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A f f i x Y o u r

R e c e n t

P a s s p o r t S i z e

P h o t o g r a p h

Attach a bank draft of Rs. 500/- (Rs. 250/- for SC/ST) drawn in favor of the Registrar, University of Rajasthan and payable atJaipur with this form as Application Fee.

UNIVERSITY OF RAJASTHANJ A I P U R

APPLICATION FORM FOR TEACHING POST

To,THE REGISTRAR,University of Rajasthan,Jaipur 302004 (INDIA)

Application for the post of......................................................in the

University Department of .........................................................in the grade of

........................................................for which an advertisement appeared

in.........................................................dated................................................

1. Name in full .....................................................................................................(in BLOCK LETTERS)

2. Father's Name ....................................................................................................Mother's Name .....................................................................................................

Husband's Name ....................................................................................................

3.Address in full ........................................................................................................................................................................................................

City: PIN

Phone # (Residence) Mobile #

E-mail:

4.Age and date of birth ............................................................................ (Attach certificate)5.Nationality ....................................................................................................6. Is he/she a natural born Scheduled Caste/Scheduled Tribe/OBC (Non-creamy layer) candidate?Yes/No .................... If yes specify category ......................................(Attach attested copy of

certificate issued by the competent authority).

7.Place of birth with name of ....................................................................................................District and State

8. (a) Candidate's mother tongue ....................................................................................................(b) What other language(s) he/she can Read......................Speak....................Write.....................

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9. Academic Qualifications:Examination Passed Year of

passingName of the

University or otherexamining body

Max. Marks/Marks

obtained

% ofMarks

obtained

Divisionobtained

Subject(Mention

distinction,if any)

Remarks

(1) High School/Secondary or

equivalent

(2) Higher Secondary/P.U.C. orequivalent

(3) Senior Secondary/Intermediate orequivalentexamination.

(4) Bachelors Degreeor equivalentexamination(B.A,/B. Com../B..Sc. etc.)

(5) Average % of marks of two examinations prior to Master's Degree.

(6) Post-Graduateexamination orequivalent (M.A.,M.Com., M.Sc.)

(7) M.Phil.

(8) Any otherDegree(s)/

Diplomas

(9) NET/SLETExamination

Ph.D. Title:

Date of Award: Name of University:

Notes : 1. Where no division is mentioned, clarification should be given in the 'Remarks' column.

2. Attested copies of mark-sheets for each examination should be attached.10. Scholarships and fellowships or Medals won with details.................................................................................................................................................................

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11. Research Activities :(1) No. of papers published before taking the doctorate degree ..................................................

(a) ........................Papers published in Foreign Journals with names . (List to be Attached)

(b) ........................Papers published in Indian Journals with names. (List to be Attached)

(2) No. of papers published after taking the doctorate degree. ..............................................

(a) ......................Papers published in Foreign Journals with names. (List to be Attached)

(b)......................Papers published in Indian Journals with names. (List to be Attached)

Notes : (a) Detailed statement for Nos. (1) & (2) above be submitted.

(b) Two Reprints of each paper, if any, as far as possible to be attached.

(3) No. of Research Scholars working under you with the date of commencement of work in each

case ........................................................................................................................................

(4) No. of Research Scholars who took the degree of doctorate giving the following details :

(i) Year of taking the Doctorate degree ......................................................................................

(ii) Date of commencement and completion of research work ...................................................

....

12. Other Publications :

(a)Books :

(i) No. of books published. ..........................................................................................................

(Specify Text Book/Reference Books/Edited Books)

(ii) Other books, if any with details ..

(iii) Nature of recognition of publications, if any, with details. .................................................

(b) Articles, if any, published in News- papers/Magazines. ................................................................

13. Any position or authority held or distinction (other than scholarship) gained including Games &

Sports and other Social activities in College/University.

...............................................................................................................................................................

Note : If necessary, details be enclosed on a separate sheet of paper.

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14.Present Position :Pay and grade at presentPost Date of

appointment

Grade Basic Pay

Other allowances,if any, and total

emoluments

Date of nextincrement

15.Appointments held before joining the present post :No. Name of post Name and address of

employerDuration ofappointment

with date

(i) Grade(ii) Basic pay &

allowances

Reasons forleaving the

post

16. Total length of Service in Years and Months as a teacher in College/University.

Teaching Experience Form To Name of College/University

Degree Classes

Post-graduates Classes

Note : Give an explanatory note below to remove ambiguity, if any.................................................................................................................................................................

17. Post Doctoral ResearchExperience

From To Name of University/Research Institute/ Centre/Laboratory

18. Membership of Academic Societies.

19. Any other work/achievement relevant to the post applied for (done after leaving the College with

dates).

........................................................................................................................................................

20. Names and addresses of three persons to 1. ..........................................................

whom reference could be made. 2. ..........................................................

3. ...........................................................

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21. Condition, if any, for accepting the post, if offered .....................................................................22.Time needed to join the service, if selected for appointment. .....................................................23.Other particulars, if any ...............................................................................................................

..............................................................................................................

..............................................................................................................

DECLARATION

I hereby declare that:

1. The entries made in this are true and correct to the best of my knowledge and belief.2. I have not been convicted by a court of Law for any offence which involves moral turpitude.3. I have not indulged in any of the acts of misconduct such as participating in Gherao of any

educational authority, whether academic or administrative, manhandling or abusing suchauthority or damaging any building or other property.

4. I have not been found to have used unfair means in any examination and have not gravelymisbehaved with a teacher or found to have tampered with or forged a marks-sheet, certificate ordegree.

I further declare that the above noted information is true and correct to the best of my knowledge and

belief and no part of it is false. In case any part of the above information is found false or incorrect I

shall, if appointed to the post applied for, be liable to be dismissed from the service.

Signature of applicant

Date...........................

N.B.- 1. Attach a bank draft of Rs. 500/- (Rs. 250/- for SC/ST) drawn in favor of the Registrar, Universityof Rajasthan and payable at Jaipur with this form as Application Fee.Please send a stamped self-addressed envelope with the application.2. Reprints and attested copies of documents submitted with the application will NOT be returned.3. Candidates called for interview and those selected will travel at their own expense.4. Candidates already in service should apply through their present employer.5. Attach separate sheets wherever necessary.

REMARKS OF THE PRESENT EMPLOYER

(in the case of those already in service)

The applicant Mr./Mrs./Miss...................................................................................is holding a

permanent/ temporary post of ..........................................in the grade of Rs .............................. and his/her

present basic pay is Rs. ...........................................p.m. His/Her application is forwarded and he/she will

be relieved in the case he/she is selected for the post applied for.

Signature

Date........................... (Designation & Office Seal)