debarred from Service or (b) convicted
by a Criminal Court. (Please tick) Yes No
I hereby declare that all entries made by me in this application are true, complete and correct to the
best of my knowledge and belief. I understand that in the event of any information being found false,
incomplete or incorrect, my candidature/appointment is liable to be cancelled/terminated.
Place ..........................................
Date ............................................
(The endorsement below is to be signed and forwarded by the Head of the Department /Employer in
case of the candidates whether in permanent or temporary capacity failing which the application is
liable to be rejected.)
Sl. No. Academic Record Response Comments Score (for official use)
1 Graduation % of marks
2 Post Graduation % of marks
3 M.Phil. % of marks
4 Ph. D Yes or No
5 NET with JRF Yes or No
NET Yes or No
SLET/SET Yes or No
6 Research Papers published in Number
Peer-Reviewed or UGC-listed
Journals
7 Teaching / Post Doctoral Number of
Experience years
8 International / National Level Number of
Awards awards
(Awards given by International
Organisations/ Government of
India / Government of India
recognized National Level Bodies)
Number of State-Level Number of
(Awards given by State awards
Government)
Total Score (for official use only)
Note: Applicant has to submit self-attested copies of necessary document in support of all their claims.
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