Scribd
Upload
9 views

Application Form

This document is an application form for a contractual post at Dr. Babasaheb Ambedkar Open University, established by the Government of Gujarat. It requires personal information, educational qualifications, language proficiency, and details of experience, along with necessary attachments. The applicant must declare the truthfulness of the information provided and acknowledge the consequences of false information.

Uploaded by

vjveer1995
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
9 views

Application Form

This document is an application form for a contractual post at Dr. Babasaheb Ambedkar Open University, established by the Government of Gujarat. It requires personal information, educational qualifications, language proficiency, and details of experience, along with necessary attachments. The applicant must declare the truthfulness of the information provided and acknowledge the consequences of false information.

Uploaded by

vjveer1995
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

DR.

BABASAHEB AMBEDKAR OPEN UNIVERSITY


(Established by Government of Gujarat)
“Jyotirmay Parisar”
Dr. Babasaheb Ambedkar Open University Marg,
Sarkhej - Gandhinagar Highway, Chharodi, Ahmedabad-382 481
Website: www.baou.edu.in
Advertisement Date: 15/06/2019.

Application form

Name of the contractual post applied for: ________________________ Sub: _________________________

1. Name of applicant _________________________________________________ Please affix your


recent passport size
(Surname) (Name) (Father’s/Husband’s Name) colour Photograph
& sign across

2. Address:-

(1) For correspondence: (2) Permanent Address

_____________________________ ______________________________

_____________________________ ______________________________

_____________________________ ______________________________

PIN:- _____________ Ph: __________ PIN:- _____________ Ph: ___________

3. Mobile Number: _________________________________

4. E-mail: ____________________________________ Aadhar No: __________________

5. Mother tongue: ____________________________ 6. Nationality: ______________

7. Date of Birth: __________________ Age as on Dt. ………….: Year _____ Month______

8. Category:- (Attach latest recognized certificate for the reserved candidates)

SC [ ] ST [ ] SEBC [ ] D.A.( Physical Handicapped) [ ]General [ ]

9. Proficiency in language:
Language Writing Reading Speaking

(1) Gujarati ___________ ___________ ____________

(2) __________ ___________ ___________ ____________

(3) __________ ___________ ___________ ____________

(4) __________ ___________ ___________ ____________

1
10. Educational Qualifications: (from S.S.C.)

Examination Board / University Year of Marks/Grade, Main subject Remarks


Passing Percentage

S.S.C.
H.S.C.
Graduation:
Degree :__________
st
1 Year
nd
2 Year
rd
3 Year
Post-Graduation
Degree :__________
st
1 Year
nd
2 Year
M. Phil.
Ph.D.

11. Other educational achievements: (Award, Prize, Medal, etc.)

12. Proficiency in Computer (Give details)

13. Details of UGC/CSIR or similarly recognized / NET/ SLET exam, if passed.

Year of examination passed: ________________ Regn. No. ____________________

2
14. Details of experience: (Kindly fill up the table )

Name of the Designation Pay scale and basic Duration


Institution pay as on
application date,
Grade Pay

16. Details of Publication and Research work:

S. No. Title Year of Publisher ISBN / ISSN Author/Co


publication No. author

(Please use separate sheet if needed)

17. Details of Seminar / Workshop / Orientation / Refresher Course:

Sr. Category State/National/


No. Name of Institution Programme Duration Whether paper International
submitted

(Please use separate sheet if needed)

18. Please give name, address and contact number of two persons for reference.

(1) ________________________________ (2) __________________________________

______________________________ ___________________________________

________________________________ ___________________________________

________________________________ ___________________________________

3
19. Details of attachments: (Attach self-attested Xerox copies)
(1) Proof of Date of Birth.
(2) Latest Certificate of SC/ST/SEBC/Handicapped
Certificate No.____________ Date of Issue of Certificate _______________
(3) Proofs of Educational qualifications
(4) Experience certificates – If your teaching experience is in a Self Finance Institution, please
submit copy of approval of your appointment / profile of the concerned University.
(5) NET / SLET examination pass certificate
(6) Details of guidance to M.Phil./Ph.D. category students.
(7) M.Phil. / Ph.D., Thesis, Titles of Publications.
(8) Details of Seminars / Workshops / Orientation programme / Refresher Course.

(9) Others.
20. Other information.

CERTIFICATE

I hereby declare that the information provided by me in the application from is true according to my
knowledge and belief. I have not given any wrong or incomplete information. I know that in case of any false
information found on my part after my appointment, my service is liable to be terminated without any notice.

I affirm that there is no criminal case/civil case or warrant or departmental proceedings pending against me
in any court of law. If any departmental proceedings or civil or criminal case found against me I will be
responsible for that, in that case, I know that, my service is liable to be terminated without any notice.

I have read the instructions given along with the application form and understood the same and I am abide
by it.

Date ___________________________ _______________________________

Place __________________________ (Signature of the applicant)

You might also like