JU AppForm Assistant Nov12
JU AppForm Assistant Nov12
1. 2. 3.
Post Applied for ..Dept./School*.. Advertisement no. with date Name of the Applicant in full . (BLOCK Letters) (First) (Middle) Current position held .since. Teaching/Research/Industrial Experience (Most recent first) Previous Positions held Employer/ Organization Period/Duration of the position/work
(Last)
4. 5.
Sl. No.
6.
SET
GATE
None
A.
University
Duration of Programme
9. Whether Ph.D. is done under the UGC 2009 Regulation (Y/N) .................
*
Those who have done Ph.D. outside India, whether a Ph.D. course work was attended (Y/N) Dated. _____________________________ Full Signature of the Applicant
Mobile No.: No. . Jadavpur University Application Form 1. Post Applied for Dept./School*..
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4. Contact details (i) Address (a) Permanent . . (b) Address for Communication . .. .. (ii) Email . (iii) Phone (Mobile)Resi./Office.. 5. Date of birth (DD/MM/YYYY) 6. Nationality By birth 7. Sex (Please tick) 8. Category (Please tick) Male / Female GEN SC ST OBC-A OBC-B Minority PWD/PC At present ..
11. Other languages the applicant can speak/write/read fluently (strike off whichever is not relevant) .
12. Academic Records Examination/ Board/Council/ Degree University/Other Examining Body 10th. Standard
Subjects/ Discipline*
12th. Standard
Graduation
a) Prestigious Honours and Awards received with name of awarding agency/government and year
(should be recognized by the international agencies or the departments/ agencies of national/state governments; documents to be attached) b) Post Doctoral Fellowship of at least 2 months duration received and availed of: Name of the Fellowship Funding Agency/Institute Host Institution Period
Use additional sheet if necessary. d) Number and details of Patents/Technology Transfer: .. (list details with year in an additional sheet; documents to be attached) e) Number of Policy documents for Government Bodies at Central & State level (list details with year in an additional sheet; documents to be attached) f) Training courses/ workshop attended (Note: For Physical Education Department: Specific sports coaching/training courses attended in Yoga, Yoga therapy, Physiotherapy; Extension services through NSS/NCC; For Department of ACCE: Attending Continuing education courses) Title of the Course Nature of the course/workshop Sponsoring/ Funding Agency Duration of the Course Host /Organizing Institute
International ..
National/State level. (NB: 1. list details with title of the paper, year and host institution in an additional sheet 2. If a paper presented in a conference/seminar is published in the form of Proceedings or Edited Volume, it should be listed only under Publications below.) 14. Publications (details of all publications should be listed in additional sheets with copies of first/Title page being attached; otherwise no credit shall be given to the numbers stated below) a) Journal Publications: (i) Number of papers in Refereed Jorurnal:
Sole author..
Sole author.. 6
Declaration
I declare that the entries made in this form are true to the best of my knowledge and belief.
DatePlace..
N.B. (i) Papers and documents submitted with the application will not be returned. (ii) Application, if sent by post should be sent under certificate of posting, preferably by registered post. (iii) Separate sheet(s) must be attached wherever applicable and necessary (iv) One original and seven photocopies of the duly filled-in application forms are to be submitted. All enclosures including self-attested copies of testimonials are to be submitted in single copy each.
Price: Rs.