Professional Documents
Culture Documents
NAGPUR UNIVERSITY
(A State University established by Maharashtra Universities Act, 1994)
Advt.No. : RTMNU/GA/227
APPLICATION FORM
(Please read the general instructions & conditions before filling)
Important Note :
(1) The Application Form available on the University website should not be changed in
any manner; otherwise it will be treated as cancelled. Additional sheets may be
used, if required to fill in the Application form by retaining it.
(2) All Communication during the recruitment process will be made through E-mail only.
Post applied for
Subject
Area of specialization
Affix recent
passport size
photograph
Date
Amount (Rs.)
Branch Name
Annexure
No. of Proof
Enclosed
Full Name
(Surname First)
Date of Birth
(DD/MM/YY)
Gender
Marital Status
(Male/Female)
Nationality
Religion
Category
(SC/ST/OBC/OPEN/PH)
Particulars of Physical
Disability, if Applicable
3. Address (In Capital Letters)
Address for Correspondence
Pin Code :
Permanent Address
Pin Code :
Page 1 of 8
4. Communication Details
E-mail ID
Phone No.
Mobile No.
Fax No.
5. Educational Qualifications (Matriculation Onwards)
Name of
Exam
/Degree
University
/Institution
/Board
Year
of
Passing
Percentage
of
Marks
Division/
/Class
/GPA
Annexure
No. of Proof
Enclosed
(Please use an additional sheet, if required, retaining the above tabular format)
Ph.D. (Mark in
Degree Awarded [
Thesis Submitted [
Appropriate Box)
6. Present Position
Designation
University/
Institution
From
Date
Basic
Pay (BP)
Page 2 of 8
Annexure
No. of Proof
Enclosed
7. Teaching Experience
Post Held
University/
Period
Institution
From
To
Years] [
Teaching
Experience
Years Months
Months]
University/
Period
Institution
From
To
Years] [
Work (T/L/W)
Experience
Years Months
University/
Period
Institution
From
To
Years] [
Page 3 of 8
Annexure
No. of Proof
Enclosed
Months]
9. Administrative Experience
Post Held
Annexure
No. of Proof
Enclosed
Administrative
Experience
Years Months
Months]
Annexure
No. of Proof
Enclosed
....
....
....
....
....
....
....
....
....
....
....
....
....
] Months
11.
] Years
Publications :
] Own
] Joint Authorship
] Own
] Joint Authorship
] Own
] Joint Authorship
Own
International
Journals
[
12.
National
Journals
Joint Authorship
International
Conferences
National
Conferences
International
Journals
National
Journals
International
Conferences
(i)
(ii)
(iii)
(iv)
(v)
Page 4 of 8
National
Conferences
Annexure
No. of Proof
Enclosed
13.
Annexure
No. of Proof
Enclosed
(i)
(ii)
(iii)
(iv)
14.
Annexure
No. of Proof
Enclosed
..
..
..
..
..
..
15.
Annexure
No. of Proof
Enclosed
..
..
..
..
..
16.
Referee 2
E-mail ID :
E-mail ID :
Mobile No. :
Mobile No. :
DATE :
PLACE :
(Signature of Applicant)
Page 5 of 8
DECLARATION-I
I hereby declare that all the entries made by me in this application are true to
the best of my knowledge and belief. If anything is found false at any stage, my
candidature for the post of .. may be
cancelled without assigning any reason thereof.
DATE :
PLACE :
(Signature of Applicant)
DECLARATION-II
I, Dr./Shri/Mrs./Ms. ...,
Son/Daughter/Husband/Wife of Dr./Shri
aged years resident at
.
do hereby declare as follows :-
1.
2.
3.
I am aware that if total numbers of living children are more than two,
due to the children born after 28th March, 2006, I am liable to be
disqualified for the same post.
DATE :
PLACE :
(Signature of Applicant)
Page 6 of 8
......
Signature of the forwarding authority
Name : ________________________________
Designation : __________________________
Place : _________________________________
Date : __________________________________
Page 7 of 8
OFFICE SEAL
Proforma-A
A/F
Ack. No.
& Date
Age /
Date
of Birth
Category :
Category
(Caste)
No. of Posts :
Academic Attainments
Qualifications
Year of
Passing
%/
CGPA
Div./
Grade
Teaching
Research
Publications
Admn.
Whether Appl.
Submitted
Through Proper
Chanel?
Rem.
(Yes/
No)
For
Office
use
Only
10
11
12
13
14
International :
Own : ..
Joint : .
Total : .
15
For
Office
use
Only
National:
Own : ..
Joint : .
Total : .
Conference :
I hereby declare that all the entries made by me are true to the best of my knowledge and belief. If anything is found false at any stage, my candidature for the post of
.... Subject .. Specialization .. may be cancelled without assigning any reason thereof.
Date :
Place :
Signature of Applicant : .
Name of Applicant : ..
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