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Annexure I
Affix recent
passport size
photograph
c. Demand Draft
Demand Draft No.
Date
Amount (Rs.)
(Part A)
2. Personal Information (In capital letters):
2.1 Name in Full
2.2 Date of Birth (DD/MM/YYYY)
2.3 Gender
(Male/Female/Transgender)
2.4 Nationality
2.5 Category (SC/ST/OBC/General/PWD
Dr./Mr./Mrs./Ms. :
Disability, if applicable
Page 1 of 10
Permanent Address
PIN CODE :
Email ID:
Phone No:
Mobile No:
PIN CODE :
Fax No.
University/
Year of
Institution/ Board Passing
Percentage
of Marks
Specialization
(if any)
Subjects
Division/
Class/CGPA
Please add additional sheet, if required, retaining the above tabular format.
Whether Qualified
UGC/CSIR /NET/ SLET/
SET Exam:
YES
NO
Ph.D. (Mark in
Degree Awarded
[
] Thesis
[
]
appropriate box)
Submitted
If Ph.D. awarded, whether Ph.D. degree is in accordance with UGC regulations,
2009 or not? If yes please submit the proof of evidence.
5. Title of Thesis/Dissertation (If published, give details on a separate sheet)
Ph.D.
M.Phil.
Master
5.1 No. of publications:
Refereed
Published
Journal only
Books (only with ISBN or similar
identification mark)
Accepted
Book Chapters
Conference Proceedings
(full papers only)
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Patents
6. Academic Distinctions (Award/Scholarship/Rank, etc.)
8. Present Position:
Designation
University/
Institution
From
Date
Basic
Pay (BP)
Pay Scale
(PS)/Pay Band
(PB) (Rs.)
Gross Pay/
Total Salary
P.M. (Rs.)
Next
Increment
Date
Nature
of duties
Period
University/
Institution
From
Teaching
To
No. of years
/ months
UG
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Nature of work
PG
Mphil /
Ph.D.
Reason for
Leaving
Research
(Postdoc)
Guide / Co-Guide
Enrolled
Submitted
Awarded
M.Phil. Degree
Ph.D. Degree
11. Research Projects Undertaken (other than that for research degree)
Title of Project
Date of
Commencement
Date of
completion
Emoluments
Drawn
Under whose
Auspices
14. Do you have a near relative among the staff of this University?
YES / NO
Designation
16. Have undertaken any foreign travel for academic purposes? If yes, give details
Duration
&Year
Country
visited
Financial support
(Personal / Private /
University/UGC)
Sponsoring Institution /
University / Agency
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Purpose of Visit
17. Name and Complete postal address of three referees (In capital letters):
Reference 1
Reference 2
Reference 3
PIN CODE:
Email:
PIN CODE:
Email:
PIN CODE:
Email:
Phone No.:
Mobile No:
Fax:
Phone No.:
Mobile No:
Fax:
Phone No:
Mobile No:
Fax:
18. Teaching preference. Applicants are requested to write down their current and future
academic plans in about 200 words.
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YES / NO
20. Declaration:
I hereby declare that all the entries are made by me in this application are true to the best
of my knowledge and belief. If anything is found false at any stage, my application may be
cancelled without assigning any reason
Date:________________
___________________________
Designation: ___________________________
Place:
___________________________
Date:
___________________________
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Office Seal
Annexure II
(Part - B)
Academic Performance Indicators(APIs)
Use Additional sheets wherever necessary
(To be filled only for the position of Associate Professor & Professor)
Name of the applicant:
Subject: .
Title with
page Nos.
No of Coauthors
Whether
applicant is
the main
author
API
Score
Sl. No. of
proof
enclosed
API Score
verified by
screening
committee
API
Score
Sl. No. of
proof
enclosed
API Score
verified by
screening
committee
Title with
page Nos.
Book Title ,
Editor &
Publisher (with
ISSN/ISBN)
No of
Coauthors
Whether
applicant is
the main
author
Page 7 of 10
Title with
page Nos.
Details of
Conference
Publication (with
ISSN/ISBN)
No of Coauthors
Whether
applicant is
the main
author
API
Score
Sl. No. of
proof
enclosed
API Score
verified by
screening
committee
Title with
page Nos.
No of Coauthors
Whether
applicant is
the main
author
API
Score
Sl. No. of
proof
enclosed
API Score
verified by
screening
committee
Title
Agency
Period
Grant/
Amount
Mobilized
(Rs. in Lakhs)
Page 8 of 10
API Score
Sl. No. of
proof
enclosed
API Score
verified by
screening
committee
Sl.
No
Title
Agency
Period (with
Grant
Amount
Mobilized
(Rs. in lakh)
Whether
policy
document/
patent as
outcome
API
Score
Sl. No. of
proof
enclosed
API Score
verified by
screening
committee
D) Research Guidance:
Number
Enrolled
Thesis
Submitted
Degree Awarded
API Score
Sl. No. of
proof
enclosed
API Score
verified by
screening
committee
M.Phil. or
equivalent
Ph.D. or
equivalent
Programme
Duration
Organized by
Page 9 of 10
API
Score
Sl. No. of
proof
enclosed
API Score
verified by
screening
committee
Sl.
No
(Whether International/
National / State / Regional /
University or college level)
Organized
by
API
Score
Title of Lecture /
Academic Session
Title of Conference/
Seminar (Whether
International /
National)
Organized
by
API
Score
Sl. No.
of proof
enclosed
API Score
verified by
screening
committee
Date:
Place:
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