SHRI LAL BAHADUR SHASTRI RASHTRIYA SANSKRIT VIDYAPEETHA Deemed University Qutab Institutional Area, New Delhi- 110016

(Application Form for Academic Positions) Affix Self attested Photograph here

Advertisement No Post Applied for IN (SUBJECT) Specialisation required for the post if any, Please read the instructions at page 8 before filling up the form

1. (i)

Name (In block letters)

(ii) Father's/Guardian's name 2. * 3. Date of Birth Nationality Male /Female 4. 5. Married/Unmarried (a) Post held if any, at the time of sending the application with date of appointment (state whether permanent or on probation or temporary) (b) Name of the Employer Age (as on the last date of the application)

The selected candidates shall produce, in original the matriculation or equivalent certificate as proof of the date of birth. No other evidence will be accepted.

6.

(a) Present basic monthly pay and allowances (State separately). Grade Basic Pay Allowances i. ii iii Dearness/ City Compensatory House rent Rs. Rs. Rs. Rs. Rs. Rs.

iv.

Any other allowance/

Rs.
.Rs.

Total emoluments/ (a) (b) 7. 8. 9. Date of next increment. Age of retirement in the present post Rs...

Minimum basic pay acceptable.

p.m.

Do you belong to the Scheduled Caste/ Scheduled Tribe ? If yes, please state clearly and attach certificate in support there of. Postal Address (Address for Communication) Permanent Address

10.

11.(a) Whether the candidate is in receipt of any pension benefits if so, the amount of pension and pension equivalent to gratuity must be indicated. (b) Whether the candidate would be entitled to any pension any benefits on his pre-mature retirement from his present post, if selected for appointment in the university, if so the amount of pension and the pensionary benefits may be indicated.
12. Academic Qualifications (Examinations passed Matriculation/Higher Secondary onwards to Doctorate/Research Degrees).

Examination Passed

Name of the University/ Board

School/ College attendant

Division with Percentage of marks obtained

Year of Passing

Subject offered

13.

Academic Distinction (eg. any prize medal award etc.)

14.

Teaching Experience at Universities or Degree Colleges : Designation Nature of post Temp./ Perm. Classes taught U.G. P.G. Period From - To Length of Experience Years .. Months..

University/ College Name

15.

Administrative Experience, if any Designation Nature of post Temp./ Perm. Nature of Duties Period From - To Length of Experience Years .. Months..

Name of Institution / Organization

16.*

Any Published work or books written by the applicant or particulars of any research or other work that he may like to mention. If necessary, a separate sheet of paper may be used for this purpose. Mention the exact Under Publication Preparation no. of Publications (Specify the No.) (Please Specify) Date of Submission

1. 2. 3. (b)

Books Research Papers Articles Details of Supervision of research degrees Awarded Research in progress Thesis / Dissertation

1. 2. 3. (c)

M.Phil Ph.D

Special subject of study or branch of specialization, if any,

17.

Membership of learned bodies

18.

No. of literary, cultural or other activities e.g. attainment in sports games etc.) in which the applicant is interested and distinction, if any, obtained.

19.

Details of experience in imparting education through any means of communication and innovations in teaching methods and / or production of teaching methods and / or production of teaching materials.

Signature of the Applicant in full ---------------------------------------------------------------------* Please also give the subjects of papers together with names of Journals and dates, reprints of important papers should be attached to the application.

DECLARATION I declare that the statements made in this application are true to the best of my knowledge and belief. Incomplete applications or omissions of any factual information intentional or otherwise or Non-submission of any desired shall entail cancellation of candidature. Date Signature of the Applicant