Professional Documents
Culture Documents
in
7. Nationality jk"Vh;rk ..
8. Religion /keZ ..
Month CGPA
Name of the Board % of
Name of & Year passed Division (if grading is Subjects studied
the
/ University mkh.kZrk dk ekg Js.kh Marks applicable) fo"k;
cksMZ@fo'ofo|ky; dk vad dk
course vkSj o"kZ fr'kr lhth,ih
uke (xzsfMax .kkyh
ikB~;e dk
uke esa)
(a) (b (c) (d) (e) (f) (g)
10th Class /
equivalent
10+2
/equivalent
Bachelors
degree
Masters
degree
M.Phil. /
equivalent
Ph.D.
Any other
exams passed
;fn vU; dksbZ
ijh{kk mkh.kZ dh gks
15. Chronological list of experience (including current position/ employment)
vuqHko] c<+rs e esa (orZeku fLFkfr/ jkstxkj lfgr)
Period of Experience
vuqHko dh vof/k Nature of Scale of Pay
To date No. of years/ Appointment osrueku
Designation & Name & address of From dc rd months / work /
scale of pay employers date (As on date of Duties
inuke o fu;ksDrk dk uke Advertisement) fu;qfDr dh
osrueku dc ls o"kZ ,oa ekg dh d`fr/dk;Z / PB AGP
,oa irk la[;k ihch ,thih
d`fr
foKkiu dh frfFk
dks
(a) (b) (c) (d) (e) (f)
b) Post-doctoral experience
iksLV&MkWDVjy vuqHko
c) Other experience, if any
vU; vuqHko] ;fn gks
Total experience dqy vuqHko
17. Details of Post doctoral experience ih,p-Mh- mikf/k ds ckn iksLV MkWDVjy vuqHko dk C;kSjk
Agency Host Institute From date To date Duration
,tsalh estcku laLFkku dc ls dc rd vof/k
Completed lEiUu
Under supervision pkfyr
xvi.
xvii.
xviii.
N.B. Applications without the above self attested testimonials (applicable to the candidate)
will not be entertained
fVIi.kh% Lo&vfHkekf.kr ek.k&i=ksa ds fcuk ;ksX; mEehnokj vkosnu&i= Lohd`r ugha fd;k tk;sxkA
State whether you have been at any time (a) dismissed, removed or debarred from Service or (b) convicted by a Criminal
crk,a fd d vki dHkh ukSdjh ls c[kkZLr@gVk, x, gS ;k [k vijkf/kd ekeyksa esa dHkh nks"kh@tsy ik, x, gS
I hereby declare that all entries made by me in this application are true, complete and correct to the best of my
knowledge and belief. I understand that in the event of any information being found false, incomplete or
incorrect, my candidature/appointment is liable to be cancelled/terminated.
eSa ?kks"k.kk djrk@djrh gw fd mi;qZDr nh xbZ lHkh tkudkfj;k esjh tkudkjh esa lR;] lgh vkSj iw.kZ gSaA mi;qZDr
dksbZ Hkh tkudkjh vlR;] xyr ;k viw.kZ fl) gks rks esjh fu;qfDr dks [kkfjt fd;k tk ldrk gSA
Place LFkku
Date fnukad .
(The endorsement below is to be signed and forwarded by the Head of the Department/Employer in the case of
the in-service candidates whether in permanent or temporary capacity failing which the application is liable to be
rejected).
LFkk;h@vLFkk;h lsokjr vH;kFkhZ fu;ksDrk@foHkkxk/;{k ls vuqeksnu rFkk vxzlkfjr djk;sa@,slk u djkus ij vkosnu vLohd`r fd;k tk
ldrk gSA
ENDORSEMENT OF THE EMPLOYER
fu;ksDrk }kjk vuqeksnu
Ref. No lanHkZ la[;k Date fnukad ..
FORWARDED
vxzlkfjr
vkosnd .. ukein ij
bl egkfo|ky;@fo'ofo|ky;@laLFkku@foHkkx esa vLFkk;h@lcLVsafVo :i esa ..fnuksa ls dk;Zjr
gSaA budk orZeku osru :i;s . gS rFkk budk osrueku :i;s gS lkFk
esa ,thih@thih :i;s .. gSA ;fn buds vkosnu dks Lohdkj fd;k tkrk gS rks
gesa dksbZ vkifk ugha gksxhA
vf/kdkjh ds gLrk{kj
eksgj lfgr
DECLARATION/UNDERTAKING
(for OBC Candidates only)
?kks"k.kk@'kiFk
dsoy vU; fiNM+k oxZ ds vkosnd ds fy,
vkosnd ds gLrk{kj
LFkku
fnukad.
4. Educational Name of the Name of the Month & Year Division % of Marks CGPA
qualifications course Board/ University Passed/Award Js.kh vad dk fr'kr (if applicable)
'kS{kf.kd ;ksX;rk ikB~;e dk cksMZ@fo'ofo|ky; mkh.kZrk dk o"kZ ,oaa ekg lhthih,
uke dk uke (;fn ykxw gks)
Bachelors
degree
Masters degree
M.Phil. /
equivalent
Ph.D.
NET/SLIET for
lectureship, if any
5. Chronological list of experience Period of Experience vuqHko dh vof/k Nature of work/duties
vuqHko c<+rs e esa dk;Z@dkZO; dh d`fr
Designation & scale of Name & address of From date To date No. of years/
pay employer dc ls dc rd Months
in o osrueku fu;ksDrk dk uke ,oa irk o"kZ@ekg dh la[;k
6. Teaching Experience No. of years No. of Publications Published [ISBN Accepted /In Communicated
'kS{kf.kd vuqHko dqy o"kZ Months dk'ku / ISSN] (Nos.) Print (Nos.) f;k esa
dqy eghus dkf'kr Lohd`r@eq.k esa
[vkb,lch,u@vkb,l la[;k
,l,u] (la[;k)
Books
i) Under-graduate level iqLrdsa
Lukrd Lrj
Research
ii) Post-graduate level Publications
Lukrdkskj 'kks/k&dk'ku
Other
Post-doctoral: publications
Teaching/Research
vU; dk'ku
iksLV MkWDVjy 'kS{kf.kd vuqHko
7.Seminars/ Conferences/ Workshops/ Training Research guidance (No.) M.Phil. / Equivalent (No.) Ph.D. (No.)
programmes, attended/organized etc. 'kks/k&funs'Z ku la[;k ,e-fQy- ;k led{k la[;k ih,p-Mh- la[;k
fopkj&xks"Bh@lEesyu@dk;Z'kkyk@f'k{k.k
dk;Ze@lgHkkfxrk@vk;kstd vkfn
In India (No.) Abroad (No.) Total (No.) Completed lEiUu
Hkkjr esa la[;k fons'k esa la[;k dqy la[;k
Under Supervision pkfyr
8. Present Name of the University / Basic Pay (Rs.) Pay Scale (Rs.) Gross / Total Increment date
Designation Institution ewy osru :i;s osrueku :i;s Salary p.m. (Rs.) (Date/Month)
orZeku in fo'ofo|ky;@laLFkku dk dqy osru frekg osru o`f) frfFk
uke :i;s fnukad ,oa ekg
Self Assessment for the Performance Based Appraisal System (PBAS) for Academic
Performance Index (API)
n'kZu vk/kkfjr ewY;kadu .kkyh ds fy, Lo;a ds fy, 'kS{kf.kd ihch,,l vkadyu n'kZu lwpdkad
,ihvkb
5. Department foHkkx
8. Address for correspondence (with Pin code) i=kpkj dk irk fiu dksM lfgr
9. Permanent Address (with Pin code) LFkk;h irk fiu dksM lfgr
11. Academic Staff College Orientation/Refresher Course attended during the year:
D;k lky Hkj esa vkius dksbZ vksfj,aVs'ku ;k fjQzs'kj dkslZ fd;k gS \
(Please see detailed instructions of this PBAS Performa before filling out this section)
(i) Lectures, Seminars, Tutorials, Practicals, Contact Hours (give semester-wise details, where necessary)
S. No. Course/Paper Level Mode of No. of classes per No. of % of Classes/ Practicals
teaching week allotted Classes taken as per
conducted documented record
Lecture (L), Seminar (S), Tutorial (T), Practical (P), Contact Hours (C)
API Score
(a) Classes Taken (max 50 for 100% performance & proportionate score up to 80%
performance, below which no score may be given
(b) Teaching Load in excess of UGC norm (max score:10)
(ii) Reading / Instructional material consulted and additional knowledge resources provided to students
API score based on Preparation and imparting of knowledge/ instruction as per API Score
curriculum & syllabus enrichment by providing additional resources to Students
(max. score:20)
(iii) Use of Participatory and Innovative Teaching-Learning Methodologies, Updating of Subject Content, Course
Improvement etc.
Total (Max:20)
(ii) Contribution to Corporate Life and Yearly/Semester wise API Score
Management of the Institution responsibilities
Total (Max:15)
Total Score (I+II+III) (Max:25)
S. Title with Page Journal ISSN/ISBN No Whether Peer No. of co- Whether you API
No. nos. reviewed. authors are the main Score
Impact Factor, author
if any
B (i)) Articles/ Chapters published in Books
S. Title with Page Book Title, ISSN/ Whether Peer No. of co- Whether you API
No. nos. editor & ISBN No reviewed. authors are the main Score
publisher author
S. Title with page Details of Conference ISSN/ISBN No No. of co- Whether you API
No. nos. Publication authors are the main Score
author
S. Title with Page Type of Publi Whether Peer No. of co- Whether you API
No. nos. Book & sher & reviewed. authors are the main Score
Authorship ISSN/ author
ISBN
No
S. No. Title of the Paper Title of Conference Organized by Whether international API Score
presented / Seminar / national/ state/
regional/college or
university level
E (iii) Invited Lectures and Chairmanships at national or international conference /seminar etc.
Criteria Last Academic. Year Total API Score for Annual Av. API Score
Assessment Period for Assessment
Period
I Teaching, Learning and Evaluation
related activities
II Co-curricular, Extension,
Professional development etc
Total I+II
III Research and Academic
Contribution
PART C: OTHER RELEVANT INFORMATION
Please give details of any other credential, significant contributions, awards received etc. not mentioned earlier.
LIST OF ENCLOSURES: (Please attach, copies of certificates, sanction orders, papers etc. wherever
necessary)
1 6
2 7
3 8
4 9
5 10
I certify that the information provided is correct as per records available with the university and/or documents
enclosed along with the duly filled PBAS Performa.
Chairperson/Principal
N:B: The Annual Self-Assessment Performa duly filled along with all enclosures, submitted for CAS promotions
will be verified by the university/college and information filed with the IQAC.
Instructions for Filling up Part B of the PBAS Performa
Part B of the Performa is based on Appendix III, Table 1 of the UGC Regulations 2010. It is to be filled out for the
recently completed academic year.
The Performa is to be filled as per these tables and self-assessment scores given. For each category, maximum
scores that can be given or carried forward is indicated in the Table.
The self-assessment scores are further to be based on the indicators/activities given below. Universities may
modify the detailed indicators and related scores based on their experience and requirement without changing
the score requirements assigned to categories and sub-categories in Appendix III, Table 1.
NB. The self-assessment scores are subject to verification by the university/ college, and by the screening cum
Verification Committee or Selection Committee as the case may be.
b.
If teacher has taken classes exceeding UGC norm, then two point to be assigned for Max Score: 10
each extra hour of classes
(ii)
Imparting of Knowledge / instruction vis a vis with the prescribed material (Text Max Score: 20
book /Manual etc) and methodology of the curriculum (100% compliance= 20
points)
(iii) Use of participatory and Innovative Teaching-Learning Methodologies, Updating of Subject Content,
Course Improvement etc.
This is to be filled as per Appendix III Table 1, Category III of the UGC Regulations 2010.
Wherever the research contribution is jointly made, the API scores should be shared between
the contributors as per the formula provided in the Table 1.
The summary must take into account the maximum score limits for each set of indicators as given in Appendix III,
Table1
IV. Similar PBAS Performa could be developed by the universities for the Cadres of Librarian / Deputy
Librarian / Assistant Librarian and Director of Physical Education & Sports / Deputy Director of Physical
Education & Sports / Assistant Director of Physical Education & Sports based on the API Scoring pattern
outlined in Appendix III: Tables IV to IX of the UGC-Regulations, 2010
APPENDIX III TABLE I
Brief Explanation: Based on the teachers self-assessment, API scores are proposed for (a) teaching related
activities; (b) domain knowledge; (c) participation in examination and evaluation; (d) contribution to innovative
teaching, new courses etc. The minimum API score required by teachers from this category is 75. The self
assessment score should be based on objectively verifiable criteria wherever possible and will be finalized by
the screening/selection committee.
Universities will be required to detail the activities and in case institutional specificities require, adjust the
weightages, without changing the minimum total API scores required under this category.
ACTIVITIES.
Brief Explanation: Based on the teachers self-assessment, category II API scores are proposed for co-
curricular and extension activities; and Professional development related contributions. The minimum API
required by teachers for eligibility for promotion is 15. A list of items and proposed scores is given below. It
will be noticed that all teachers can earn scores from a number of items, whereas some activities will be
carried out only be one or a few teachers. The list of activities is broad enough for the minimum API score
required (15) in this category to accrue to all teachers. As before, the self-assessment score should be based
on objectively verifiable criteria and will be finalized by the screening/selection committee.
The model table below gives groups of activities and API scores. Universities may detail the activities or, in
case institutional specificities require, adjust the weightages, without changing the minimum total API scores
required under this category.
Brief Explanation: Based on the teachers self-assessment, API scores are proposed for research and
academic contributions. The minimum API score required by teachers from this category is different for
different levels of promotion and between university and colleges. The self-assessment score will be based
on verifiable criteria and will be finalized by the screening/selection committee.
*Wherever relevant to any specific discipline, the API score for paper in refereed journal would be
augmented as follows: (i) indexed journals by 5 points; (ii) papers with impact factor between 1 and 2
by 10 points; (iii) papers with impact factor between 2 and 5 by 15 points; (iv) papers with impact
factor between 5 and 10 by 25 points. ** If a paper presented in Conference/Seminar is published in the
form of Proceedings, the points would accrue for the publication (III (a)) and not under presentation (III
(e)(ii)).
Notes.
1. It is incumbent on the Coordination Committee proposed in these Regulations and the University to
prepare and publicize within six months subject-wise lists of journals, periodicals and publishers under
categories IIIA and B. Till such time, screening/selection committees will assess and verify the
categorization and scores of publications.
2. The API for joint publications will have to be calculated in the following manner: Of the total score for the
relevant category of publication by the concerned teacher, the first/Principal author and the corresponding
author/supervisor/mentor of the teacher would share equally 60% of the total points and the remaining
40% would be shared equally by all other authors.