Uko ukyunk egkfogkj ukyunk ekfur fo ofo ky;] lalñfr ea=ky;] Hkkjr ljdkj Nava Nalanda Mahavihara, Nalanda

Transcription

1 (For office use only) Date of Receipt Application: Application Form No. APPLICATION FORM FOR TEACHING POSITIONS Advertisement No. Dated: Post Applied for: Particulars of Demand Draft: Name of the Bank: Branch: Amount: (Rs. 200/- for General and Rs. 50/- for SC/ST/PWD candidates) Please Paste Recent Passport Size Photograph Draft No.: Dated: Personal Details (Use Block Letters) First Name: Middle Name: Last Name: Father s Name: Mother s Name: Date of Birth: / / Age (As on Today): Y M D Category (Gen/SC/ST/PWD) If Physically Disabled: (a) Indicate Category (OH/VH/HH) (b) % of disability ( copy enclosed) Sex (Male/Female): Nationality: Telephone No. Mobile No. ID: Postal Address Permanent Address Page 1 of 14

2 (Please add additional sheets if required, for teaching/research/publication section in the format as in this form) Educational Qualifications Examination Year Main Subject Marks High School /Matriculation (%) College Attended University/Board Points Intermediate Bachelor s Degree Master s Degree M. Phill. In case of Integrated course/programme, the points shall be awarded for both the degrees covered under the course/programme as per the entitlement above. Note: Points to be calculated in accordance with screening/shortlisting standard guidelines available in the other Central University. Degree Year of Award Thesis Title Date of Registration Date of submission Points Ph.D. Other Distinctions Note: Points to be calculated in accordance with screening/shortlisting standard guidelines available in the other Central University. Whether Qualified UGC/ CSIR Certificate No. NET / NET-JRF Whether exempted from NET: Yes/ No I certify that I am exempted from NET in accordance with the provisions of UGC Regulations, Page 2 of 14

3 Research Experience Name of University/ College/Institution Post held/designation From To Experience Note: Points to be calculated in accordance with screening/shortlisting standard guidelines for direct recruitment for the post of Assistant Professor, Associate Professor and Professor available in the other Central University. Full-time Teaching Experience Name of University / College/Institution Designation Status (Permanent/ Temporary/ Ad-hoc) Classes Taught Course/ Subject From To Experience (in Y-M) Note: Points to be calculated in accordance with screening/shortlisting standard guidelines for direct recruitment for the post of Assistant Professor, Associate Professor and Professor available in the other Central University. Present Employment Details Please indicate, whether you are currently employed: Yes/ No (if yes give details and attach self - attested copy of the appointment letter) Organization Name Position Held Date of Appointment Status (Permanent/ Temporary/ Ad-hoc) Page 3 of 14

4 ACADMIC PROFILE Publication in Relevant Area Only is to be calculated in accordance with screening/shortlisting guidelines for direct recruitment for the post of Assistant Professor, Associate Professor and Professor available in the other Central University. I certify that the points claimed on the basis of being the first, sole or corresponding author is based on the convention adopted by the journal/other publication. Research Papers/Review Articles/ Conference Proceedings Title with page nos. Publication Type Journal ISSN/ISBN No. Refereed or Not Sole / Co- Author Research Publication Books, Chapters, Edited work, Article Articles etc. Title of the Book (s) Publication Type Sole / Co- Author Publisher (City/country) &Year of Publication Journal ISSN/ISBN No. Refereed or Not Page 4 of 14

5 Research Projects Title Major/ Minor Period (Months) Total Grant / Funding Received (Rs.) Name of Sponsoring/ Funding Agency Outcome of the Project Ongoing Consultancy Projects Title Stream Name of Awarding / Funding Agency Amount mobilized in received (Rs.) Page 5 of 14

6 Completed Projects Uko ukyunk egkfogkj ukyunk Title Major/ Minor Funding Agency acceptance (Yes/No) Projects Output Title Project Output National / International Page 6 of 14

7 Research Guidance: Uko ukyunk egkfogkj ukyunk Level of Guidance No. of candidate registered Thesis Submitted (numbers) Degree Awarded (numbers) M. Phil. Ph.D. Project Guidance at undergraduate lavel: Level of Guidance No. of Years (supervision) Undergraduate Training Course: Name of Course/Programme attended Sponsoring Institution Duration Page 7 of 14

8 Papers presented in Conference/ Workshop / Symposium: Title / Subject of paper Title/Subject of conference/ seminar / workshop Organising Institution (with City & Country) Type of Conference / Seminar / Workshop Proceedings Published (Yes/No) Lectures or Presentations at Conferences/ Symposia: Title / Academic Session / Subject Organising Institution (with City & Country ) Type of Conference / seminar / Workshop (National/Internationl) Date of Lecture Duration (in Mins.) Page 8 of 14

9 Summary of Points from Educational Qualifications (Out of 100): Total points earned: Summary of Academic Performance Indicator: Sl. No. Criteria Claimed 1. Research Papers / Distribution as per UGC guidelines (in % of total score) 55% Publication etc. 2. Research Projects 20% 3. Research Guidance 10% 4. Training Courses and Conference 15% Note: / Symposia presentations applicable as per UGC guidelines Total is to be calculated in accordance with screening/shortlisting standard guidelines for direct recruitment for the post of Assistant Professor, Associate Professor and Professor available in the other Central University. MISCELLANEOUS INFORMATION Computer Skills (e.g. word processing, spreadsheet, databases or any other specific software with familiarity level of Basic/Intermediate/Advance) ICT Usage Skills Specialized Packages / Software s Familiarity Page 9 of 14

10 Mention your most significant contribution as a teacher (in 100 words) Mention your most significant research contribution (in 100 words) Page 10 of 14

11 Mention your proposed Roadmap for teaching and research for next five years (in 100 words) Mention your Vision statement for the Department for next five years (in 100 words) (Only in case of Professor) Page 11 of 14

12 Honours and Awards (Please provide details in the box below) Significant contributions not mentioned above (Please provide details in the box below) Membership / Fellowship of Learned Bodies / Societies (Please provide details in the box below) Literary, Cultural or other activities (Please provide details in the box below) Page 12 of 14

13 DISCLOSURE Have you been debarred or punished for adopting unfair means in any Examination by the Institution / Board or University? Yes / No If yes, specify Have you at any time convicted by court for any criminal offence? Yes / No If yes, specify Were you ever discharged or dismissed from any previous employment? Yes / No If yes, specify Three Referees Familiar with your Academic Work Full Name Institutional Affiliation Designation Institutional Address Mobile/Phone No. Page 13 of 14

14 No Objection Certificate from Present Employer Please indicate if NOC is not available: Yes/ No Forwarded with the remarks that the facts stated in the above application have been verified and found correct and this Institution/ Organization has no objection to the candidature of the applicant being considered for the post applied for. Name of Head of Institution _ Designation Signature & Seal of Head of Institution Address Place Date Declaration I declare that the statements made and documents enclosed with the application form are true to the best of my knowledge and belief. If any information is found to be incorrect, my candidature is liable to be cancelled and that I may be subject to legal / disciplinary proceedings. Date: Place: Applicant s Signature Page 14 of 14