7/31/2019 pun form

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Website: http://jobs.puchd.ac.inSerial No.________________

The candidate should attach ninePhotostat copies of this formalongwith the original PANJAB UNIVERSITY, CHANDIGARH

Advertisement No. ___________Application for Teaching/Research Post

(Use separate form for each post)(For Office Use)

Name of the Post with specializationDepartment Dairy No.

Date

A Name in Full(In block letters) Mr./Mrs./Ms

Father Name: _________________________________________________

Mother Name:

Date of Birth: Place of Birth:Nationality: Marital Status:

Member of Scheduled Caste/Tribe/Backward Class/ Physically Handicapped ___________(If Yes,Please Attach certificate from Tehsildar /Magistrate I Class of the area).

B. Addresses :

Permanent address(in block letters):

Affix recent Passportsize photograph

Present Address: (for Correspondence) (in block letters): ___________________________________________________________________________________ __________________________

________________________________________ ______________________Phone/Mobile No. _____________________ E-mail:__________________________________________________

C. Minimum Pay acceptable: _______________________ Joining time (If Selected) __________________________

D. Educational Qualification: (Please attach one set of attested copies alongwith original application only)

Examination Univ/Board MainSubject Year ofPassing MarksObtd.(with

MaxMarks)

Class/Divn./Grade(attachconversion formula)

Merit/Prizes/Medals won if any.

1. Matric2. 10+2/Pre-Med /Pre-

Engg.3. B.A/B.Sc/B.Com.etc.4. M.A/M.Sc/M.Cometc.

5. M. Phil

6. Ph. D.

7. Any other Exam.(please specify)

8. Eligibility Test for

Assistant Professor

E. Professional Training :

PeriodS. No.

Organisation

From To Details of Training

F: Employment Experience (details in chronological order, starting with first job

Date ofName & AddressEmployer/Institution

Joining Leaving

Designation Nature ofJob

Pay p Basic.m. &Grade

ReasonFor Leaving

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G. Period of Teaching Experience (in Years)Website: http://jobs.puchd.ac.in

Subjects/Papers Taught PeriodFrom To

(i)Postgraduate Classes_________

(ii)Degree Class

(iii) Any Other

H. Total Academic Performance Indicator (API) score as per guidelines/Instructions (Appendix) available at PanjabUniversity website. However, candidates from other then academic institution should attach detailed account of

their personal achievements. (Please attach 9 photocopies)

I. Membership of Professional Societies, if any :

J. National/International Awards / Fellowships

K. Paragraph of self-evaluation regarding different fields of activity relating to the job:

L. Referees :

These should be professionally competent persons, well acquainted with some aspects of the applicants training,accomplishments, capability and character but must not be relations. At least two of them should be citizens of India. Forapplicants having done post-graduate or post -doctoral research, the research supervisors must be listed. Supervisior ofeach major employment and present or most recent employment must be listed.

Name Occupation/Position Address1 .2 .3 .

M. Additional Information: (No annexure need be enclosed )

N. Whether willing to join as temporary/Contract/Guest Faculty (if not selected) Yes / No

--------------------------------------------------------------------------------------------------------------------------------------------------------------------O . List of Enclosers:

1 . __________________ 2 . _________________ 3 . ____________________ 4 . _________________

5 . ________________ 6 . ______________ 7 . Draft No . ____________ Dt . ___________ Amount _______

P. Declaration: I solemnly declare that:i) The foregoing information is complete and correct. I am not aware of any circumstances which may impair my

fitness for employment in the Panjab University, Chandigarh

ii) I have never been dismissed either from Govt. or from University, College or other Public or PrivateOrganisation service

iii) I have never been prosecuted, kept under detention or bound down/fined, convicted by the Court of Law for any

offence.

Place: __________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Signature of Applicant

Date: __________________

_ _ _ _ _ _ _ _ _ _ _ _ _Signature of EmployerWith Official Seal

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