Gautam Buddha University

Gautam Budh Nagar- (U.P.)

Application Form for Faculty Positions

Rolling Advertisement Adv. No. 5/2011

IMPORTANT

:-

To be filled in by the Candidate

Post Applied for

...... Specialization....................

School of Studies

.....

Photograph
Paste here firmly your recent
Photograph
(Do not staple)

1.

Name (in Block letters)

_______________________________________________

2.

Fathers/Husbands Name

_______________________________________________

3.

Date of Birth

_______________________________________________

4.

Category (SC/ST/OBC/Gen.)
(Pl. enclose certificate)

_______________________________________________

5.

If Physically Handicapped (Pl. enclose certificate)_______________________________________________

6.

Gender (Male/Female)

_______________________________________________

7.

Marital Status

_______________________________________________

8.

Highest Qualification

_______________________________________________

9.

Mobile No. & E-mail ID

_______________________________________________

10.

Postal Address

_______________________________________________
_______________________________________________
_______________________________________________

11.

Permanent Address

_______________________________________________
_______________________________________________
_______________________________________________

12.

S.
No.

Academic Qualification Record:

Exam

Board/ University

Year of
Passing

Specialized
Subject(s)

1.
2.
3.
4.
5.
6.
7.

(Please enclose all above mention academics qualification certificate)

Marks
%

Div./
Grade

13.

Experience Record (in chronological order); use extra sheet if required.

S.
No.

Organization

Designation

Pay- Scale

Grade
Pay

Duration
From
To

Total
Experience

1.
2.
3.
4.
5.
6.
Total Experience

14.

Details of Academic Experience (in years and months)

(a) Teaching at Post Graduate Level

From ___________To_______________

Subjects taught at P.G. Level

____________________________________
____________________________________

Teaching at other Level(s), if any

(b) Ph.D. Research

____________________________________

From _____________To____________

Topic of Ph.D. Research

____________________________________
____________________________________

(c) Research Supervision

(i) Ph. D level ________________________

(ii) P.G. level _________________________

(d) Other Research Experience, if any

____________________________________

Name(s) and Duration of Research Project(s)

15.

____________________________________

Academic Distinctions

No. of Research Papers published in journals (where payment for publication is not required).
Please submit details on a separate sheet.
(a)
In Refereed Journals:

Single/double author(s) Multiple authors

International
National
(b)

In Proceedings of Refereed

(i)

International: _______________________________

Conferences

(ii)

National

:________________________________

Note: Reprints of published Research Papers, along with details of Journal/Proceedings of Conference i.e. Name,
Year, Number, Vol., Page No. and Name of the Publisher may be mentioned & Impact factor.

16.

Other responsibilities held at University/Department Level:

_________________________________________________________________________________________
_________________________________________________________________________________________

17.

Consultancy Project undertaken at University/Department Level (if any):

________________________________________________________________________________________
________________________________________________________________________________________

18.

Last Salary Drawn:

Designation

19.

Pay Scale

Membership of Professional Bodies:

Basic Pay

Academic
Grade Pay

D.A.

Gross Salary

(i) _____________________________________________
(ii) _____________________________________________
(iii) _____________________________________________

20.

Give Names, designation and addresses of three persons (not related to you), to whom reference may be
made about your work, conduct & performance.
(i)

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

(ii)

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

(iii)

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

21.

If not found suitable for the position you have applied for, would you like your candidature to be
considered for lower position:

22.

. Yes / No

State any other information not covered elsewhere(Please attach a sheet, if required)
_________________________________________________________________________________________
_________________________________________________________________________________________

DECLARATION TO BE SIGNED BY THE CANDIDATE

I hereby declare that the details given above are correct to the best of my knowledge and belief. I declare
that in case an opportunity is given, I shall join Gautam Buddha University, G.B. Nagar within. days. I
understand that if any information provided above is found to be false or inaccurate my candidature shall be treated
as cancelled.
Dated:
(Signature)
Name:.......................

Gautam Buddha University

Greater Noida (U.P.)

Post Applied For........... Specialization .......... School of Studies..........

Particulars
Exam

Name:

Academic Qualification
(High School onwards)
Board/
Year
Univ.

Experience
Div.

Publication/
Conference/
Books

Total Experience:

Journals:

Teaching (name of courses also):

International:
National:

Date of Birth:

Seminar/
Conference:

Category:

International:
Present Post:

National:

Research:

Books:

Industry:
Remarks:

Signature of the Candidate