Application Form For Teaching Post
Application Form For Teaching Post
Please tick appropriate category in the box and enclose S.C. S.T. O.B.C. Female Phy. EWS UR
necessary documents. Reservation as per M.P. state v-tk- v-t-tk- vU; fiNMk oxZ efgyk Handicap. vkfFkZd vukjf{kr
Government Rules.
Non- fnO;kax :Ik ls
d`i;k mfpr oxZ dks pkS[kVs esa fpfUgr djsa ,oa vko’;d detksj
vfHkys[k layXu djsaA vkj{k.k e-iz-jkT; ’kklu ds fu;ekuqlkj Creamy
layer
Sir, egksn;]
I hereby submit my application for the post mentioned below, with the following details
Self attested latest
eSa uEukafdr tkudkjh ds lkFk fuEufyf[kr in gsrq viuk vkosnu&i= izLrqr dj jgk@jgh gwWA passport size
1. Post applied for……………………………………………………………………… photograph
vkosfnr in dk uke………………………………………………………………
Loizekf.kr uohure
Subject fo"k; ………………………………………………………………………… ikliksVZ vkdkj dk
Nk;k&fp=
Field of specialization ¼fo’ks"kKrk dk {ks=½ …………………………………………..
2. (a) Full name (in English, capital letters)
(Dr./Shri/Smt./Ku./Ms.)…………………………………….…… …………
(b) Age on 01.04.22 fnukad dks vk;q ……..Years o"kZ….……Months ekg ……Days fnol………
(d) Nationality jk"Vªh;rk ……………(e) State to which belong fdl izns’k ds ewyfuoklh gS ……………...……………..…………..… .…
(f) If resident of Madhya Pradesh, then for how long ;fn e/;izn’s k ds fuoklh gS] rks dc ls …………………………………………..… ..
4. If employed at present, then designation of the post held and the address of institution…………………………………..… .
;fn orZeku esa dk;Zjr gS rks /kkfjr in dk inuke ,oa laLFkk dk irk……………………………………………… Pin fiu …………..… .…
Marks vd
aa Subjects Educational Remaks
Class/Division/Gra
Name of Year of passed Board / if any
Js.kh@xzM
de awarded
Name of the the passing mRrh.k University
s
iw.kkZd
Percentage
Obtained
examination Certificate/ mRrh.kZ fo"k; f’k{kk vU;
Out of
a
gksus dk
izkIrkad
izfr’kr
ijh{kk dk uke Degree eaMy@fo’ofo| fooj.kk
o"kZ ky;
izek.k&i=@
mikf/k dk uke
High School
or equivalent
gkbZLdwy ;k led{k
Higher
Secondary
School (10+2)
or equivalent
gk;j lds.Mjh Ldwy
¼10$2½ ;k ded{k
Graduation
Lukrd
Post-graduation
LukRdksRrj
Ph.D
ih-,p-Mh-
Others
vU;
8. If holding Ph.D. degree, then ;fn ih,p-Mh- dh mikf/k izkIr dh gks] rks
(a) Details about Ph.D. degree (Year of award) .................................Subject.............................
ih,p-Mh- mikf/k dk fooj.k ¼mikf/k izkIr dk o"kZ½ fo"k;
(b) Whether Ph.D. degree awarded as per UGC Regulation 2009? YES/NO
D;k 'kks/k mikf/k ;w-th-lh- fofu;e 2009 ds vuq:i gS \ gkW@uk
(If yes, please give documentary proof)
¼;fn gkW rks izys[k&izek.k dh Nk;kizfr layXu djsa½
(c) Title of the Ph.D. thesis ………………………………………………………………...…
ih,p-Mh- 'kks/k izca/k dk 'kh"kZd
………………………………………………………………………………………………
9. If qualified National Eligibility Test ( NET/JRF) conducted by the UGC, CSIR or similar test accredited by
the UGC like SLET/SET then give details ( attach documentary proof)
;fn ;w-th-lh-] lh-,l-vkbZ-vkj- }kjk lapkfyr jk"Vªh; ik=rk ijh{kk (NET) vFkok bl ijh{kk ds leku ;w-th-lh- }kjk ekU; vU; ijh{kk tSls
SLET/SETmRrh.kZ gS] rks fooj.k nsa ¼lk{; layXu djsa½
ijh{kk@ of ts-vkj-,Q@
VsLV dk fdlds }kjk lapkfyr¼;w-th-lh-@lh-,l-vkbZ-
passing ysDpjf’ki
uke vkj@jkT; bR;kfn½
mark
mRrh.kZ gksus
dk o"kZ ,oa
ekg
NET usV
SLET LysV
SET lsV
GATE xsV
*Govt./Quasi Govt./Autonomous/Private.
'kkldh;@v)Z 'kkldh;@Lok;Rr’kklh@futh
14. Membership of Learned Societies and/or Professional Bodies (if any) fo}r lfefr;ksa vkSj@;k O;olkf;d laLFkkuksa
dh lnL;rk ¼;fn dksbZ gks½
………………………………………………………………………………………………
15. Details of extra curricular activities (NCC, NSS, Sports, Debates, etc. ) ikB~;Rs rj xfrfof/k;ksa dk fooj.k ¼,u-lh-
lh] ,u-,l-,l- [ksydwn] okn&fookn] vkfn½
s As student – fo|kFkhZ ds :Ik essa…………………………………………………………..……………………………………
…………………………………………………………………………………………………………………………………….
After entertaining into service – lsok esa vkus ds mijkUrok………………………………………………………………….
……………………………………………………………………………………………………………………………….
16. (a) Has there been any break in your academic career? If so, give details. D;k dHkh vkids 'kS{kf.kd thou&o`Rr dk
dze Hkax gqvk\ ;fn gkW] rks dkj.k lfgr fooj.k nsaAs
……………………………………………………………………………………………
(b) Have you been punished during your studies at college/university? If so, give details. D;k dHkh vkidks
fo|ksiktZu ds nkSjku fo’ofo|ky;@egkfo|ky; }kjk n.M fn;k x;k\ ;fn gkW] rks fooj.k nsaAs
…………………………………………………………………………………………
(c) Have your been punished during your services or convicted by a court of law? If so, give details D;k dHkh vkidh
lsok ds nkSjku vkidks nf.Mr fd;k x;k gS ;k fdlh U;k;ky; }kjk vkidks nks"kh izekf.kr fd;k x;k \ ;fn gkW rks fooj.k
nsaA s
…………………………………………………………………………………………
(d) Were you at any time declared medically unfit or asked to submit your resignation or discharged or dismissed? If
yes, give details in a separate sheet. D;k dHkh vki fpfdRld n`"V;k v;ksX; ?kksf"kr gq;s vFkok vkils R;kxi= nsus ds fy;s
dgk x;k vFkok vkidks lsokeqDr ;k c[kkZLr fd;k x;k gS\ ;fn gkW] rks i`Fkd i`"B ij fooj.k nsaAs s
……………………………………………………………………………………………
(e) Do you have any case pending against you in any court of law? If yes, give details. D;k vkids fo:) dksbZ
U;kf;d izdj.k fopkjk/khu gS\ ;fn gkW]a rks fooj.k nsaA
………………………………………………………………………………………
dksbZ vU; lqlaxr fooj.k] ;fn mij ugha fn;k x;k gksAs
………………………………………………………………………………………………
18. References lanHkZ%&
These should be three persons residing in India holding responsible positions; they should be intimately
acquainted with the applicant’s capabilities, conduct and character, but must not be a relation ,sls rhu O;fDr;ksa
ds uke tks Hkkjr esa jg jgs gks vkSj dksbZ vf/kdkfjd in /kkfjr fd;s gks tks vkosnd dh {kerkvksa O;ogkj ,oa pfj= ls ifjfpr gksa ijarq
os mlds fj’rsnkj u gksAs
I. Name ukes ………………………………………………………………………….
Designation/Occupation in@O;olk;s …………………… Addressirk……………………………
II. Name ukes …………………………………………………………………………………
Designation/Occupation in@O;olk;s ……………………… Address irk……………………………
III. Name ukes ……………………………………
Designation/Occupation in@O;olk;s …………………………… Address irk………………………
s
19. List of enclosures layXudks dh lwph
(Attach extra sheets for details and lists, if necessary)
¼vko’;d gksus ij vfrfjDr i`"Bksa esa fooj.k ,oa lwph lfgr layXu djsa½
(i) Attested photocopy of High School / Higher Secondary School or equivalent examination certificate in support of age
vk;q lR;kiu gsrq gkbZ Ldwy@gk;j lsd.Mjh Ldwy vFkok led{k ijh{kk izek.k&i= dh lR;kfir Nk;kizfr
………………………………………………………………………………………………………..............................
(ii) Attested photocopies of Degrees, Diplomas and other certificates of educational qualifications
’kS{kf.kd ;ksX;rk laca/kh mikf/k] i=ksikf/k ,oa vU; izek.k&i=ksa dh lR;kfir Nk;kizfr;kW layXu djsA
……………………………………………………………………………………………
(iii) Attested photocopy of caste certificate, if applicable (Candidate must be domicile of M.P.)
tkfr izek.k&i= dh lR;kfir Nk;kzifr] ;fn ykxw gks ¼vH;FkhZ dks e-iz- dk ewy fuoklh gksuk pkfg, ½
………………………………………………………………………………………
4. Department/ Subject :
7. Permanent Address
(with PIN code) :
Mobile/Telephone No. :
Email :
Name of the
Place Duration Sponsoring Agency
Course/Summer School
Total
Total
Chapters in Edited Book:
Total
Total
Total
Total
Total
(d) Consultancy:
Title of Total points
Funding Amount mobilized
the Project Agency Duration
with
(In Lac)
From To
5. (a) Patents:
10
Signature of the Applicant
6. Invited lectures / Resource Person/ paper presentation in Seminars/ Conferences/fullpaper
in Conference Proceedings (Paper presented in Seminars/Conferences and also published
as full paper in Conference Proceedings will be counted only once)
Whether
Title of
Title of Organized International(Abroad Total
Sl.No the Year
Conference/Seminar by ) /International(With points
Paper
in
Country)/Nation
al/State/Universi
ty
Total
7. Other Relevant Information
Please give details of any other credential, significant contributions, awards received etc. not
mentioned earlier.
S. No Details (Mention Year, Value etc. where relevant)
Date:
Place:
Signature& Designation of the Applicant
11
Signature of the Applicant
Appendix-I – II UGC (Regular 2021)
Table 1 :- (As per UGC regulation 2018 Appendix II Table 2)
Methodology for University and College Teachers for calculating Academic/Research Score
(Assessment must be based on evidence produced by the teacher such as: copy of publications, project
sanction letter, utilization and completion certificates issued by the University and acknowledgements for patent
filing and approval letters, students’ Ph.D. award letter, etc,.)
International publishers 12 12
National Publishers 10 10
Book 08 08
(c) MOOCs
Development of complete MOOCs in 4 20 20
quadrants (4
credit course)(In case of MOOCs of lesser
credits 05
marks/credit)
12
Signature of the Applicant
Course Coordinator for MOOCs (4 credit 08 08
course)(In
case of MOOCs of lesser credits 02
marks/credit)
(d) E-Content
International 10 10
National 07 07
(b) *Policy Document (Submitted to an International body/organisation
like
UNO/UNESCO/World Bank/International Monetary Fund etc. or Central
Government or State Government)
International 10 10
National 07 07
State 04 04
(c) Awards/Fellowship
International 07 07
National 05 05
6. *Invited lectures / Resource Person/ paper
presentation in Seminars/ Conferences/full
paper
in Conference Proceedings (Paper presented
in
Seminars/Conferences and also published as
full
paper in Conference Proceedings will be
counted
only once)
International (Abroad) 07 07
International (within country) 05 05
National 03 03
State/University 02 02
13
Signature of the Applicant
The Research score for research papers would be augmented as follows :
Peer-Reviewed or UGC-listed Journals (Impact factor to be determined as per Thomson Reuters list) :
i) Paper in refereed journals without impact factor - 5 Points
ii) Paper with impact factor less than 1 - 10 Points
iii) Paper with impact factor between 1 and 2 - 15 Points
iv) Paper with impact factor between 2 and 5 - 20 Points
v) Paper with impact factor between 5 and 10 - 25 Points
vi) Paper with impact factor >10 - 30 Points
(a) Two authors: 70% of total value of publication for each author.
(b) More than two authors: 70% of total value of publication for the First/Principal/Corresponding author and
30% of total value of publication for each of the joint authors.
Joint Projects:Principal Investigator and Co-investigator would get 50% each.
Note:
Paper presented if part of edited book or proceeding then it can be claimed only once.
For joint supervision of research students, the formula shall be 70% of the total score for Supervisor and Co-
supervisor.
Supervisor and Co-supervisor, both shall get 7 marks each.
*For the purpose of calculating research score of the teacher, the combined research score from the
categories
of 5(b). Policy Document and 6. Invited lectures/Resource Person/Paper presentation shall have an upper
capping of thirty percent of the total research score of the teacher concerned.
The research score shall be from the minimum of three categories out of six categories.
Criteria for Short-listing of Candidates for Interview for the Post of Assistant Professors in Universities
14
Signature of the Applicant
#However, if the period of teaching/Post-doctoral experience is less than one year then the marks shall be reduced
proportionately.
Note: ( A) (i) M.Phil + Ph.D Maximum - 30 Marks
(ii) JRF/NET/SETMaximum - 07 Marks
(iii) In awards category Maximum - 03 Marks
( B) Number of candidates to be called for interview shall be decided by the concerned universities.
(C)
Academic Score - 80
Research Publications - 10
Teaching Experience - 10
Total - 100
(D) Score shall be valid for appointment in respective State SLET/SET Universities/ Colleges/ Institutions only
15
Signature of the Applicant