Sardar Vallabhbhai Patel University of Agriculture & Technology, Meerut 250 110 (U.P.
)
APPLICATION FORM FOR TEACHING POST (To be filled by the candidate)
Please affix your latest passport size self attested photograph
[Part-1]
Name & Address of Issuing Bank Draft Number Date Amount
Post Applied for : Advertisement No. S. No of Post Closing date for receipt of application
1. Name in full (in capital letters) First name-Middle name-Surname 2. Date of birth (DD, MM, YY) and Sex 3. Age as on closing date 4. Fathers name 5. Designation of the candidate (if employed) 6. Name of the Institution/ Organization where employed. 7. Actual place of posting 8. (a) Full postal address for correspondence with pin code; 8. (b) Telephone No., e-mail ID and Mobile no.
Day Day
Month Month
Year Year
Sex
Male
Female
e-mail: ____________________ __________________________
9. Permanent address with Pin code
10. Are you a citizen of India? If so, whether by birth/domicile. 11. *Category (Write SC/ST/ OBC/ General and Name of State)/ Sub Category
Physical handicap Yes No
12. Have you ever been convicted by a court of law for any offence? If so, details thereof. 13. Have you ever been punished or debarred from service of Government, other organization. If so, details thereof. 14. Indicate if you possess essential Qualification if yes fill the full detail 15. If selected, are you prepared to accept the minimum initial pay offered? If not, state the lowest initial pay that you would accept in the prescribed scale. Signature of the Candidate : Date and Place :
Essential :
*Attach attested copy of certificate issued by competent authority of U.P. government.
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[Part-2]
A. Academic Qualifications Exam/Degree/ Institute/Board/University Diploma High School Intermediate Graduation Masters Ph. D. Post-Doctorate Other Please enclose attested copies of certificate/ Degree with the application form. B. Administrative/ Research Management Positions (RMP) / Project Management and In-charge. Nature of Work Duration From To
Year
Subject(s) with major field
Class/Division/ Grade/%marks
Rank/Medal/ Award If any
Remarks
Year
C. Employment Record & Experience (appointment letter & Experience certificate enclosed) Designation Pay scale Nature of work Organization/ Institution & Place of posting From
Period To
Duration (years, month, day)
D. Experience in relevant field Experience in the field of preferential qualifications including SRF/JRF/PDF etc. Name of relevant Field Duration From To
Year
E. In-service Award/Recognition / Fellowship Name of the Awarding Organization (place / Award/Recognition / country) Fellowship
Year
International/ National / Institutional/ Award/ Recognition/President/ Member
F. Special Attainments (Technology development, Variety released, Patent, Prototype, Concept, Methodology, highlight any salient research/success story) Category Title Year Details
G. Seminars/Symposia/Courses/Workshop organized Title of Seminars/ Place of Seminars/ Symposia/Courses/Workshop Symposia/Courses/Workshop
Year From
Duration To
H. Externally funded Project Title
Duration
Year
As PI/Co-PI
Funding Agency Name
Amount
I. International Exposure Title of the programme
Country visited
Year From
Duration To
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J. Any other relevant information not covered above (NCC/NSS/Sports etc.) Attach certificate [Link]. Item Duration Details
K. Publications 1. Research paper in international journals * 2. Research paper in national journals* 3. Review article in referred journals/Research paper in Univ. journal/Lead paper 4. Books/Manuals (published by publishers) 5. Manuals (Institute level) 6. Chapter in book 7. *Popular articles in magazine/research paper in non referred journals
Abstract in published proceedings/souvenir will be considered as equivalent to popular article.
*Submit the list of research paper in following format: Author Year Title Journal with Vol., Nos. Page(s) Thomson Reauters rating if any
DECLARATION a) I hereby declare that the entries in this application are true to the best of my knowledge/ belief and also that I have not concealed any fact or with held any information regarding my past services and record and that if any entry is found to be false or incorrect or that if at any time this is found to have been concealed, I will be disqualified for selection or if appointed will be liable to termination without any notice or compensation. I certify that I have read the employment notice carefully.
b)
Date and Place
Candidates signature
Certificate from personnel Office (for in service candidate)
Certified that Mr/ Kumari/ Smt/ DrS/o, D/o.. is working as in the pay scale from ..to as permanent/ Temporary. No vigilance enquiry/ disciplinary case is pending against him/her. He/ She has not been punished since last 5 years. His/ her work of last five years is found satisfactory. If selected he/ She will be relieved Office File Ref. No. . Date.. . Signature................................... Name........................................ Designation with office seal...... Phone No................................... E Mail ID....................................
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