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Please affix a
recent passport
size photograph
1.
Advertisement No.
..
2.
..
3.
:..
4.
:.
5.
Marital status
:..
6.
Present address
:.
.
7.
8.
Permanent address
9.
:..
(in words)
:..
10.
Nationality
:.
11.
Religion
12.
Category (SC/ST/OBC/PH/GEN) :.
(Please attach attested photocopy of certificate, in the proforma, prescribed for the
purpose)
Educational Qualification starting with secondary education:
(Please attach attested photocopies of certificates/mark sheet)
13.
Examination/
Degree
14.
Research Degree(s):
University
Degree
the
15.
16.
Name
Employer
of Post held
Period
From
To
Pay Scale/Pay
Band & Grade
Pay with Basic
Pay
Nature of work
(Please attach
separate sheet,
if required)
17.
Teaching/Research experience,
if any.
18.
Number of publication (please attach one copy each of three publications which you
consider most important alongwith complete list of publications):
Publication
Capacity
Books
Independently
:..
.
Published
Accepted
for Under
Publication
preparation
Jointly
Papers/Articles
Independently
Jointly
Abstracts
Independently
Jointly
Patents
Independently
Jointly
19.
20.
21.
Name & Address of two referees (should be familiar with your recent work)
I
Name
Occupation
Position
Address with
Number
II
or
Pin
I hereby declare that all the statements made in this application are true and complete to
the best of my knowledge and belief. I understand that the Jawaharlal Nehru University has
a policy against sexual harassment and is committed to providing an environment free
from discrimination and harassment. I further understand that at any time I am found to
have concealed/distorted any material information, my candidature/ appointment shall be
summarily terminated without any notice/compensation.
Place:
Date: