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Babasaheb Bhimrao Ambedkar University (A CENTRAL UNIVERSITY, Estd.-1996)

The document appears to be an application form for teaching and non-teaching positions at Babasaheb Bhimrao Ambedkar University. The multi-page form requests applicants to provide personal details, educational qualifications, work experience, publications, research experience, and references. Applicants are asked to sign a declaration confirming the truth and accuracy of the information provided in the application.

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Jravi Shastri
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© Attribution Non-Commercial (BY-NC)
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Download as PDF, TXT or read online on Scribd
41 views

Babasaheb Bhimrao Ambedkar University (A CENTRAL UNIVERSITY, Estd.-1996)

The document appears to be an application form for teaching and non-teaching positions at Babasaheb Bhimrao Ambedkar University. The multi-page form requests applicants to provide personal details, educational qualifications, work experience, publications, research experience, and references. Applicants are asked to sign a declaration confirming the truth and accuracy of the information provided in the application.

Uploaded by

Jravi Shastri
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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BABASAHEB BHIMRAO AMBEDKAR UNIVERSITY (A CENTRAL UNIVERSITY, Estd.

-1996)
VIDYA VIHAR, RAEBARELI ROAD, LUCKNOW-226025 Website: www.bbau.ac.in

Application Form for Teaching and Non-Teaching Posts


Advertisement No: Last date of receipt of filled in Application Form: Registration No: (For Office use Only) Paste your recent passport size Photograph here

14/08/2013

Details of Bank Payment DD Number BANK

Amount

Name of the Bank

DD issuing branchs Name

1. Name of the Post Applied for:----------------------------------------------------Department:------------------------2. Applicants Area of Specialization:-------------------------------------------------------------(Applicants area of specialization must be relevant to the area of specialization notified in the advertisement) 3.

Personal Details: First Name Middle Name Surname

(a) Name (in capital letters) (b) Date of Birth c) Fathers Name d) Mothers Name e) Nationality f) Gender g) Religion h) Community/Category (delete the ones not applicable) i)Marital Status j)If physically disabled indicate the relevant particulars i) Blindness or Low Vision ii) Hearing Impairment

Day

Month

Year

Age as on date of Advertisement

Age

Months

Male

Female

GEN / SC / ST / OBC /Other categories: -----------------------------------If other Categories give details--------------Married/ Unmarried If applicability write Yes Percentage of Disability Sl No of proof enclosed

iii) Locomotors Disability or Cerebral Palsy(includes all cases of


Orthopedically Handicapped)

k) Present Postal Address with Pin Code

E-mail: Mobile Ph: Landline with STD Code Fax

4.

Educational Qualifications (attached additional pages if required)


Name of the Course Name of the Board/University Month & Year Passed Division %of Marks Aggrega te Marks CGPA(if grading is applicable) Subjects Studies Sl No of proof enclosed

10 Class/ Equivalent 12 Class/ Equivalent Bachelors Degree


th

th

Masters Degree

M.Phil/Equivalent

Ph.D. Indicate whether Ph.D. degree has been awarded: Yes/ No In case of Yes please submit the followings Date of Registration Date of Submission Date of Notification
Sl No of proof enclosed

NET UGC / CSIR, for lectureship if any

Subject

Roll No

Year

Any other Exam passed equivalent to NET ( SLET/SET etc.)

5. Chronological List of Experiences (Including current position/Employment)


Designation & Pay Band Name & Address of the Employer Nature of Employment (Permanent/Temporary/ Contract/Others (specify) Period of Experience Date From Date To No of Years/ Months (as on day of adv.) Nature of Work/Duties Sl. No of proof enclosed

6. Total Period of Experience (Please ensure that the period of Teaching & Research experiences claimed do not overlap) a)Teaching i)Under Graduation Level ii)Graduation Level No of Years No of Months

Sl No. of proof enclosed

iii)Post Graduation Level b)Post-Doctoral: Teaching/ Research c) Research Experience d)Other Experience, if any
7.

Publications, if any, in last five years (Mention here only numbers. The details of copies of reprint to be enclosed - for teaching posts only)
Published ( No.) ISBN/ISSN No Accepted/ (No.) In Print Communicated (other than published/ Accepted) Sl No. of proof enclosed

Publications Books Books (as co-author) Books(edited) Chapter in Books Research Paper Articles in referred Journals Conference Proceedings Other Publications/Patents (specify)

8. Seminars/Conferences etc. In India Seminars/Conferences/Workshops/Symposiums/Training Programmes etc. Organised Seminars/Conferences/Workshops/Symposiums/Training Programmes etc. Participated as Paper Contributor Presentator / Discussant Seminars/Conferences/Workshops/Symposiums/Training Programmes etc. Attendant 9. Membership in Professional Body Name of the Organization Annual ship Member Life Membership Membership No Sl No of proof enclosed / (No.) In Aboard (No.)
Sl No of proof enclosed

10. Research Guidance (No. of Students Guided) Completed Under Supervision

Post Graduate(No.)

M.Phil/Equivalent (No.)

Ph.D. (No.)

Sl No. of proof enclosed

11. Research Projects Undertaken (other than that for a research degree) Subjects of Research Date of Commencement Date of Completion Emoluments Drawn Under Auspices whose Sl No of proof enclosed

12. Present Positions


Designation Name of the Institution Nature of Institution (Govt./Autonomous Body/Self Financing/ Private/NGO/Others (specify) Basic Pay Pay Band & Gross Pay/Total Salary P.M.( in Rs.) Sl. No. of proof enclosed

13. References (Three) Name & Complete Postal Address Referee-1 (Present Employer) Referee-2 Referee-3

E-Mail Phone(Landline) with STD Code Mobile Ph. Fax: 14. Are you willing to accept the minimum initial pay in the grade? If not state reasons for claiming higher starting pay.

15. Total No. of self attested testimonials attached


( Applications without self attested testimonials will not be entertained)

Declaration:
I----------------------------------------------- Son/Daughter of----------------------------- hereby declare that all the statements and entries made in this application are true, complete and correct to the best of my knowledge and belief. In the event of any information being found false or incorrect or ineligibility being detected before or after the selection committee and Board of Management meetings, my candidature/appointment may be cancelled by the University. Signature of the Applicant Name(in block letters): (Application not signed by the candidate is liable to be rejected.) Date:

Endorsement by the Employer:


(The endorsement below is to be signed & Forwarded by the Head of the Institution/Employer of the organization/institution in the case of the in-service candidate) Forwarded to BBAU, Lucknow-226025 The applicant Dr./Mr./Mrs./Ms---------------------------------------------- who has submitted this application for the post of----------------------------------- in the BBAU, Lucknow has been working in this organization namely----------------------------------------- in the post of--------------------- in a temporary/contract/permanent capacity with effect from------------- in the Pay Band of of Rs.----------------------------. He/She is drawing a basic pay of Rs.-------------------. Further, it is certified that the applicant has requisite qualifications/experiences as per the post advertised. There is no disciplinary/vigilance case has ever been held or contemplated or is pending against the said applicant. There is no objection for his/her application being considered by the BBAU. Signature of forwarding Officer Name:-------------------------Designation:-----------------------------Place:-------------------------------------Date:--------------------------------------Seal

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