sardar patel university non teach form 20-5-2017.docx · web view2.(i) please tick mark )...

APPLICATION FEE : Rs.250/- FOR NON-TEACHING POST

For Office Use OnlyInward No. Est. No. Sr. No.Date ___/___/2017 Date ___/___/2017Section Establishment

SARDAR PATEL UNIVERSITYVALLABH VIDYANAGAR-388120

(Dist. ANAND - GUJARAT)

APPLICATION FORM FOR THE POST OF

The Newspaper in which you read the Advertisement ________________Advertisement No. B/S/2/ Dated : ____/05/2017

Affix the3.5 c.m X 3.5 c.m.

latest Photograph only on First Copy

bySelf Attested

Demand Draft No. Date:___/____/2016 Rs._______

Name of Bank BranchPayable at Branch City

IMPORTANT: Before filling in the form please read the form, Instructions and Qualifications carefully.INSTRUCTIONS TO APPLICANTS :(i) The candidate should submit TWO Copies of the application form neatly typed in prescribed

form along with separate enclosures with each copy to reach the Registrar, Sardar Patel University, Vallabh Vidyanagar on or before the last date.

(ii) Candidates are advised to satisfy themselves before applying, that they possess atleast, the essential qualifications laid down in the advertisement.

(iii) Separate application is required for each post, otherwise the application form will be rejected.(iv) No correspondence & Phone inquiry will be entertained in respect of advertisement, interview,

selection and appointment etc. (v) Those who are already in employment should forward their applications through proper

channel and applications not sent through proper channel are liable to be rejected. (vi) Sardar Patel University reserves the right not to fill up any of the vacancies & right to reject

any application & right to alter the number of post in any cadre without assigning any reason.(vii) If the any column is not applicable to the candidate concerned in that column please write

“Not Applicable” OR “NIL”. (viii) Incomplete application shall not be considered & applicants may not be called for Interview. ---------------------------------------------------------------------------------------------------------------------------------1. (In Block letters) Name in full : Mr./Mrs./Ms./Dr.

Father’s NameHusband’s NameSurname Mother’s Name :

2.(i) Please Tick mark () appropriate column. Please enclose Caste Certificate of appropriate authority, if applicable.S.C. S.T. Baxi Punch / SEBC General Phy. Handi Ex-Serviceman

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(Attach a certificate from the competent authority with Caste validity certificate for S.C./S.T./ Socially and Educationally Backward Class (SEBC) and non- Creamy-layer Certificate.)

(i) Caste Certificate No. Issue Date

(ii) Name of Issuing Authority

3. Date of Birth Date Month Year Age (Years)

In figures

In Words(Capital)

(A true copy of the Higher Secondary School Leaving Certificate in which the Birth Date is registered should be enclosed.)

A Birth Place Tal. Dist. State

B Native Place Tal. Dist. State

C Race & Religion Nationality Mother tongue

D Blood Group Height (cms) Weight (Kgs.)

E Personal Marks of Identification

F Pan Card No.

G Election Card No. City/District where Registered

H. Aadhaar Card No.

4.Please Tick mark () appropriate column Married Unmarried Divorced Widow

If married Name of Wife

If married Name of Husband (A Copy of marriage certificate should be attached)

5.

Approximate time required for joining, if appointed

Minimum Salary Acceptable Rs.

6. Full Address for correspondence (In Block Letters)

Present

City PINTal. Dist.State


Phone No Mobile No.E-Mail

Permanent

City PINTal. Dist.StatePhone No Mobile No.E-Mail

7. Educational Qualifications : Examinations passed (Attested copies of all testimonials/ Certificates including Marks, Grade, Certificate should be attached) :

Sr. No.

ExaminationPassed

Principal Subject

Sub

sidi

ary

Sub

ject Name of the

University or Examination

Body

Total Marks with Class,

Grade, Exact

percentage (%) Y

ear &

Mon

th o

f P

assi

ng th

e E

xam

inat

ion

No.

of a

ttem

pts

for p

assi

ng

each

of t

he

exam

inat

ions

Lang

uage

in

whi

ch s

tudi

es

wer

e ca

rrie

d ou

t

Enc

l. at

Pag

e N

o.

1 2 3 4 5 6 7 8 9 10

1 S.S.C

2 H.S.C.

3 * F.Y.

4 * S.Y

5 * T.Y.

6

Pos

t Gra

duat

ion I Sem

II Sem

III Sem

IV Sem

7 M.Phil.

8 Ph.D. Date :

Title of Ph.D. Thesis

9 B.Ed.

10 M.Ed.

11


12

13

* In case of semester system the candidate should change the table appropriately.

(8) Details of Typing/ Computer Course. (Please attached Certificate.)

W.P.M. Class / Grade

Month & Year of Passing Examination Body Encl. at

Page No.

1 English Typing

2 Gujarati Typing

3 Computer

4 CCC

5 CCC +

(9) Details of Experience : (Post held in Private or Public employment giving details of Work) (Teaching, Laboratory, Industry etc.)

Full Name & Address of the

Employer where Employed

Designation (Type of

work)

Date of joining

Date of Leaving

Grant-in Aid/ Self

Finance/ Private

Full time/ Part time/

Ad hoc

Basic Pay & Pay

Scale or Fixed pay

Reason for leaving

Previous Employment E

ncl a

t pa

ge N

o.

1 2 3 4 5 6 7 8 9


(10) Present Position :

Full Name & Address of the Employer where

EmployedDesignation Work

Done

Grant-in Aid/ Self Finance/ Private

Full time/ Part time/

Ad hoc

Basic Pay or Pay Band & A.G.P. OR Fixed Pay

Date of appointment E

ncl a

t pa

ge N

o.

(11) Number of Research Papers/ Articles/ Books/ Seminar/ Conference/ Workshop/ Winter School/ Symposium/ Summer camp, attended.

Total Publications Total Number attended

Sr. No. Level

Res

earc

h P

aper

s

Arti

cles

Boo

ks

Man

uscr

ipt

Rea

dy fo

r pr

ess

Sem

inar

Con

fere

nce

Wor

ksho

p

Win

ter

Sch

ool

Sym

posi

um

Sum

mer

ca

mp

1 Local

2 State/Regional Level

3 National Level

4 International Level

Total No.

(12) Any other relevant information (Special experience/merits) not included above (Participation in curricular and co-curricular activities,NCC/NSS/Sports/Cultural Activities etc. enclose all Certificates)Sr. No. Activities Institution From To No. of

DaysEncl. at

page No.

1 N.C.C.

2 N.S.S.

3 Sports

4 Cultural activities

(13) Languages Known Tick mark () appropriately :

Sr. No. Language Read Write Speak1 English

2 Gujarati

3 Hindi

4(14) Persons from whom copies of testimonials are enclosed :


Sr. No. Name Occupation Address Encl. at

page No.

(i)

(ii)

(iii)

(15) Name, address and Phone No. of not more than two persons to whom reference can be made:

No. Name Full Address Phone No.Period for which

he/she has known to the candidate

1

2

(16)

(1)Have you ever been arrested/prosecuted/kept in detention/convicted by a court of Law or whether any case is pending against you in a Court of Law?

Yes

No

If the answer to the above question is “Yes” give details

(2)Have you ever been debarred from any examination/rusticated by any University or any other educational institution or whether any case is pending against you in any University or any other educational institution?

YesNo


(3) Has any disciplinary action been taken against you by any University/ Institute where you have served/Studies?

YesNo


I, hereby declare that the information furnished above is true and correct to the best of my knowledge and belief and also that I have not concealed any fact or withheld any information regarding my past service and record. If any information is found to be false or incorrect or anything is found to have been concealed, I will be disqualified for selection or if appointed, will be liable to termination without any notice or compensation.

Place

Date Signature of the Applicant-----------------------------------------------------------------------------------------------------------------------------* It is essential for the applicant to forward the application through his/her present

employer. Application forwarded directly are liable to be rejected.

* Forwarded with compliments to the : Registrar, Sardar Patel University, Vallabh Vidyanagar-388120


FOR USE OF APPLICANTS IN EMPLOYMENT I declare that the above statement made by the applicant are correct to the best of my knowledge and belief. I have "No Objection" to his/her applied and selected for the concerned post in your University. He/She will be relieved.

Place Signature of Authority

Date Designation

Office Stamp

Note : All Copies of Marksheet / Certificates should be self attested, List of enclosures attached by the applicant should be arranged strictly in the following order. Please tick ()Sr. No. Details Enclosed with Application Form ()

Encl. at Page No.

1. Application Form with Photograph.2. Address Slip in one separate page only.3. Caste Certificate (If necessary)4. Higher Secondary School Leaving Certificate.5. S.S.C. / H.S.C. all Marksheet.6. F.Y.,S.Y. & T.Y. all Marksheet & Degree Certificate.7. Postgraduate’s Degree -Previous & Final Year all Marksheet & Degree Certificate.8. English Typing (If any)9. Gujarati Typing (If any)10. Computer Course Certificate (If any)11. CCC Passing Certificate (If any)12. CCC+ Passing Certificate (If any)13. M.Phil. Marksheet & Notification.14. Ph.D. Notification & Degree Certificate.15. GSLET Passing Certificate.16. NET Passing Certificate.17. B.Ed./ M.Ed.18. Other Qualifications Certificates19. Pan Card, Aadhar Card & Election Card Copy20. Testimonials / Experience Certificates.21. Publications/ Research Papers/ Articles.22. Workshops/ Seminars/Conferences/Symposium attended Certificates23.24.25.26.27.


Please fill ALL the following ADDRESS SLIPS with typing neatly only one copy of this page should be submitted attached with the first copy of your form with Full Name & Postal Address (With Pin Code) for further communication.

BY Registered Post / Courier BY Registered Post / CourierName NameAddress Address

City PIN City PINTal. Dist. Tal. Dist.State StateMobile No. Mobile No.E-Mail E-Mail







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