Jamia Millia Islamia

(A Central University)
NAAC Accredited Grade “A++”
Jamia Nagar, New Delhi-110025

PROFORMA
(To be filled and submitted along with the Employment Application Form)

Advertisement No. & Date : ______________________________________

Sr. No. & Name of Post : ______________________________________

Faculty/Department/Centre : ______________________________________

Name of the Applicant : ______________________________________

Amount & Date of Deposit : ______________________________________

Valid Email : ______________________________________

Mobile No. : ______________________________________

User’s Bank & Branch Name : ______________________________________

Transaction No./ID/Ref. No. : ______________________________________

UTR No.
(Along with Payment Receipt)

Dated :…………………………. …………………………….

(Signature of Applicant)
 SCORING PROFORMA
(To be filled by the candidates applying for the post of Assistant Professor only)

Name of the Candidate:

Faculty/Department/Centre:

Advt. No. Dated:

Email Id _________________________________ Mobile No. ___________________________

Score Actual Score

Page
S. No. Academic Record Claimed by Obtained
No.
the Candidate (For Office use)
Graduation:-
 80 % & above = 15 marks
1.  Between 60 & 80% = 13 marks
 55% to less than 60% = 10 marks
 45% to less than 55% = 05 marks
Post-Graduation:-
 80 % & above = 25 marks
2.  Between 60 & 80% = 23 marks
 55% (50% for SC/ST/OBC non-creamy layer/PWD) to less than
60% = 20 marks
M.Phil. :-
3.  60% & above = 07 marks
 55 to less than 60% = 05 marks
4. Ph.D. : 30 marks
(Candidates with M.Phil. + Ph.D. will be entitled to maximum 30 marks)
NET with JRF : 07 marks
5.
NET: 05 marks
SLET/SET: 03 marks
(Candidates with JRF/NET/SET together will be entitled to maximum 07 marks)
Research publications in peer-reviewed or UGC listed
6. journals
( 2 marks for each publication subject to a maximum of 10 marks)
Teaching/ Post-doctoral experience
7. (2 marks for each year, subject to a maximum of 10 marks. Experience less than a
year but with six months or more also needs to be reckoned proportionately)
Awards:-
 International/ National Level: 03 marks
(Award given by International Organizations/Government of India/
8. Government of India Recognized National Level Bodies)
 State-Level: 02 marks
(Award given by State Government)
(subject to a maximum of 3 marks)
Total Score
Note: After 13th June, 2019 Research Publication only from the Journals index in UGC-CARE list will be considered.
Enclose all relevant documents mentioned in above columns in sequence.

DECLARATION
I hereby declare that the entries in the above columns are true to the best of my
knowledge, belief and nothing has been concealed or misrepresented.

Place: ……………………
Date: ……………………. (Signature of the Candidate)
 UTR No./ Ref. No.:
…….……………….…………
Date: ………………………
Affix Application Fee:-
recent passport size For General: Rs. 500
photograph For SC/ST: Rs. 250
here JAMIA MILLIA ISLAMIA For office use only
(A Central University) Application fee paid
NAAC Accredited Grade “A++” Call for Interview Yes
Jamia Nagar, New Delhi-110025 No
Sign ……………………….
APPLICATION FORM FOR APPOINTMENT ON THE TEACHING / OTHER ACADEMIC POSITION

1. Candidate’s Full Name

2. (i) Advt. No.: Dated:

(ii) Post applied for: …..…………………………………………………………………………………….

( i i i ) Department/Centre: ….………………………………………………………………………..………..
3. Father’s / Husband’s
name in Full

4. Address:
(i) Correspondence: (ii) Permanent:

………………………………………………….. …………………………………………………..
………………………………………………….. …………………………………………………..
………………………………………………….. …………………………………………………..
Pin: ……………Mobile No: ............…………. Pin: ……………Mobile No: ............………….

Email Id: …………………………………………………………………………………..…………………………………

5. Date of Birth: (Based on Matriculation/Hr. Sec. School Certificate)

Date Month Year

6. Whether U.R. S.C. S.T. O.B.C. PWDs (Divyangjan) (Please tick the correct box)
`
7. Marital Status: Married Unmarried Widow
8. Educational Qualifications: (Enclose the self-attested copies of all the mark sheets, certificates, etc.)

S. No. Qualifications* Board / University Year Div. / %age Subjects

1 Matric/S.S.C.

2 Inter./Sr. Secondary

3 B.A./B.Com./B.Sc./B.E./B.Tech.
4 M.A./M.Com./M.Sc./M.E./M.Tech.

5 M.Phil.

6 Ph.D.
7 N.E.T.

8 Others
* Strike out which is not applicable (Attach enclosures, if necessary)
9. Details of Work Experience:-

Period of Service
Roles and Name and Address of the
S. No. Particulars of the Post
Total Responsibilities Employer
From To
Period

10. Research work / Published work /Scholarship / Fellowships (Attach enclosures, if necessary)

11. If employed presently, furnish the following details:-

(i) Basic Pay Rs. …………………. (ii) Level of Pay ............................ (iii) Allowances Rs………….……………..

(iv) Total Rs. : ……………………………………. (v) Date of next increment ……………………………………..

12. If appointed, time and notice required for joining the post:-

13. Name of two referees:-

Period for which the referee is
S. No. Name of Referee Address of the Referee
known to the candidate

1.

2.

* Applicant may send two testimonials from persons under whom he/she has studied or worked.
NOTE: Books, research papers and typescripts should be sent with the application and not separately.

DECLARATION
I hereby declare that the entries made by me in the above columns are true to the best of my knowledge and belief.

Place: …………………….
Date: ……………………. (Signature of the Candidate)

If employed, remarks of the Forwarding Authority.

Attach separate sheet, if required.
Signature……………………………………………

Name ……………………………………………….

Designation………………………………………….

Address……………………………………………..
Place………………………

Date………………………
 Jamia Millia Islamia
(A Central University) NAAC
Accredited Grade “A++”
Jamia Nagar, New Delhi-110025
IMPORTANT Advt. No…………………….……………… Date ……………………..
1) Attach 10 duly filled in and signed copies of this proforma with the application form.
2) Candidates applying for the post of Assistant Professor are required to fill the attached scoring proforma. Particulars of Mr./Ms./Mrs. ……………………………………………..

For the post of …………………………………………..………………..

Date of Birth, Academic Qualifications Details of Work Experience

Name, Address and Research and Published
Mother Tongue &
Contact No. for Work
Other Languages Board / Division Post & Total
correspondence Exams. Year From-To Employer
University & %age Level Years

School Cert.
Date of Birth:
……………
………………….. ……………
Age: ………Years Graduation

……………
Mother Tongue: Post
Graduation
…………………..
……………
Other
……………
Languages:
M.Phil.
……………………
Ph.D.
…………………… Others

……………………

Date: …………………. (Candidate’s Signature)

 Jamia Millia Islamia
(A Central University) NAAC
Accredited Grade “A++”
Jamia Nagar, New Delhi-110025

ACKNOWLEDGEMENT

Received an application from Dr./Mr./Mrs./Ms._________________________________

for the post ___________________________________________in the Faculty / Department /

Centre _________________________________________________________in response to the

Advt. No.__________________________________________Dated ___________________ along with

payment receipt Transaction No./ID/Ref. No./UTR No.______________________________

Dated _____________________

Date:…………………………… (Signature of the Receiver)