Paste recent
For Post of Associate Professor/ Professor
photograph
here and sign
INFORMATION SUMMARY SHEET
across
JU Application Form No
SB Collect Reference No. DU................................
1. Post Applied for .......................................................... Dept./School*............................................
2. Advertisement no. with date ....................................................................
3. Name of the Applicant in full ..................................................................
(BLOCK Letters) (First) (Middle) (Last)
4. Current position held............................................................................................ since ..............
5. Teaching/Research/Industrial Experience (Most recent first)
Previous Positions held Employer/ Period/Duration of the
Organization position/work
Use additional sheet, if necessary
6. Date of birth (DD/MM/YYYY) :
7. Category (Please
GEN SC ST OBC-A OBC-B Minority PWD/PC
tick)
8. Qualified for (Please tick):
A. NET SET GATE None
B.
Title of Research University Duration of Degree obtained/ thesis
Programme submitted in theYear
M.Phil/M.Tech.
Ph. D.
9. Whether Ph.D. is done under the UGC (Minimum Standards and Procedure for Award of M.PHIL./PH.D Degrees)
Regulations, 2016 (Y/N) ..................................................................................................................
Dated .......................................... ..........................................................
Full Signature of the Applicant
Mobile No.:
1
* Strike off whichever is not relevant.
No
Jadavpur University Application Form
1. Post Applied for ........................................................ Dept./School
2. Advertisement no. with date ..............................................................
3. Name of the Applicant in full......................................................................................................... ..............
(BLOCK Letters) (First) (Middle) (Last)
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 ............................................................ At present ............................................................
7. Gender( Please tick): Male/Female/Third Gender
GEN SC ST OBC-A OBC-B Minority PWD/PC
8. Category:
9. Father's Name/ Mother's Maiden Name .....................................................................................................
10. Applicant's mother tongue .....................................................................................................................
11. Other languages the applicant can speak/write/read fluently :
Name of the Languages Speak Write Read
i)
ii)
iii)
iv)
v)
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12. Academic Records
Examination/ Degree Board/Council/ Duration of the Division/Class With Subjects/ Discipline2
University/Other Course &Year % of Marks
Examining Body of Completion
10th. Standard
12th. Standard
Graduation
(Honours/Major)
MA./M.Sc/ ME/ M.Tech
(U GC/AIC TE/NCTE/
CoA/PCI recognized) (In
the subject as per
Advertisement)
M.Phil
(2 year course)
Any other
Ph.D.
Arts/Science/ Tech./
Engineering
UGC NET-JRF/ CSIR
/AICTE/ Institute
Fellowship
* State the name of the degree (such as BA/BSc/B.Tech, MA/MSc/ME/M.tech etc,), Honours/major subject in case of
graduation and subject/discipline and area of specialization in case of post-graduation and for higher degrees obtained
13. Research Activity (documents to be produced)
a) Prestigious Honours, Fellowships 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):
....................................................................................................................................................................................
* Strike off whichever is not relevant. 3
b) Research projects carried out/ongoing funded by government funding agencies/industries or
organization of National and International repute (state whether Sole, Principal or Co Investigator)
(documents to be attached)
___________________________________________________________________________
Title of the Project Funding Period Completed/ Amount
Agency/Institute ongoing
Use additional sheet if necessary.
c) Consultancy Projects:
Title of the Project Funding Period Completed/ Amount
Agency/Institute ongoing
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 International, Government Bodies at Central/State
level/Local:(list details with year in an additional sheet; documents to be attached)
f) Number of Papers presented in conferences/seminar etc. (by self or by co-authors)
• International..............................................
• National/State level ...........................................
(NB: 1) List details with title of the paper, year and host institution in an additional sheet.
Participation certificates must be attached, otherwise no credit shall be given to the numbers claimed
above; 2) If a paper presented in a conference/seminar is published in the form of Proceedings or Edited
Volume with ISB/ ISSN Number, it should be listed only under Publications/Book Chapter .)
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 Journal as notified by UGC, dated 11th July, 2016 :
(ii) Number of papers in reputed Journals as notified by UGC, dated 11th July, 2016 :
b) Books:
(i) international publishers:
• Sole author ............................................................... ..........................................................
• Co-authored: (State number of co-authors)................. ..........................................................
(ii) national level publishers:
4
• Sole author ............................................................... ..........................................................
• Co-authored: (State number of co-authors) ............... ..........................................................
•
(iii) other Local publishers:
• Sole author ............................................................... ..........................................................
• Co-authored: (State number of co-authors)................. ..........................................................
c) Number of Chapters contributed* in Edited Volumes published by:
(i) international publishers:
• Sole author ............................................................... ............................................................
• Co-authored: (State number of co-
authors)............................................................................................
(ii) national level publishers:
• Sole author ............................................................... ............................................................
• Co-authored: (State number of co-
authors)...............................................................................................
d) No. of Research Guidance:
No. of M. Phil/M.E./M.Tech./MCA/M.Arch/M.Pharm awarded:
No. of Ph. D. awarded/ submitted :
No of Invited Lectures delivered in Conferences and Seminars
15. Name and contact details of two referees
Name Profession/Position Institutional Affiliation Address and Contact
16. Additional Remarks, if any:
Declaration
I declare that the entries made in this form are true to the best of my knowledge and belief.
Date .................................... Place .................................... Signature of the Applicant
* Editorial Chapter and Full Papers in Conference Proceedings having ISBN and ISSN will be considered as book
chapter
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.
(v) Copy of SB Collect Payment Receipt must be attached with the application (v) All
claims made above must be substantiated by attaching relevant documents.
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Jadavpur University
API Score Calculation Sheet for the Post of Associate Professor/ Professor
1. Name of the Applicant in full …………………………………………………….…………………….
2. Application for the post of………………………………………………………………………………
In (Department/School/Subject)....………………………………………………………………………
3. Category (General/SC/ST/OBC/Minority/PWD/PC)…..………………………………………………….
4. NET/SET/Ph.D. done under the UGC (Minimum Standards and Procedure for Award of M.PHIL./PH.D
Degrees) Regulations, 2016 /Ph.D. Abroad(with course work)………………………..
5. Subject Specialization as advertised (if any): Yes/No
6. API for Academic Records (calculate according to Table-I of the Guidelines):
7. API for Teaching , Learning and Evaluation Related Activities and Domain Knowledge
(calculate score according to Table-II of the Guidelines):
8. API for Professional Development, Co-Curricular And Extension Activities
(calculate score according to Table-III of the Guidelines):
9. API for Research Performance (calculate according to Table-IV of the Guidelines):
6
( Attach Calculation Sheet in each case of API categories as mentioned above from point no. 6 to 9)
Experience Number of Years Level/Position University/College/Industry
1. Research
2. Teaching
3. Industrial
API verified by: (For Office Use)
___________________________ ______________________________________________
Head, ………………………… Officer(s)/Teacher(s) in Charge
7
FOR USE OF SCREENING/SELECTION COMMITTEE
________________________________________________________________________________
Comments of the Screening Committee:
------------------------------------------------------------------------------------------------------------------------
Comments of Selection Committee:
API for API for API for API for Consolidate Consolidate
Academi Teaching , Professional Research Score of Score of
c Records Developme Performan Table-III Table-I,
Learning and
nt, Co- ce and Table-II
Evaluation Curricular
Related Table- and
And
Activities Extension
IV* Table-IV
and Domain Activities*
Knowledge*
Table-I Table-II Table-III Table-IV
Score
obtaine
d by
the
Applica
nt
Normalised X X X
Score
Obtaine
d by
the
Applica
nt
*Not included in the normalised parameter
Name and Signature of members of the Screening/Selection Committee:
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
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