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FORM OF APPLICATION FOR FACULTY POSITIONS

(For use of candidates)
Name of the Post Department : ............................................................................................... : ...............................................................................................
Attested Photograph

Area of Specialization: (a) : ............................................................................................... (b) : ............................................................................................... Advertisement No. : ................................................ 01. 02. 03. 04. 05. 06. Name in Full (Block Letters) Fathers Name Date of Birth: Marital status: Nationality: Permanent address dated: ...................................

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Telephone Number Mobile number E-mail Id (if any) 08. Please, state whether you belong to SC/ST/OBC/Physically Handicapped / Gen category 09. Are you willing to accept the minimum initial pay offered, if not, state what is the lowest initial pay that you would accept 10. Present Post held with Designation & name of the Organization where employed 11. Present salary with pay scale Pay Band Grade Pay Basic Pay D.A.

H.R.A.

Any Other Total Rs. Allowances

12.

Were you at any time declared medically unfit, asked to submit your resignation, discharged or dismissed from Government or private service?

-213. Details of educational qualifications: Please give particulars of all examinations passed and degrees obtained commencing with the High School Level (10th standard / Matriculation) Examination. Please attach photocopies of certificates and mark sheets duly attested.
* Clearly mention conversion formula of CGPA to percentage marks, if marks are not mentioned.

Examinatio n

School / College / Institute

Name of Marks Obtained Distinction/ Class/ Regular/ Distance Date of the Board/ (with Max. Marks) Division//Grade Education Passing University/ Institution

Duration of course

14. Details of employments: Please give particulars of your present and past employments in chronological order, starting with the present one:
Sl. No . Organizatio n/ Institute Positio n held Nature of duties / work Date of joining Date of leaving Last Pay Scale of pay Years of experience /Remark

-315 Research & Development, Project, Publication etc.: (Attach detail) (a) Please state the following in the format below: No. of Ph.D. thesis guided Completed On-going No of PG projects guided No. of Projects involved in Sponsored Consultancy No. of Patents

(b) Please state, no. of Publications (Published/Accepted) in the format below: Please attach first page of each publication as proof. Technical Reports In Journals (refereed) Refereed National International National International National International In Conferences Un-refereed Books published/ Edited/ Articles in magazines

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No. of conferences organized/participated (Attach detail) Organized International National Participated (Paper presented) International National

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(a) Teaching Experience

No. of Years :

(b) Post Ph.D. experience

No. of Years :

(c ) No. of different courses taught : UG & PG Please give a list of courses taught on a separate sheet with course titles, level (UG/PG) and number of times taught. (d) Areas of specialization (a) (b) (e) Title of your Ph. D. Thesis (enclose abstracts of Thesis) (f) Laboratory Experience: Please describe, in brief on a separate sheet, your experience in (i) Setting up teaching and research laboratories (ii) Conducting laboratory courses & (iii) Using different types of instruments, systems, computers etc.

-418 Details of the short term courses organized/Attended Name of the short term course Duration Sponsored by No. of participants

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Membership of Professional Bodies/Societies (Please specify National/International)

20.

Extra-curricular Activities/Administrative Responsibilities handled :-

21.

Any other information in favour of the candidature of the Application.

22.

References: (At least three names of referees with their clear and complete addresses along with e-mail ID. Referees should be persons with or under whom the candidate has worked and one of the referees should be from the last Organization/Institute served. Referee should not be close relative of the candidate). 1.

2.

3.

23. (a) (c) (e)

Check List (item-wise) documents attached. (b) (d) (f)

-524. Details of Draft: (a) Draft No : ....................................... Date : .................................. (b) Amount : ....................................... (c) payable at : .........................................................................................................................................

Declaration: I solemnly declare that: 1. 2. 3. 4. 5. The foregoing information is complete and correct. I am not aware of any circumstances which may impair my fitness for employment in the GZSPTU Campus, Bathinda. I have never been found guilty in plagiarism, and no such case is pending against me. I have never been disqualified from University work/appearing in any University examination. I have never been dismissed either from Govt. or from University, college or other Public or Private Organization service. I have never been prosecuted, kept under detention or bound down/fined, convicted by the Court of Law for any offence.

Place: Dated:

___________________________ SIGNATURE OF APPLICANT

Signature of Employer With official Seal Recommendation of the Employer: (If employed)

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Provisional Admit Card Filled by the office Roll No: ______________________ Date of Examination: ____________

Name Father Name D.O.B Post Applied

: ______________________ : ______________________ :_______________________ : _______________________

Photo Attested

Department/Branch: _______________________ Category : _______________________

Address: __________________________________________________ __________________________________________________________ __________________________________________________________

Signature of Candidate Signature of Authorised Signatory (Roll No. Issuing Authority)