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 : ______________________________________
Post applied for : _______________________ Sl. No.________
Deptt./Office : ______________________________________
Name of the Applicant : ______________________________________
Date & Amount of fee deposited : ______________________________________
(Plz attach payment slip)
User’s Bank & Branch Name : ______________________________________
Transaction No./ID/Ref. No. : ______________________________________
UTR No./UPI No.
Valid Email (Capital Letter only) : ______________________________________
Mobile No. : ______________________________________
Dated :…………………………. …………………………….
(Signature of Applicant)
For office use only
Affix
Application fee paid
recent passport size
Eligible Yes
photograph
here JAMIA MILLIA ISLAMIA No
(A Central University) Sign ………………………
NAAC Accredited Grade “A++”
Jamia Nagar, New Delhi-110025
APPLICATION FORM FOR APPOINTMENT ON THE NON-TEACHING POSITION
1. Candidate’s Full Name
2. (i) Advt. No.: Dated:
(ii) Post applied for: …..…………………………………………………………………………….…………………….
( iii ) Deptt. / Office: ….……………………………………………………………………….…………………..………..
3. Father’s / Husband’s
Name in Full
4. Address:
(i) Correspondence: (ii) Permanent:
………………………………………………….. …………………………………………………..
………………………………………………….. …………………………………………………..
………………………………………………….. …………………………………………………..
Pin: ……………Mobile No: ............…………. Pin: ……………Mobile No: ............………….
Email Id: (in Capiltal letter) ……………………………………………………………… Nationality ..…………………
5. Date of Birth: (Based on Matriculation/Hr. Sec. School Certificate)
Date Month Year
6. Category GEN 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 Degrees, Marksheets, Certificates, etc.)
S. No. Qualifications* Board / University Year Div. / %age Subjects
1 Matric/S.S.C.
2 Inter./Sr. Secondary
3 B.A./[Link]./[Link]./B.E./[Link].
4 M.A./[Link]./[Link]./M.E./[Link].
5 [Link].
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
S. No. Particulars of the Post Name and Address of the
Total Pay Level
From To Employer
Period
10. If employed presently, furnish the following details:-
(i) Pay Level …………………. (ii) Basic Pay Rs. ………........................... (iii) Allowances Rs. ………….…………….
(iv) Total Rs. ……………………………………. (v) Date of next increment ……………………………………..
11. If appointed, time and notice required for joining the post:-
12. 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.
UNDERTAKING
I have read the applicable guidelines, which are binding. I do hereby solemnly affirm and declare that the information
given in the application, the statements made and the supporting documents enclosed with this application form are true
and correct to the best of my knowledge and belief. If any information given by me in this application form is found to be
fake, misrepresented or concealed, my candidature/appointment is liable to be rejected and I may be subjected to the
legal/disciplinary proceedings.
Place: …………………….
Date: ……………………. (Signature of the Candidate)
If employed, remarks of the Forwarding Authority.
Attach separate sheet, if required.
Signature……………………………………………
Name ……………………………………………….
Designation………………………………………….
Place………………………
Address……………………………………………..
Date………………………
Jamia Millia Islamia
(A Central University)
NAAC Accredited Grade A++”
Jamia Nagar, New Delhi-110025
Advt. No…………………….…………… Date ……………………..…
Particulars of Dr./ Mr./Mrs./Ms. ………………………………………
Date of Birth, Mother Academic Qualifications Details of Work Experience
Name, Address and Contact No. for Tongue & Other
correspondence Languages Board / Percentage/ Post & Total
Exams. Year Employer From-To
University CGPA Level Years
Name:- Date of Birth:
…………………..
10th Passed
Address for correspondence-: (as on 31.07.2025)
Age: ……………….Years 12th Passed
Mother Tongue:
Graduation
…………… ……………
Post applied for:- Other Languages:
Post
Graduation
……………
Mobile:- ……………
Category Others:-
Email id (in capital letter):- (Gen/OBC/SC/ST/PwBD)
:- ……………
……………
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._________________________________
applied for the post of _______________________________________________________________in
the Deptt. / Office __________________________________________________in response to the
Advt. No ._________________________Dated ___________________ along with payment receipt
Transaction No./ID/Ref. No./UTR No./UPI No.___________________________ Dated
_____________
Date:…………………………… (Signature of the Receiver)
