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RASHTRASANT TUKADOJI MAHARANAGPUR UNIVERSITY

(A State University established by Maharasht ra Un iversities Act, 1994

Application Form No. (For office

Advt .No. : RTMNU/ GA/ 227 Dated : 5 th February

APPLICATI ON FORM

(Please read the general instructions & conditions before filling)

Important Note :

(1) The Application Form available on the University website should not be chany manner; otherwise it will be treated as cancelled. Additional sheets

used, if required to fil l in the Application form by retaining it.

(2) All Communication dur ing the recrui tment process wi ll be made through E-m

Post applied for :

Subject :

Affix passp

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4. Comm unication Details

E-mail ID

Phone No.

Mobi le No.

Fax No.

5. Educational Qualifications(Matriculation Onwards) AnNo.

EnName ofExam

/ Degree

University/ Institution

/ Board

Yearof

Passing

Percentageof

Marks

Division// Class

/ GPA

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7. Teaching Experience AnNo.

EnPost Held Basic Pay &

Pay Band with

A.G.P.

University/

Institution

Period Teaching

Experience

From To Years Months

Total Teaching Experience : [ Years] [ Months]

8. Work [Technical (T)/ Laboratory (L)/ Workshop (W)] Experience AnNo.

EnPost Held Basic Pay & University/ Period Work (T/ L/ W)

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10. Research Experience

....

....

....

....

....

....

....

....

....

....

....

....

....

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13 . Membership/ Fellowship of learned Accredit ed Bodies :

(Enclose additional sheet, if required, in the same format)

AnNo.

En

(i)

(ii)

(iii)

(iv)

14 . Competence in Computer Applicat ions : AnNo.

En

..

..

..

..

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DECLARATION-I

I hereby declare that all the entries made by me in this application are

the best of my knowledge and belief. If anything is found false at any sta

candidature for the post of ..

cancelled wit hout assigning any reason th ereof.

DATE :

PLACE : (Signature of Applican

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ENDORSEMENT BY THE EMPLOYER(For in-service candidates only)

To be signed and forwarded by t he present employer

Forw arded to:

The Regist rar,

Rasht rasant Tukadoji Maharaj Nagpur Universit y,

Chhatrapat i Shivaji M aharaj Administ rative Premises,

Ravindranath Tagore Marg,

Nagpur-440001

The applicant Dr ./ Shri / Mrs./ Ms.

who has submitted this application for the post of

in the Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, has been w

in .., on the .in a temporary/ per

capacity with effect from ... in the Scale

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RASHTRASAN T TUKADO JI M AHA RAJ NAG PUR U NIV ERSITY

Sta tem ent show ing detai ls of part iculars of app licant for the Post of Subject

Specializat ion - . Cate gory : No . of Posts : Adv . N o. RTM NU / GA/ 22 7 dat ed 5 th

I hereby declare that a l l the entr ies made by me are true to the best of my knowledge and bel ief. I f anything is found fa lse at any s tage, my candida

.... Sub je ct .. Speci al iza t io n .. ma y be c an cel le d w it h ou t a ssig ni ng a ny r ea

Date :

Place : Signa t ur e of Ap pl ican t :

Na m e o f A p pl ican t :

Sr.

N o.

A/ F

Ack. No.& D a t e

Na m e & Corre sponde nc e

Address of the Appl icant w ithContact No. & E-mai l ID

Age /

D a t eof Birth

Category

(Caste)

Academic Atta inm ents Experience (Yrs. / M onths) Publ ications

Qual i f icat ions Year of

Passing

% /

CGPA

Div. /

Gra de

Teaching Research Admn.

1 2 3 4 5 6 7 8 9 10 11 12 13

For

Office

use

Only

International :

Ow n : .

Joint : .

Tot al : .

Na t iona l :

Ow n : .Joint : .

Tot al : .

Conference :