BODOLAND UNIVERSITY

RANGALIKHATA (DEBARGAON) KOKRAJHAR, ASSAM 783370, INDIA

APPLICATION FORM FOR TEACHING POSITIONS
(Ref.: Advertisement No. ________________________)
(Please read carefully the general conditions/instructions given below before filling the application form)

GENERAL CONDITIONS/INSTRUCTIONS

1. Indian nationals only need to apply.

2. Applicants should fill particulars in his/her own handwriting neatly and clearly.
3. Latest Passport Size Photograph should be pasted at specified place.
4. Self Attested photo copies of all relevant certificates, degrees, marksheets, testimonials, etc. in support of
age, qualifications, caste, experience must be enclosed with each application.
5. Candidate belonging to/applying under any reserved category SC/ST(P)/ST(H)/OBC &
MOBC/PwD(OH/VH/HH) must enclosed photo copy of caste/category certificate, issued by the competent
authority.
6. Applicants in employment should get their application endorsed from their employer.
7. The envelope containing application form should be superscribed as :
Application for the post of (Name of the post).
8. Applications should be addressed to :The Registrar, Bodoland University, Rangalikhata (Debargaon),
Kokrajhar, Assam 783370, along with self address (Rs. 5.00) stamp envelope.
9. Only short listed candidates will be called for interview.
10. The University reserves the right to fill or not to fill any or all of the posts advertised.
11. No correspondence whatsoever will be entertained from the candidates regarding postal delay, conduct &
result of interview and reasons for not being called for the interview.
12. Canvassing in any form will be a disqualification.
13. Applicant must fill in all the particulars from Page No. 01 to 11.
14. No TA/DA will be given for Interview.
15. Incomplete application form/without prescribed fee/without supporting documents (as per Sl. 4),
Application would be rejected.
16. Application fee must be submitted to The Registrar, Bodoland University, in the form of Demand Draft,
Payable at SBI, North Kokrajhar Branch (Code 7379), Kokrajhar.
17. Applicants are required to submit three sets of application with all relevant documents in a single envelope.

**********************************************************************

Post applied for : Department.........................

Name of the applicant (in CAPITAL letters) :..
Category you belong to
(Please tick ): PWD Ex-Servicemen
GEN SC ST(P)/ST(H) OBC/MOBC
OH VH HH

Date:..
Signature of Applicant.
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BODOLAND UNIVERSITY Tele: 03661-277183 (Office)

KOKRAJHAR-783370, BTC, ASSAM Fax: 03661-277183
Debargaon, P.O. Rangalikhata,
Kokrajhar-783370,B.T.C, Assam
E-mail: [email protected]
______________________________________________________________________________________________________________

APPLICATION FOR THE POST OF

ASSOCIATE PROFESSOR/ASSISTANT PROFESSOR
(Applications in triplicate copies)

Please paste
recent
passport size
photograph
General Details
Post Applied For ___________________________________ Advt. No. and Date: _______________________
Name of Department / Centre: _____________________________________________
Draft No., Name of Bank and Date:__________________________________________________________
Rs. 1000/-per application for General (UR)/OBC/MOBC
Rs. 500/- per application for SC/ST (P)/ST(H)/PWD
* For applicants from abroad, please check the How to apply section of the Guidelines.
(Demand Draft in favour of: Bodoland University, Kokrajhar, B.T.C., Assam)
Demand

A. Personal Details
1. First Name: ______________________ Middle Name: ________________ Last Name:_________________
2. Parents/Spouse Name _________________________________________________________________
(indicate relationship)
3. Date of Birth ___________________ Age on 1st February, 2017: __________Y ________M _______D
(YYYY/MM/DD)

4. Category (General (UR)/OBC/MOBC/SC/ST(P)/ST(H)): _______________________________________

5. If you are differently abled, please specify here_____________________________________________
6. Nationality _____________________Gender _____________ Marital Status: ___________________
7. Telephone No. _____________________________ Mobile No. ________________________________
8. Email ______________________________________________________________________________
9. Personal website address if any __________________________________________________________
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10. Postal Address Permanent Address

_________________________________ __________________________________
_________________________________ __________________________________
_________________________________ __________________________________
_________________________________ __________________________________

B. Educational Qualifications*:
(Please add additional sheets if required, for teaching/research/publication section in the format as in
this form)

Examination Exam Subject(s) Marks (%age) (School/ Board/Council/

Institution Passed & /CGPA+ %age College/ University
Year University)

Class 10 or
Equivalent

10+2 or
Equivalent

Bachelors
Degree

Masters
Degree
M Phil
Please indicate any other information, e.g. Rank, Distinction:
*Attach self-attested copies of all certificates and Mark sheets from the competent authority of the above mentioned
qualifications.
Other Degrees (e.g. Post Graduate Diplomas etc.):
Examination Exam Subject(s) Marks Institution University
Passed & (%age)/
Year CGPA+ %age

Doctoral Degrees:
Degree University Subject / Field Title of Thesis Year of Duration of
Award Research work for
Degree
 3

Whether Qualified UGC/ CSIR NET/ NET-JRF/ SLET/ SET ______________________________

Roll No.___________________________ Yr. of passing ______________________________
Whether exempted from NET: Yes/ No _______________

C. Full-time Teaching Experience*

Name of Designation Status Classes Course/ From To Experience
University (Permanent/Temporary Taught Subject (in Y-M)
/College/Institution /Ad-hoc) (UG/PG/Others)

*Attach self-attested copies of certificates from the competent authority of the above mentioned experience.

D. Research Experience*:
Name of University Post From To Experience
/College/Institution held / Designation

*Attach self-attested copies of certificates from the competent authority of the above mentioned experience.

E. 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) _______________________________
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Present pay Currency Scale of Pay Basic Allowances Gross Amount

and (including Grade
Allowances Pay)

F. ACADEMIC PROFILE:
(Please add additional sheets if required, for teaching/research/publication section in the format as in
this form)
Publications in Relevant Area Only*
API Score is to be calculated in accordance with UGC Guidelines for direct recruitment for all post of teaching
faculties. By filling the details, the candidate certifies that the points claimed on the basis of being the first,
sole or corresponding author is based on the UGC Guidelines.

1. Research Papers / Review Articles

Title with page Authors as they Journal Name Mention whether Impact Factor API
nos. appear ISSN/ISBN No. listed in Thomson- of Score
Reuters or Scopus or Journal
Research Gate

*Attach self-attested copies of the first page/cover page of all publications.

2. Research Publications - Books, Chapters, Edited work, Articles, Conference Proceedings, etc.:
Title Authors as Edited Publisher Journal/Book; Refereed API Score
they appear Booklet/ (city/country ) ISSN/ISBN or Not
Book/Chapter & Year of No.
in a Publication
book/
Conference
Proceedings/
other
Articles.

*Attach self-attested copies of the first page/cover page of all publications.

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3. Research Projects:
Title Major/Minor Period Total Name of Outcome of API
(Months) Grant/Funding Sponsoring/ the Score
received(Rs.) Funding Project
Agency (Mention
publications
and
patents)

4. Ongoing Consultancy Projects:

Title Stream Name of Awarding/ Amount mobilized in API Score
Sciences/Arts/ Funding Agency received(Rs.)
Humanities etc.

5. Completed Projects:
Title Major/ Funding Agency API Score
Minor acceptance
(Yes/No)
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6. Projects Output:
Title Project Output Patent/Tech National/ International API Score
Transfer/Product/Policy
Doc.

7. Research Guidance:
Level of Guidance No. of candidate Thesis Submitted Degree Awarded API Score
(numbers) (numbers)
registered

M Phil

Ph. D.

8. Details of M Phil / Ph D Students:

Student name Thesis title (State whether Year University/ Institute
M Phil /Ph D)

9. Project Guidance at undergraduate level:

Student name Title of Project No. of Years (supervision) University / Institution

10. Training Courses:

Name of Course/ Sponsoring Institution Duration API Score
Programme attended
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11. Papers presented in Conferences/Workshop/ Symposium:

Title /Subject of Title/Subject of Organizing Type of Proceedings API
conference/seminar/ Institution Conference/ published Score
paper
workshop (with City & Seminar/ (Yes/No)
Workshop
Country)

12. Invited Lectures/ Presentations/Chairperson in the Conferences/ Symposia:

Title/Academic Organizing Type of Conference/ Date of Duration API
Session/ Institution (with Seminar/ Workshop Lecture (in min) Score
Subject City & Country) (National/International)

Total API points earned from category-III:

Sl No. Criteria API Score API Score API Score applicable
Claimed Distribution as per as per UGC guidelines
UGC guidelines (in %
(After capping)
of total API score)

1 Research Papers (Journals etc.) 30%

2 Research Publications (Books etc.) 25%

3 Research Projects 20%
4 Research Guidance 10%

5 Training Courses and Conference/ 15%

symposia presentations
Total API Score 100%
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Summary of API Score as per PBAS (for the entire period of assessment)

Minimum Score Score obtained by Verified API Score of

Category
required the candidate the candidate
Category-I
Category-II
Category-III
Miscellaneous Information:
1. Computer Skills
Windows Packages Describe nature of usage Proficiency
(e.g. MS -Office etc.) (Mention ability to install &
program)

Linux based packages Describe nature of usage Proficiency

( e.g Open office, Libre Office etc.) (Mention ability to install &
program)

Scientific packages Describe nature of usage Proficiency

(e.g. SPSS/ Matlab etc.) (Mention ability to install &
program)

2. Mention your most significant contributions as a teacher (in 100 words)

 9

3. Mention your most significant research contributions (in 100 words)

4. Mention your proposed roadmap for teaching and research for next five years (in 100 words)

5. Mention any professional responsibilities you may have taken (e.g. Editorial / Conference organizer etc.)

6. Honours and Awards (Please provide details in the box below)

7. Significant contributions not mentioned above (Please provide details in the box below)
 10

8. Membership / Fellowship of Learned Bodies / Societies (Please provide details in the box below)

9. Literary, Cultural or other activities (Please provide details in the box below)

10. Mention why you are interested to join in Bodoland University

Disclosure
Have you been debarred or punished for adopting unfair means in any Examination by the Institution / Board
or University? Yes / No
If yes, give details____________________________________________________________
Have you at any time been convicted by a court for any criminal offence? Yes / No
If yes, give details____________________________________________________________
Were you ever discharged/ dismissed/demoted/asked to retire from any previous employment?
Yes / No
If yes, give details ____________________________________________________________
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Three Renowned Referees Familiar with your Academic Work

Full Name & Designation Institutional name & Mobile/Phone No. Email
Address

1
2
3

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.

Place:
Date: Applicants Signature in full