Application for the Post of Lecturer

Notification No :ADE
Department / Programme : Mechanical Engineering & Mechanical (HSC) 2/5/2019-2020
Faculty/ College/ Institute/ Office : Polytechnic Notification Date :06 Aug
2019

Application Form No 800008308

Name Miss. BHOOMIKA RASHMIKANT SHUKLA

Father's Name RASHMIKANT SHUKLA

Mother's Name KALPANABEN SHUKLA

Address & Contact Details 202 , INDRAPRASTH FLAT, 13, SARASWATI SOCIETY ,--
Landmark: -- Area:VASNA ROAD
City: VADODARA, Dist: VADODARA,INDIA, Pin: 390007
State: GUJARAT, Phone: --, Mobile: 91-9998217902

Email ID: bhoomika2910@gmail.com

Gender Female Date of Birth : 29/10/1984 Marital Status Married

PAN Card No -- Aadhar Card No : -- Passport No. --

Religion Hindu

:: Reservation

Category : UnReserved (Open)

Whether You belongs to PWD (People With Disabilities) Category? No

:: Qualifying Examination

Month-
Percentage
S.N. Exam Passed Specialization Board/University Year of Class CGPA/Grade
(%)
Passing

GUJARAT SECONDARY AND HIGHER June

1. 10th Standard None Distinction 89.71 --
SECONDARY EDUCATION BOARD 2000

GUJARAT SECONDARY AND HIGHER May

2. 12th Standard Science First 66.77 --
SECONDARY EDUCATION BOARD 2002

June
3. B.E./B.Tech Mechanical Gujarat University First 63.47 --
2006

MASTER OF Gujarat Technological University July

4. M.E./M.Tech Distinction 78 8.38
ENGINEERING (GTU) 2014

Areas of Specialization

Areas of Specialization Not Entered

D.Sc/D.Litt Details

D.Sc/D.Litt Details Not Entered

NET Details

NET Details Not Entered

SET (State Eligibility Test) Details

SET Details Not Entered

GSET Details

GSET Details Not Entered

Whether M.Phil is awarded as per the UGC Regulation 2009.

M.Phil Details Not Entered

Whether PhD is awarded as per the UGC Regulation 2009.

Ph.D. Details Not Entered

 PhD Supervision Details
No PhD Supervision Details Found
:: Work Experience

Organization Nature of Appointment Pay From Exp. (In

S.N. Post Held To Date Exp. Type Past/Present
Name (Permanent/Temporary) Scale Date Months)

ITM UNIVERSE ASSISTANT 4 Year &

1. , VADODARA PROFESSOR
Permanent 15600 10/06/2014 13/11/2018 Academic Past
5 Months

PARUL
INSTITUTE OF 3 Year &
2. ENGINEERING
LECTURER Permanent 01/01/2009 14/08/2012 Academic Past
7 Months
& TECHNOLOGY

SEALING SALES 1 Year &

3. TECHNOLOGY COORFINATOR
Permanent 06/02/2007 10/05/2008 Administrative Past
3 Months

Professional Development, Co-Curricular and Extension Activities

No Records Available - 1. (a) Student related Co-Curricular, Extension and Field based Activities.

No Records Available - 1. (b) Contribution to Corporate Life and Management.

No Records Available - 1. (c) Professional Development Activities.

Academic / Research (A/R) Score ICT Information (UGC)

Academic and Research Contributions

No Records Available - 1. (a) Research Papers in Peer-Reviewed or UGC listed Journals.

2. Publications (Other than Research Papers)

No Records Available - 2. (a) Books Authored which are Published.

No Records Available - 2. (b) Translation Works in Indian and Foreign Languages by Qualified Faculties (Chapters/Articles in Books).

3. Creation of ICT Mediated Teaching Learning Pedagogy and Content and Development of New and Innovative
Courses and Curricula

3. (a) Development of Innovative Pedagogy

Sr.
Description Institute / Agency for which it is developed A/R Score Evidence/Proof Doc
No.

1. No Proof

3. (b) Design of New Curricula and Courses.

Sr.
Description Institute / Agency for which it is developed A/R Score Evidence/Proof Doc
No.

1. No Proof

3. (c) MOOCs

3 (c). (a) Development of Completed MOOCs in 4 Quadrants (4 Credit Courses) (In case of MOOCs of lesser Credits, 05
Marks/Credit)
Sr.
Description Institute / Agency for which it is developed A/R Score Evidence/Proof Doc
No.

1. No Proof

3 (c). (b) MOOCs (Developed in 4 Quadrant) per Module / Lecture.

Sr.
Description Institute / Agency for which it is developed A/R Score Evidence/Proof Doc
No.

1. No Proof

3 (c). (c) Content Writer/Subject Matter Expert for Each Module of MOOCs (at least one Quadrant)
Sr.
Description Institute / Agency for which it is developed A/R Score Evidence/Proof Doc
No.

1. No Proof

3 (c). (d) Course Co-ordinator for MOOCs (4 Credit Course) (In case of MOOCs of lesser Credits, 02 Marks/Credit)
Sr. Description Institute / Agency for which it is developed A/R Score Evidence/Proof Doc
No.

1. No Proof

3. (d) E-Content

3 (d). (a) Development of E-Content in 4 Quadrants for a Compelete Course/E-Book.

Sr. Module Content Institute Period Period Development A/R Evidence/Proof
No. Name Subject Agency From To Level Score Doc

1. No Proof

3 (d). (b) E-Content (Developed in 4 Quadrants) per Module.

Sr. Module Content Institute Period Period Development A/R Evidence/Proof
No. Name Subject Agency From To Level Score Doc

1. No Proof

3 (d). (c) Contribution to Development of E-Content Module in Complete Course/Paper/E-Book (at least one Quadrant)
Sr. Module Content Institute Period Period Development A/R Evidence/Proof
No. Name Subject Agency From To Level Score Doc

1. No Proof

3 (d). (d) Editor of E-Content for Complete Course/Paper/E-Book

Sr. Module Content Institute Period Period Development A/R Evidence/Proof
No. Name Subject Agency From To Level Score Doc

1. No Proof

4. Research Guidance

4. (a) Research Guidance

Program Thesis Submitted Degree Awarded API Score Annexure No

M. Phil / P.G Dissertation

Ph. D

4. (b) Completed Research Project(s)

Whether Whether
Total
Outcome / Final
Whether Name of Grants /
Outputs Report
Sr. Major or Sponsoring Date of Date of Funding A/R Annexure
Title Sent to Published
No. Minor / Funding Commencement Completion Amount Score No
Sponsoring as
Project Agency Received
Govt. Monograph
(Rs.)
Agency Book

1.

4. (c) Ongoing Research Projects.

Whether Whether
Total
Outcome / Final
Whether Name of Grants /
Outputs Report
Sr. Major or Sponsoring Date of Date of Funding A/R Annexure
Title Sent to Published
No. Minor / Funding Commencement Completion Amount Score No
Sponsoring as
Project Agency Received
Govt. Monograph
(Rs.)
Agency Book

1.

4. (d) Consultancy
Sr. Date of Date of Annexure
Title / Subject of Research Project (s) Name of Agency A/R Score
No. Commencement Completion No

1.

5. Patents / Policy Docs / Awards / Fellowship

5. (a) Patents
Sr. No. Patent Status Description International/National level Patents A/R Score Evidence/Proof Doc

1. 0 0 No Proof
 5. (b) Policy Document (Submitted to an International body / Organization like UNO/UNESCO/World Bank/International
Monetary Fund etc. ot Central Government or State Government)
Sr. No. Description International/National level Patents A/R Score Evidence/Proof Doc

1. 0 No Proof

No Records Available - 5. (c) Awards / Fellowships.

6. Invited Lectures / Resourse Person / Paper Presentation in Seminars / Conferences / Full Paper in Conference
Proceedings (Paper Presented in Seminars / Conferences and also Published as full Paper in Conference
Proceedings will be counted only once.)

No Records Available - 6. (a) Invited Lectures delivered at National or International Conferences / Seminars.

No Records Available - 6. (b) Papers presented at National or International Conferences / Seminars.

Academic / Research (A/R) Score Summary - Academic and Research Contributions

Total A/R Score

Sr. A/R Group A/R
Sub-Category calculated by
No. Score Score
Candidate

1. (a) Research Papers in Peer-Reviewed or UGC listed Journals 0 0 0

2. Publications (Other than Research Papers)

(a) Books Authored which are Published by:

International Publishers 0

National Publishers 0

Chapter in Edited Book 0 0

Editor in Book by International Publisher 0 0

Editor in Book by National Publishers 0

(b) Translation Works in Indian and Foreign Languages by Qualified Faculties

Chapters or Research Paper 0

0
Book 0

Creation of ICT Mediated Teaching Learning Pedagogy and Content and Development of New and Innovative Courses
3.
and Curricula

(a) Development of Innovative Pedagogy 0 0

(b) Design of New Curricula and Courses 0 0

(c) MOOCs

(a) Development of Completed MOOCs in 4 Quadrants (4 Credit Courses) (In case of

0
MOOCs of lesser Credits, 05 Marks/Credit)

(b) MOOCs (Developed in 4 Quadrant) per Module / Lecture 0

(c) Content Writer/Subject Matter Expert for Each Module of MOOCs (at least one 0
0
Quadrant)
0
(d) Course Co-ordinator for MOOCs (4 Credit Course) (In case of MOOCs of lesser
0
Credits, 02 Marks/Credit)

(d) E-Content

(a) Development of E-Content in 4 Quadrants for a Compelete Course/E-Book 0

(b) E-Content (Developed in 4 Quadrants) per Module 0

(c) Contribution to Development of E-Content Module in Complete Course/ Paper/ E- 0

0
Book (at least one Quadrant)

(d) Editor of E-Content for Complete Course/ Paper/ E-Book 0

4. (a) Research Guidance

Ph.D. 0 0
0
M. Phil / P.G.Dissertation 0

(b) Research Projects Completed

More than 10 lacks 0

0
Less than 10 lacks 0

(c) Research Projects Ongoing

More than 10 lacks 0

0
Less than 10 lacks 0
 (d) Consultancy 0 0

5. (a) Patents

International 0
0
National 0

(b) Policy Document (Submitted to an International body / Organization like

UNO/UNESCO/World Bank/International Monetary Fund etc. or Central Government or State
Government)

International 0
0
National 0 0

State 0

(c) Awards / Fellowships

International 0
0
National 0

Invited Lectures / Resourse Person / Paper Presentation in Seminars / Conferences / Full Paper in Conference
6. Proceedings (Paper Presented in Seminars / Conferences and also Published as full Paper in Conference Proceedings
will be counted only once.)

International (Abroad) 0

International (Within Country) 0

0 0
National 0

State / University 0

Grand Total 0

:: Additonal Information : Teaching / Research / Additional Info and Orientation / Refresher Course / QIP / Other

Teaching Experience

PG (In Years) 0

UG (In Years) 8

Diploma (In Years) 0

Research Experience

Total Number Of Years 0

Years Spent In M.Phil. 0

Years Spent In Ph.D. 0

Years Of Guiding M.Phil. 0

Years Of Guiding Ph.D. 0

Additional Information

Field Of Specialization Under The Subject/Discipline CAD /CAM

Orientation / Refresher Course / QIP Attended / FDP/ Short Term Certificate

Yes
Courses / Other?

Organizing
Sr.No. Name Of The Course/Programme Place From Till
Agency

ITM UNIVERSE , 03 May 06 May

1. TEACHING & RESEARCH METHODOLOGY ITM UNIVERSE
VADODARA 2017 2017

ITM UNIVERSE ,
2. FDP ON AUTOCAD 09 Jan 2017 13 Jan 2017 ITM UNIVERSE
VADODARA

FINITE ELEMENT METHOD: THEORY &

3. INDUS UNIVERSITY 27 Jun 2016 01 Jul 2016 INDUS UNIVERSITY
PRACTICE

4. FDP ON ENTREPRENEURSHIP ITM UNIVERSE 19 Jun 2017 03 Jul 2017 CED GUJARAT

Understand Language but cannot Mother Examination(s) Passed,

Sr.No. Language Speak Read Write
read,write or speak Tongue if any

1. Gujarati Yes Yes Yes No No --

2. Hindi Yes Yes Yes No No --

3. English Yes Yes Yes No No --

:: References Details

Reference 1: (Must be From Current Employer)

Name: SHALINI SINGH | Designation: ASSISTANT PROFESSOR | Address: B40 Sayaji Township , New VIP road . | EmailID:
SINGHSHALINI0905@YAHOO.CO.IN | Mob No: 91-9429885842

Reference 2: (Must be From Outside)

Name: HETAL FFITTER | Designation: VALUE ENGINEER | Address: 301 , NILKANT APARTMENT , HARINAGAR GOTRI ROAD. | EmailID:
EHENF@YAHOO.CO.IN | Mob No: 91-9824006431

Reference 3: (Must be From Outside)

Name: MEHUL CHUDHARY | Designation: ITI INSTRUCTOR | Address: SURAT SURAT | EmailID: MEHUL0512@GMAIL.COM | Mob No: 91-
9913676504

:: Future Plans

Your Vision for the Department / Programme / Institution

• Students are representative of department & institute in the field so to prepare students for professional excellence. To undertake
consultancy type work from industry for research related work & for the growth of department.

Your Contribution in the University/College/Institute [where you are currently employed]

(Academic/Research/Extension/Academic Administration)
• NA

Three Major Strengths, Supporting Candidature for the Post for which you have Applied
• 1. Ability to Communicate Clearly 2. Prepared and Organize 3. Sound Character

Future Academic Development Plan for your own self

• I would like to implement new and recent techniques for teaching. As a teacher to learn more and more to keep updated with the
latest trends and practices to guide the students.

Any other Information relevant for the Post Applied for

•-

:: Uploaded Required Documents

S.N. Uploaded Required Documents Is Uploaded

1. School Leaving Certificate-LC Yes

2. SSC/Matriculation Yes

3. HSC/Intermediate Yes

4. Graduation Marksheets Yes

5. Graduation Degree Certificates Yes

6. PG Marksheets Yes

7. PG Degree Certificates Yes

8. Experience Ceritificate Yes

9. Experience Certificate 2 Yes

:: Legal Declaration

● Whether any Legal Matter/Inquiry is pending against You?

NO

● Whether You have been found Guilty of Moral Turpitude?

NO

● Whether any Legal Matter/Inquiry is pending against You?

NO
To, The Maharaja Sayajirao University of Baroda

DECLARATION

1. I have read the Notification very carefully and according to the best of my understanding, I meet and fulfill all
the eligibility criteria.

2. I hereby solemnly affirm that the information given in this application form is true and correct to the best of
my knowledge and belief. I understand that if any of the information given by me in this form is found incorrect,
my candidature is liable to be cancelled at any stage without assigning any reason / without prior notice.

3. I also affirm that I have never been convicted by court of low or suspended / dismissed by any employer/
organization from job.

4. There are no legal matter/inquiry pending against me in my present and/or past job.

5. I will abide by all rules of The Maharaja Sayajirao University of Baroda as well as Govt. of Gujarat, UGC, MHRD
and other statutory bodies/councils etc.

6. I confirm that I shall abide by the decision/s of the University with regard to my application.

UNDERTAKING

I Miss. BHOOMIKA RASHMIKANT SHUKLA, Son / Daughter of RASHMIKANT SHUKLA, resident of 202 ,
INDRAPRASTH FLAT, 13, SARASWATI SOCIETY ,--
Landmark: -- Area:VASNA ROAD
City: VADODARA, Dist: VADODARA,INDIA, Pin: 390007
State: GUJARAT, Phone: --, Mobile: 91-9998217902 hereby confirm and undertake that –

1. I have read and understood all the terms & conditions as stated in the aforesaid Advertisement for the
notified post.
2. I fulfill the conditions as specified in the aforesaid Advertisement published for the Mechanical Engineering
& Mechanical (HSC) and accordingly I have submitted my application.
3. All the particulars provided by me in this application are true, correct and complete to the best of my
knowledge and belief.
4. I shall produce all the original documents along with self-attested copies at the time of next stage of
recruitment process as and when required by university, failing to which I fully understand that my
candidature shall deemed automatically canceled without assigning any reason(s) what so ever.
5. In case any false particulars given by me in this application, I shall be liable for being blacklisted or
debarred from all further selection processes of the Selection Committee and I shall also be liable for
disciplinary proceedings.
6. If called for an interview, I shall attend the interview at own expense.

Place: Signature:
Date: Name: Miss. BHOOMIKA RASHMIKANT SHUKLA
Forwarded through:

Employees of The Maharaja Sayajirao University of Baroda:

I herewith forward the application of

____________________________________________________________________________________________
for the post of
____________________________________________________________________________________________
at The Maharaja Sayajirao University of Baroda. He/she is working as a
____________________________________________________________________________________________.
I have "No Objection" to his/her application being considered and, if selected, for his/her appointment to the concerned post in
the University.

Name and Signature of the Dean / Principal / Head of the

Name and Signature of the Head of the Department
Institution

Date and Place:

For candidates employed outside of The Maharaja Sayajirao University of Baroda:

I herewith forward the application of Mr./Ms./Dr./

____________________________________________________________________________________________ for the
post of
________________________________________________ at
The Maharaja Sayajirao University of Baroda. He/she is working as a
____________________________________________________________________________________________ in our
organization on a temporary / permanent basis. We have "No Objection" to his/her application being considered and, if
selected, for his/her appointment to the concerned post in your University.

Name and signature of the authority competent to forward with seal

Date and Place: