Sie sind auf Seite 1von 2

A

Website: http://jobs.puchd.ac.in

Serial No

The candidate should attach nine Photostat copies of this form alongwith the original

PANJAB UNIVERSITY, CHANDIGARH

Advertisement

Application for Teaching/Research Post

(For Office Use)

Dairy No.

Affix recent Passport size photograph

(Use separate form for each post)

Name of the Post with specialization

Department

Date

Name in Full(In block letters) Mr./Mrs./Ms

Father Name:

Mother Name:

Date of Birth:

Place of Birth:

Nationality:

Marital Status:

(If Yes,

Member of Scheduled Caste/Tribe/Backward Class/ Physically Handicapped

Please Attach certificate from Tehsildar /Magistrate I Class of the area).

B. Addresses :

Permanent address(in block letters):

Present Address: (for Correspondence) (in block letters):

Phone/Mobile

C. Minimum Pay acceptable:

E-mail:

Joining time (If Selected)

D. Educational Qualification: (Please attach one set of attested copies alongwith original application only)

Examination

Univ/Board

Main Subject

Year of

Marks

Class/

Merit/Prizes /Medals won if any.

 

Passing

Obtd. (with

Divn./Grade(attach

Max

conversion formula)

 

Marks)

1. Matric

           

2. 10+2/Pre-Med /Pre-

           

Engg.

3.

B.A/B.Sc/B.Com.

           

etc.

4.

M.A/M.Sc/M.Com

           

etc.

5. M. Phil

           

6. Ph. D.

           

7. Any other Exam.

           

(please specify)

8.

Eligibility Test for

           

Assistant Professor

           

E. Professional Training :

S. No.

Organisation

Period

Details of Training

From

To

F: Employment Experience (details in chronological order, starting with first job

Name & Address Employer/Institution

Date of

Designation

Nature of

Pay p Basic.m. & Grade

Reason

Reason

Joining

Leaving

Job

For Leaving

Page 1 of

 

Website: http://jobs.puchd.ac.in

G.

Period of Teaching Experience (in Years)

 

Subjects/Papers Taught

Period

From

 

To

(i)Postgraduate Classes

   

(ii)

Degree Class

 

(iii)

Any Other

 

H.

Total Academic Performance Indicator (API) score as per guidelines/Instructions (Appendix) available at Panjab

University website. However, candidates from other then academic institution should attach detailed account of their personal achievements. (Please attach 9 photocopies)

I. Membership of Professional Societies, if any :

J. National/International Awards / Fellowships

K. Paragraph of self-evaluation regarding different fields of activity relating to the job:

L. Referees :

These should be professionally competent persons, well acquainted with some aspects of the applicant’s training, accomplishments, capability and character but must not be relations. At least two of them should be citizens of India. For applicants having done post-graduate or post -doctoral research, the research supervisors must be listed. Supervisior of each major employment and present or most recent employment must be listed.

1 .

2 .

3 .

Name

Occupation/Position

Address

M. Additional Information: (No annexure need be enclosed )

N. Whether willing to join as temporary/Contract/Guest Faculty (if not selected)

Yes / No

--------------------------------------------------------------------------------------------------------------------------------------------------------------------

O . List of Enclosers:

1

.

2 .

3 .

4 .

5

.

6 .

7 .

Draft

No

Dt

Amount

P. Declaration: I solemnly declare that:

i) The foregoing information is complete and correct. I am not aware of any circumstances which may impair my fitness for employment in the Panjab University, Chandigarh

ii) I have never been dismissed either from Govt. or from University, College or other Public or Private Organisation service

iii) I have never been prosecuted, kept under detention or bound down/fined, convicted by the Court of Law for any offence.

Place:

Date:

Page:2 of 2

Signature of Applicant

_

Signature of Employer

With Official Seal