APPLICATION FORM APPLICATION FOR APPOINTMENT OF PROGRAMME CO-ORDINATOR / SUBJECT MATTER SPECIALISTS. Post Applied for:

Transcription

1 APPLICATION FORM ICAR - KRISHI VIGYAN KENDRA BELAGAVI BIRD Society Campus, Tukkanatti, (Funded by Indian Council of Agricultural Research), Gokak Taluka, Dist : Belagavi, Karnataka State Affix your recent passport size photograph (Self Attested) APPLICATION FOR APPOINTMENT OF PROGRAMME CO-ORDINATOR / SUBJECT MATTER SPECIALISTS Name of the candidate: Post Applied for: Advertisement No.. & Date: Instructions to the candidates 1. The application should be filled in by the applicant in his/ her own handwriting. 2. Please specify all points clearly and completely. 3. Incomplete applications will be rejected.

2 1. Name of the post applied for 2. Name in full (BLOCK IN LETTERS) (as entered in SSLC or equivalent) 3. Address for communications with pin code 4.E mail I D 5. Contact numbers: ( With STD codes) 6.Date of Birth (bonafide certificate to be enclosed) 7. Native place: Taluka: District: State: 8. Religion: 9. Caste: 10.Sub-Caste: 11. Nationality 12. Name of the State to which you belong 13.a) Do you belong to Scheduled Caste or Scheduled Tribe?(Please Tick) * SC / ST b) Do you belong to other backward * Cat.1 / 2A/ 2B/ 3A/ 3B classes?(please Tick) c) Do you claim reservation under any of the Special Categories(Please tick) * Rural / Woman / Ex-serviceman/ *(Respective category/caste certificates Kannada medium / Physically from the competent authorities as per.handicapped/ Project Displaced Person prevailing Govt. Orders in the prescribed formats have to be enclosed)

3 14. Father s Name Address Occupation Nationality 15. Have you been outside India? If so, give particulars. Country Period of visit Purpose of visit 16. Languages that you can read, write and speak. Reading Writing Speaking Examination passed 17. Particulars of examinations passed and degrees obtained starting from S.S.L.C. Examination or Degree % age, AGP/OGPA Subject Board/University Year 1. SSLC 2. PUC 3.Bachelor s Degree 4. Master s Degree 5.M. Phil. 6. Ph.D. 7. Others Note: Field of specialization should be indicated clearly at the PG level. Certified copy may be attached.

4 18. Additional Qualifications: Examination or Degree 1.Post Doctoral Experience. %age, AGP/OGPA Subject Board/ University Year/duration 2. PG Diploma/ M. Phil 3. Higher Academic Training in recognized academic/scientific/ professional institution in relevant field (21 days and above duration) Note; The specialization at the Master s degree and ph.d should be clearly indicated. 19. Experience in Teaching/Research/ Extension: Post Name of Employer Date of joining Date of leaving Period of working (years/ months) Reason for leaving Basic pay (Certified Copy of the experience & Pay drawn certificates to be enclosed)

5 20. Scientific publication in the concerned field. Particulars Titles of the papers/ Books Name of the Journal published/symposia/semin and Year/ Publisher ar/ Conference etc. Full length papers published in refereed journals (national/international level) Research Note/ Abstracts published in journals/ Seminars/ Symposia/ Conferences Full length papers presented & published in seminars/ symposia/ Conferences at International/ National/ University level Books published by individuals Research Bulletins/ Extension Bulletins/ Chapters in Books published by universities/ National institutes/govt. departments/standard Commercial Publishers/ Training manuals/ Laboratory Manuals Extension leaflets/ folders/ brochures Published by Universities/ National Institutes/ Govt. Departments/ Standard Commercial Publishers. Popular articles published in leading Dailies/Institutional/ Govt. Departmental/ Periodicals/ Radio talks/ TV programmes/ Phone in programmes

6 21. Additional Information, if any: 22. List of enclosures. List of Enclosures Sl. No Enclosure with application Any Remark I hereby declare and certify that the entries furnished above are true to the best of my knowledge and belief. Date: SIGNATURE OF THE APPLICANT

7 Forwardal Certificate by the Employer Certified that Mr./ Ms. is working in our Institute/ Organisation in the Department in the post of w.e.f. in the pay scale of. He / She is presently drawing a basic pay of Rs. and gross salary Rs. We have no objection in forwarding his / her application for a post in the ICAR-KVK, Tukkanatti, Taluk: Gokak District: Belgaum. Place: Date: Signature and Designation

8 ICAR- KRISHI VIGYAN KENDRA BELAGAVI Information to the candidates applying for appointment 1. The entire notification along with the detailed qualification and application pro-forma prescribed for each of the categories of the posts notified is accessible from the website of the BIRDS society, Belgaum. The candidates have to obtain application pro-forma through website only 2. Separate applications should be made for each post. 3. The society reserves the right to fill any or all the vacancies. 4. Candidates already in service should submit their applications through their Employer. They should also ensure that the application reaches the society on or before the last date prescribed. If any delay in sending the application through proper channel is anticipated, an advance copy of the application should be sent within the last date prescribed. 5. Applicants are required to send copies of marks statement all examinations and certified copies of service particulars furnishing details along with the application. 6. No TA/DA will be admissible to attend the interview 7. Applications received after the due/last date and incomplete application will be rejected. 8. Any pressure brought on the selection committee or the members of the Board of Directors by a candidate will be disqualified the candidature for the post. 9. The candidates who have studied under Trimester system and other than 10 point grading system are required to produce the equivalent percentage certificate obtained from the respective university. 10. Applications must be accompanied by attested copies of Marks sheets, Certificates, Experience Certificates, Publications, Research Notes, Certificates of Awards/Medals, Certificate related to past service etc. and the details of research or related publication, if any, in support of eligibility. 11. Candidates already in service (Government /Quasi Government / Private) should submit their applications through proper channel. 12. The envelope, in which application is being sent should super scribe the name of the post applied. 13. Applications should be submitted only through post and applications received through electronic media, applications received after closing date and without supporting documents shall summarily be rejected. 14. If the closing date happens to be a closed holiday, the next working day shall be taken as closing date.