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Draft No: Dated: Rs:

APPLICATION FORM

1. Project/Scheme No:

2. Name of the Post: Passport size


photograph

3. Name of the Candidate:

4. Father’s Name:

5. Mother’s Name:

6. Date of Birth:

7. Permanent Home Address:

8. Contact No. and Email ID:

9. Martial Status:

10. Academic qualification:

Examination Year of Name of the Marks Division/percentage of


Passing Board/University obtained marks
OCPA/Univ.
11. NET (Yes/No)

GATE (Yes/No)

12. Title of Thesis: 1. M.Sc.

2. Ph.D

13. Any Award/Medal

14. Experience
(Duration, nature of duty and output)

15. Publications (Authors, Year, Title, Journal, Paper (Included in NAAS list
of journals)

16. Two Reference: 1.

2.

17. Have you ever been arrested/convicted in criminal case? If so, please give
details and also present status of the case.

The information given above by me are true to the best of my knowledge and belief. If any
information is being found false, my candidature/services, if selected, may be terminated
without any notice.

Dated: (Signature of the applicant)

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