TEACHING The Maharaja Sayajirao University of Baroda · PDF fileTEACHING The Maharaja...

of 16

MSUP-2709/1-1500-07-13 (ADE-Teac. MO)

The Maharaja Sayajirao University of Baroda Fatehgunj, Vadodara-390 002, Gujarat (India)

Kindly read important notes before filling-in form: 1. Use black ink to fill in the form and Do NOT overwrite.

2. Fill in all fields in CAPITAL letters only. 3. Please TICK appropriate box whichever is applicable e.g.

If you are a Male :-> Gender: Male / Female

Employee should sign strictly inside this box only with black ink

1. Personal Information Section

Prefix: : Dr./ : Prof./

: Mr./ : Ms. First Name Middle Name Last Name

Name of the Employee: (In case of changed name, write current name)

Name of the Employee: (In Gujarati)

Name as printed on Legally Valid Document (in English) (Passport/Aadhar Card/Degree/Uni. Records/PAN card/Voter Election Card)

Father’s/Husband’s Name:

Mother's Name:

Previous name of the Employee: (In case of changed name)

Reason for name change: Due to Marriage / other reasons

Univ. Circular Reference Number & Date:

Marital Status: Unmarried / Married/ Divorced/ Widowed/ Deserted

Gender: Male / Female / Transgender

Date of Birth (DD/MONTH/YYYY): / / Place of Birth:

Identification marks: 1. 2.

Religion: Citizen of (country name):

Domicile of State: Blood Group (with Rh):

Address for Correspondence

State: Gujarat District: Tehsil: City/Town/Village:

Address (House no,

street/area/suburb etc.):

PIN Code:

Native Address (As per University Records)

State: District: Tehsil: City/Town/Village:

Address (House no,

street/area/suburb etc.)

PIN Code:

Permanent Address [Write only if different than ‘Address for Correspondence’]

State: District: Tehsil: City/Town/Village:

Address (House no,

street/area/suburb etc.)

PIN Code:

Contact Details

Phone # (R): STD Code: Phone No: Phone # (O): STD Code: Phone No:

Mobile number: +91 - Email ID:

Please paste a passport

size (35 mm X 45 mm)

Colored Photograph here,

Do NOT staple. Photo

should not exceed the

borders.

The COLORED photograph

MUST be recent and with

white background only.

TEACHING (Office Use only)

Form No :

Employee should sign strictly inside this box only with black ink

of 16

Passport Details (If any)

Passport Number: Place of Issue: State:

Issue Date (DD/MONTH/YYYY): Valid up to (DD/MONTH/YYYY)

2. Legal Reservation Information Section

Category: General / Reserved If Reserved: SC / ST / SEBC/ PH

Caste: Sub-Caste:

Height in cms: Weight in kg:

If Physically Challenged: Visually Impaired ( %) / Speech and/or Hearing Impaired ( %) / Orthopedic Disorder ( %)

If Mentally Challenged: Attention-Deficit/Hyperactivity Disorder/Emotional Disturbance/Epilepsy/Intellectual Disability/Dyslexia/ Dyscalculia/ Dysgraphia/Speech and Language Impairments/Spina Bifida/Traumatic Brain Injury

4. Family Information Section (use additional sheet if required)

Sr.№

First Name Middle Name Last Name Gender (M/F/T)

Date of Birth (DD/MM/ YYYY)

Is my (e.g. Husband/ Wife/ Son/ Daughter/

Mother/ Father/ Brother/ Sister/ Specify if Other)

Tick

() if Nomin

ee

If nominee, Nomination

%

1 / /

2 / /

3 / /

4 / /

5 / /

6 / /

7 / /

8 / /

9 / /

10 / /

3. Languages Known [Tick () below the column if applicable]

Sr.№.

Language Name Read Write Speak

Understand the spoken language but cannot read, write or speak

Is this your Mother Tongue? (Only one)

1

2

3

4

5

6

7

8

9

of 16

5. Educational Details Section (use additional sheet if required)

Degree/ Diploma/

Certificate Name

(BE/BA etc.)

Specialization (if any) Subject / Stream)

Name of Board /University

Name of School/College

Date of Passing

(DD/ MONTH/ YYYY) OR

MONTH/YYYY

Examination Seat No.

(Last)

Degree / Passing Certificate No.

Grade / Total Marks Obtd.

Out of

S.S.C.

H.S.C.

Graduate Degree (Specify Below) _________

Postgraduate Degree, specify below: _________

Research Degree: M. Phil.

Research Degree: Ph. D. / Any Other (specify): ________

NET/SLET

CCC/CCC+

Diploma (specify) _________

ITI Certificate

Any other Qualification _________

Any other Qualification _________

6. Present Employment Details

Appointment Status: Confirmed / On Probation / Temporary: Staff Type: Teaching

Date of first Appointment: Date of Confirmation:

(if applicable)

/ /

(DD/MM/YYYY)

Superannuation Date: / /

(DD/MM/YYYY) Retirement Date: 14/June/_____ OR 31/OCT/_______

Place of Employment University Head Office / Faculty / College / Institute / Unit (Pl. specify):

Present Designation

Whether Promoted or Appointed to Present Designation:

Promoted / Appointed Date of Joining Present Designation:

/ /

(DD/MM/YYYY)

Date and No. of Letter of Appointment / Promotion in the Present Designation:

Letter No.: S.R. No. & date as per Letter of Appointment / Promotion, if any)

SR No.

/ /

(DD/MM/YYYY)

/ /

(DD/MM/YYYY)

of 16

Name of Faculty/College/Institute/Unit where appointed / promoted:

Name of Department / Section

(as per establishment list):

Name of Department /

Section (work arrangement wise):

Pension Scheme: CPF / GPF / New Pension Scheme GPF/CPF/UCPF №:

Employee Code: (As on salary slip) PAN:

EL (Balance as on 01-07-2013) : HPL (Balance as on 01-07-2013) : LWP (Enjoyed upto 30-06-2013) :

Present Basic Salary

[as on salary slip July paid in August 2013 (Pay Band + Grade Pay)]

Pay Band Grade Pay/AGP Basic Pay

Allowance as on latest salary slip Amount in Rs. Deduction as on salary slip Amount in Rs.

NOTE: Write amounts only if the allowance or deduction is applicable to you, else write ‘N.A.’

House Rent Allowance (HRA) GPF/CPF/UCPF

Dearness Allowance (DA) Professional Tax

Compulsory Local allowance (CLA) Income Tax (TDS)

Medical Allowance (MA) Group Insurance Scheme

Exam Allowance (EA) Society Saving

Transport Allowance (TA) Quarters Rent

Washing Allowance (WA) Furniture Rent

Work Allowance Water Charges

Cash Allowance Cumulative Time Deposit (CTD)

Dearness Pay Allowance (DPA) LIC

Special Allowance GPF Arrears

Arrears Others

Advances and Recovery

Festival Advances Recovery

Loan Advances Recovery

Society Loan Recovery

Govt. Credit Society Loan Recovery

Food Grain Advances Recovery

Housing Loan Recovery ( HDFC/ SBI/

Allahabad/ BOB/ Gruh Finance)

(Specify if Other ___________________)

Vehicle Loan Recovery

GPF/ CPF/ UCPF Loan Recovery

Salary Bank A/c Details:

Bank of Baroda A/c No. (14 digit) Name of the Branch MICR Code

Nature of Scale: Senior Scale / Selection Grade / Reader Designation / CAS- Associate Professor /

CAS-Professor

Stage: Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6

of 16

7. Previous Experience in the M. S. University of Baroda (Prior to joining in the present designation) (use additional sheet, if required)

Name of the Faculty / College / Institute /

Unit / Section of Univ. Head Office

Designation

From (DD/

MONTH/ YYYY)

To (DD/

MONTH/ YYYY)

Job Description

Salary Scale Details (Pay Band, Grade

Pay etc.)

Uni. Order No.

Order Date

8. Previous Experience (Previous to Joining The Maharaja Sayajirao University of Baroda, Vadodara) (use additional sheet if required)

Name of the Faculty / College / Institute /

Unit / Other Organization

Designation From

(DD/MONTH/YYYY)

To (DD/MONTH/YYYY)

Job Description

Salary Scale Details

(Pay Band, Grade Pay etc.)

of 16

Please attach annexure, in requisite numbers, to this form to provide details in this section. The details include information about volumes or books authored/co-authored/edited, research papers, conference papers, projects and research collaborations done by you.

10. Attached Copy of Documents and Certificates Section

Please attach self-attested copy (clear and sharp copies are required) of the documents mentioned in the list. Mandatory must be submitted with form. Optional documents, if available and applicable, must be submitted.

Sr. №.

Name of Document/Certificate Mandatory Attached (Yes/No)

1 School Leaving Certificate Mandatory

2 PAN Card Mandatory

3 Caste/ Tribe Certificate with Category (Whether Applicable? - Yes/ No) Mandatory

4 Changed name in Govt. Gazette (Whether Applicable? - Yes/ No) Mandatory

5 Certificate for Physically Challenged (Whether Applicable? - Yes/ No) Mandatory

6

7

8

9

10

11

12

13

11. Declaration by Employee

I hereby declare that the information filled in by me in this form is accurate and true to the best of my knowledge. I will be responsible for any discrepancy, arising out of the form signed by me. Place: Date:

Signature of the Employee

12. For Office Use Only

Designation Remarks / Particulars / Recommendations Signature and date

Head of the Department/

Section Head

Dean of the Faculty/

Principal of Colleges/

Head of Institution/

Registrar

Data Entry Operator

Data Entry Supervisor

Note: Employee MUST retain photocopy of this completely filled in form (all pages) for future reference. Available

information in this form will be considered as final.

9. Academic Performance Information

of 16

Teaching, Learning and Evaluation related Activities

Sr.

No.

Particulars API Score for Financial year (01-04-12 to 31-3-2013)

1. Lectures, seminars, tutorials, practical contact hours

should be based on verifiable records. On basis of

Lectures undertaken as percentage of lectures

allocated

2. Lectures or other teaching duties in excess of the

UGC norms for which no remuneration is charged.

Two points to be assigned for each extra hour of

classes/credit for the entire semester

3. Preparation and Imparting to knowledge/instruction as

per curriculum; syllabus enrichment by providing

additional resources of students (100% compliance =

20 points)

4. Use of participatory and innovative teaching learning

methodologies; updating of subject content, course

improvement etc.

5. Examination duties (invigilation, question paper

setting, evaluation/assessment of answer scripts) as

per allotment.

Total Score Obtained /125

Minimum Score to Obtain 75

Sr. No. Title of Paper Taught during the year Class

CATEGORY I

of 16

Details of Part 1 and 2 : Lectures, Seminars, Tutorials, Practical, Contact Hours and duties in

excess of the UGC norms

Sr. No. Academic Year

Class Course/Paper/Subject Taught

Of Teaching*

Teaching Hours per Week

Teaching Hours*

First Semester

Second Semester

As per UGC

Norms

Allotted effective hours of teaching per week

I.

II.

III.

IV.

V.

Total Points Acquired (Max. 50 per year for Part 1 & 10 per year for Part 2)

Details of Part 3 : Reading/Instructional material consulted and additional knowledge resources

provided to students

Sr. No. Academic Year Class Course/Paper Consulted Prescribed Additional

Resource

Provided

1.

2.

3.

4.

5.

Total Points Acquired (Total 20)

Details of the above given Table ANNEXURE - I

of 16

Details of Part 4: Use of Participatory and innovative Teaching-Learning (T-L) Methodologies,

updating of subject content, Course Improvement etc.

Sr. No.

Particulars Financial year (01-04-2012 to 31-03-2013)

1. Updating of Courses, design of curriculum, (5 per single course)

2. Participatory & Innovative T-L Process with material for problem based learning, case studies, Group discussions etc.

a) Interactive Courses : 5 points/each

b) Participatory Learning modules : 5 points/each

c) Case studies : 5 points/each

3. Use of ICT in T-L process with computer-aided methods like power-point/Multimedia/ Simulation/ Software etc., (Use of any one of these in addition to Chalk & Board: 5 points)

4. Developing and imparting Remedial/Bridge Courses (each activity : 5 points)

5. Developing and imparting soft skills/communications skills/personality development courses/modules (each activity 5 points)

6. Developing and imparting specialized teaching-learning programmes in Physical education, library; innovative compositions and creations in music, performing and visual arts and other traditional areas (each activity: 5 points)

7. Organizing and conduction of popularization programmes/training courses in computer assisted teaching/web-based learning and e-library skills to students

a) Workshop/Training course : 10 points each

b) Popularization programmes : 5 points each

Total Score (Max. Score per year 20)

Part 5: Examination Duties Assigned and Performed

Sr. No.

Particulars API Score for Financial year 01-04-2012 to

31-03-2013

1. University end Semester/Annual Examination work as per duties, allotted. (Invigilation – 10 points, Evaluation of answer scripts – 5 points; Question paper setting – 5 points) (100% compliance = 20 points)

2. University examination/Evaluation responsibilities for internal/continuous assessment work as allotted (100% compliance = 10 points)

3. Examination work such as coordination, or flying squad duties etc. (maximum of 5 or 10 depending upon intensity of duty) (100% compliance = 10 points)

Total Score (Max. 25 per Year)

of 16

Academic Performance Indicators (API) – Category – II

Co-Curricular, Extension, Professional Development Related Activities

Sr. No.

Type of Activity API Score obtained for Financial Year

01-04-2012 to 31-03-2013

1. Extension, Co-curricular & Field based activities

Extension work through NSS/NSC and other channel

Cultural Activities

Subject Related Events

Advising and Counseling

Total (Max.: 20)

2. Contribution to Corporate Life and Management of

the Institution

In charge of any academic / administrative body

Member of academic body at Faculty level

Member of academic body at Departmental level

Total (Max.: 15)

3. Professional Development Activities (NOT Covered in

Category III)

Participation in seminars, conference

Talks, lectures

Membership of associations

Short term, training courses

Dissemination and general articles

Total (Max.: 15)

Total Score Acquired of (1 to 3)

Minimum score needed is 15

ANNEXURE - II

of 16

9.A. Published Papers in Journals

Sr.No. Title Journal

with Vol.

No. Year &

Page No.

ISSN/ISBN

No.

Whether peer

reviewed/impact

factor, if any

Whether

published

in E-form or

Hard copy

No. of Co-

Authors

Whether you

are the main

Author or

Guide/Mentor

9.B (i). Articles / Chapters Published in Books:

Sr.No. Title of the

Article/paper with

page Nos.

Title of the Book

along with the

Name of Editor,

Publisher and

Date of

Publication

ISSN/ISBN

No.

Whether Peer-

Reviewed

Whether you

are the Main

Author

No. of Co-

Authors and

Date of

Publication

API (CATEGORY III) (Research & Academic Contributions)

of 16

9.B (ii). Full Papers/Articles Published in Conference Proceedings:

Sr.No. Title of the Article/Paper

with Page Nos.

Details of Conference

Publication along with

Place and Date of

Publication

ISSN/ISBN No. Whether

you are the

Main

Author

No. of Co-

Authors and Date

of Publication

9.B (iii). Books Published as Single Author or as Editor:

Sr.No. Title Type of Book &

Authorship

Publisher

&

ISSN/ISBN

No.

Whether Peer-

Reviewed

No. of Co-

Author & Year

of Publication

Whether you

are the Main

Author

of 16

9.C (I & ii). On-going Research Projects and Consultancies:

Sr.No. Title Agency Period Grant/Amount

Mobilized

(Rs. In Lakhs)

9.C (iii & iv). Completed Projects and Consultancies:

Sr.No. Title Agency Period Grant/Amount

Mobilized (Rs. In

Lakhs)

Whether Policy

Documents/Patent

as an Outcome

of 16

9. D Research Guidance:

Degree Number Enrolled Thesis Submitted Degree Awarded

M.Phil or Equivalent

Ph.D. or Equivalent

9. E. (i) Training Courses, Teaching–Learning–Evaluation Technology, Faculty Development

Programmes:

Sr. No. Programme Duration and Dates Organized by

9. E. (ii) Papers presented in Conferences, Seminars, Workshops and Symposia:

Sr.No. Title of the Paper

Presented

Place & Date of

Conference/Seminar

etc.

Organized by Whether

International/National/State/Regional/

University or College Level

of 16

9. E. (iii) Invited Lectures and Chairmanships at National or International Conferences/Seminars:

Sr.No. Title of Lecture/Academic

Session

Title of

Conference/Seminar etc.

Date(s) of

the Event

Organized by Whether

International/

National/State

9. F. Contribution on Conducting/Organizing Academic Programme:

Sr.No. Name(s) Programme(s), Place & Date(s) Participated as

of 16

9. G. Participation in Academic Bodies of other Universities:

Sr.No. Name(s) Academic Bodies of Universities/Institutions

and Place

Participated as

9. H. Fields of Specialization under the Subject/Discipline:

a) b)

TEACHING The Maharaja Sayajirao University of Baroda · PDF fileTEACHING The Maharaja...

Documents

Transcript of TEACHING The Maharaja Sayajirao University of Baroda · PDF fileTEACHING The Maharaja...