Application Form for Teaching Staff
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Transcript of Application Form for Teaching Staff
Department : _______________________________________________ Specialization : _______________________________________________ Position Applied For : ________________________________________________ I. Personal Details :(In Capital letters)
Title Dr/Mr/Ms/Er/Ar
First Name:
Middle Name:
Last Name:
Date of Birth (DD/MM/YYYY):
D D M M Y Y Y Y
Marital Status: MarriedUnmarriedDivorcee Widow
Nationality:
Name of the state to which you belong:
Category GeneralSCST OBC Others ________________
PAN No.: EPF A/c No.:
Blood Group: Height (Cm.): Weight (Kg.):
IMPORTANT INSTRUCTIONS
1. Please fill out the application from carefully and completely; if questions are not applicable, enter “NA”. Do not leave questions blank.
2. A resume will be accepted for additional information it may contain, but not in place of completed application.
3. Attach self-attested copies of required Certificates ant Testimonials as detailed in the appendix.
4. Experience of less than six months in an organization will not be considered.
5. Experience obtained 10+2 level or below will not be considered.
6. Experience obtained in part-time capacity will not be taken into account.
7. In case of published work, only number of publications already published is to be mentioned. The publications in press, in preparation
etc. will not be taken into account.
Recent PP size
color photograph
to be affixed
II. Address
Permanent Address:
House No.: Street:
Locality:
City: Pin code:
State: Country:
Present Address:
House No.: Street:
Locality:
City: Pin code:
State: Country:
Preferred address for correspondence: Permanent / Present (Please Tick)
Contact Phone Numbers:
Residence Contact No(s).:
Permanent:
Present:
Mobile No(s).:
1.
2.
Emergency No(s).:
1.
2.
Email: Web Page (If any):
Were you at any time declared: Medically Unfit Asked to submit you resignation Discharged or dismissed from Services (if yes, Please provide details Any disciplinary proceedings were initiated against you (if yes, Please provide details)
III. Family Details:
Relation Name Age Education Occupation Organization
Father
Mother
Husband / Wife
Child 1
Child 2
IV. Educational Qualification
Level
Name of Course/ Degree/
Diploma/ Certificate
Name of Institute/ College
Name of the
board/ University
Year of Passing
Duration (years)
Full Time/ Part Time/
Correspondence/ Distance Learning
Specialization/ Subjects
% CGPA
Div.
X
XII
UG
PG
PG (Additional, if any)
Any Other (Please Specify)
If you do not hold Ph.D. degree, have you registered for the same? Yes No If yes, please give details of University, Name of Professor (Guide) and Expected date of completion ________ _________________________________________________________________________________________
V. Other Qualifications/ Certifications Qualified (Yes/No) Subject/
Specialization) Year Score
JRF
NET
SET/ SLET
GATE
Any Other (Please Specify)
Training Programmes attended ________________________________________________________________________ __________________________________________________________________________________________________
VI. Research Degrees Degree Title Date of
Registration Date of
Submission Date of
Award of Degree
Institute/ University
Research Guide(s) Details
Name Designation & Institute/ University
API Score*
M.Phil.
Ph.D./ D. Phil./ FPM
D.Sc./ D.Litt.
VII. Post – Doctoral Research
S. No. Name of Program
Duration Period Training
Organization with Location
Subject / Area of Training From To
VIII. Brief Employment Details (Starting from your current organization)
Name of the organization
& its Location
(City)
Designation
Nature of Employment
(Regular / Part Time /
visiting / Adhoc /
Contractual
Class & Subjects Taught
Period Specialization / Functional
Area
Gross Salary (per
month) From To No. of Years
IX. Administrative / Teaching Experience (Full – time)
Administrative Experience (in years)
Teaching Experience (in years) P.G classes (in years)
U.G Classes (in years)
Research Experience excluding years spent in M.Phil / Ph.D. (in years)
X. Details of Present Employment:
Name & address of the organization:____________________________________________________________________ __________________________________________________________________________________________________ Nature of employer’s business: _________________________________________________________________________ ___________________________________________________________________________________________________ Date of joining at present organization:________/________/________ Designation at the time of joining the present organization:_________________________________________________ Present Designation:_________________________________________________________________________________ Present Salary Details (Monthly in INR)
Pay Scale Basic Pay AGP/ DP DA HRA Other Allowances
Gross Total
PRESENT JOB RESPONSIBILITIES
XI. Subjects Taught (Last Three Years)
S.No. Subject Title University /
Institute Level
(UG / PG / Doctoral) Year
XII. Academic Guidance (Last Two Years) for Bachelors / Masters Programs
S.No. Thesis Title Level (UG / PG) Year
XIII. Ph.D / M.Phil Thesis Guidance
Degree Number Completed Number Progress
Ph.D.
M.Phil.
XIV. Details of Other Training Programs (Any Certification etc.)
S.No.
Name of Program
Duration
Period Training Organization with Location
Subject/ Area of Training
From To
XV. Journal Publications (Last Three Years) National
S.No. Journal Name
Paper Title
ISSN/ ISBN
Number
Type (National)
Whether you
were the main
author?
Page No’s
Volume No. of Co-
authors
Year of Publication
Whether peer
reviewed? Impact
Factor (if any)
API Score*
International
S.No. Journal Name
Paper Title
ISSN/ ISBN
Number
Type (Internati
onal)
Whether you were the
main author?
Page No’s
Volume
No. of Co-
authors
Year of Publicatio
n
Whether peer
reviewed? Impact
Factor (if any)
API Score*
XVI. Details of Professional Training Programs attended (MDPs/FDPs/Workshops etc.) (Last Five Years) S.No. Name of Program Duration Period Training Organization
with Location Subject/ Area of Training
API Score* From To
XVII. Papers presented in Conferences, Seminars, Workshops, Symposia S.No. Title of
the paper presented
Title of Conference/Seminar
etc
Date(s) of the event
Organised by
Whether International/ National/State/Regional
/University or College Level
API Score*
XVIII. Invited Lectures and Chairmanships at National or International Conference/ Seminars etc. S.No. Title of
Lecture/ Academic
Session
Title of Conference/Seminar
etc
Date(s) of the event
Organized by
Whether International/ National/State
API Score*
XIX. Ongoing Projects / Consultancies S.No. Title
Agency
Period
Grant/ Amount Mobilized
(Rs. Lakhs) API Score*
XX. Completed Projects / Consultancies S.No. Title
Agency
Period
Grant/ Amount Mobilized (Rs.
Lakhs)
Whether Policy Documents/Patent
as outcome
API Score*
XXI. Books published as single author or as editor S.No. Title with
page no. Type of Book &
Authorship Publisher
& ISSN/ISBN
No.
Whether Peer
Reviewed
No. of Co- author & Date of
Publication
Whether you are the
main author
API Score*
XXII. Articles/ Chapters published in Books S.No. Title with page
no. Book Title,
editor & publisher
ISSN/ISBN No.
Whether peer
reviewed.
No. of Co- authors
and Date of
Publication
Whether you are the
main author
API Score*
XXIII. Award / Honors / Scholarships S.N.
Name of Award Name of Organization Year API Score*
* API Score computed as prescribed under UGC guidelines.
XXIV Professional References (3 References with whom the candidate has worked including from the last Organization/ Institute Served)
Name Current Position Organization Contact Details (Email ID, Mobile No., Phone No.)
Email ID:
Mobile No.:
Phone No.:
Email ID:
Mobile No.:
Phone No.:
Email ID:
Mobile No.:
Phone No.:
XXV Preferred location for Interview Dehradun Delhi
XXVI. Job Reference (Kindly tick mark) DIT University Website Newspaper
(name of newspaper) Job Portals
(Name of Portal) Employee Referral (Name of Referee)
Any other Source (Please specify)
XXVII. Membership of Professional Bodies / Associations
S.No. Name of the Professional Bodies / Associations Duration
XXVIII. Linkages with International University / Industry / Research Organization
S.No. Name of the Organization
Department Resource Person (Name & Designation)
Email ID Nature of association
XXIX. Experience in Other Areas
S.No. Administrative Positions / Student Welfare / Curricular Activities / Extra Curricular Activities / Professional & Outreach Activities
Years
XXX. Language Proficiency (Please indicate languages and level of proficiency – Good, Average or Nil)
Languages Writing Reading Speaking
Good Average Nil Good Average Nil Good Average Nil
HINDI
ENGLISH
FRENCH
GERMAN
OTHERS (Specify________)
XXXI. Computer Proficiency (Theoretical & Practical) (Please indicate your overall competency level) Microsoft Office
S.No. Computer Skills Very Good Good No Knowledge
1 Word processing
2 Spreadsheet (Excel)
3 PowerPoint
4 Microsoft Outlook
Languages / Technical Software
5
6
7
8
9
10
11
XXXII.
Past Employment / Association / Acquaintance with DIT University / any other affiliate organization of the Unison Group: (If yes, Please give details underneath)
Yes No
XXXIII.
a) Have you ever applied or been interviewed for a job at Unison Group earlier? (Please Tick)
Yes No
If Yes, Please give details
b) Do you have any acquaintances or relatives associated with Unison Group? (Please tick)
Yes No
If Yes, Please give details
XXXIIV. Any Major Illness / Physical handicaps (if any) (Please give details)
a) Major Illness: (if any)
b) Physical Handicaps: (if any)
Appendix
S.No. List of Documents to be attached: Pls. Tick
1 Updated Resume duly signed
2 Educational Certificates, Mark sheets & Degree (from class 10th till highest degree)
3 Appointment Letter of current organization / last served organization
4 Appointment Letters of previous organizations as specified in Clause VIII: Employment Details
5 Latest Salary Slip / Bank Statement
6 Permanent Address Proof (Voter ID / Domicile Certificate / Passport / Any other)
7 Photo Identity Proof (PAN Card / Voter ID / Passport / Driving License)
8 Experience & Relieving Certificate from previously served organizations
9 Documents certifying Conferences / Workshops attended / conducted and presented
10 Certificates of Training Courses / Short – Term Refresher Courses
11 Documentary Proof of Sponsored / Consultancy Projects undertaken
12 Documentary Proof of Publication
13 Certificates of Awards & Recognition
14 JRF / NET / GATE / SLET / SET Qualified Certificate (If Applied & Cleared)
15 Any other relevant document(s)
Declaration I hereby affirm and certify that the information presented in this Employment Application Form and documents annexed with the application form are true and complete. I understand that falsification, misrepresentation or omission of any fact will be sufficient for the rejection of my candidature and / offer of employment / initiating disciplinary action which may lead to dismissal, if discovered at a later date. I understand that employment is based strictly on merit and declare that I will not violate the rules of the organization or canvassing, directly or indirectly, to seek employment with DIT University, Dehradun and / or to seek any undue / special favors outside the framework of rules in force from time to time. If selected, I shall abide by the Rules and Regulations covering the employment with DIT University, Dehradun presently in force or as amended from time to time. I shall also act responsibly, interact honestly and respectfully with all others, respect the resources made available to me and be accountable for my actions. Place: ______________________ Date: ______________________
___________________ Signature of Applicant