UGC-HUMANRESOURCEDEVELOPMENTCENTRE
D.D.U. Gorakhpur University, Gorakhpur-273009
🕾Office:0551-2203599 E-mail:ascddugkp@gmail.com Website: www.ugcascgkp.edu.in
APPLICATION FORM FOR FACULTY INDUCTION PROGRAMME/REFRESHER COURSE/SHORT-TERM
COURSE
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Subject- ENGLISH (Refresher Course)
1. Name Dr./Mr./Mis. (In BLOCKLETTERS): Dr. SHRAVAN RAJERAMJI BANASURE
2. Father’s Name: RAJERAMJI BAJIRAO BANASURE
3. Mother’s Name: SMT. LILABAI RAJERAMJI BANASURE
4. Subject/Department: ENGLISH
5. Institutional Address: KALA WANIJYA MAHILA MAHAVIDYALAYA, BALLARPUR,
DIST. CHANDRAPUR. - 442701 (Maharashtra)
6. Name of the Affiliating University: GONDWANA UNIVERSITY, GADCHIROLI. (Maharashtra)
7. Address for Correspondence: ‘GURUKUNJ’, Balaji Ward, Ballarpur, Dist. Chandrapur-442701 (MS)
E-mail ID: Mobile No.: shravanbanasure@gmail.com Telephone No.: 9158901348(W), 8459535957
8. (a)Date of Birth: 4th April 1989 (b) Educational Qualification: M.A.(English), M. Phil., NET, Ph. D.
9. Category[GEN/SC/ST/OBC]: OBC Religion.: Hindu
10. Research Experience: Ph.D.: 05 Yrs. Year of Completion. 10Yrs. Field of Research. Indian Literature.
11. Details of Employment: Date of Appointment as Lecturer.: 20/12/2013
12. Status of Appointment : Part time Fixed Honorarium Temporary Ad-hoc Permanent
Type of Institution (tick in the box): Govt. Aided Self Financed
(a) Designation : Assistant Professor (b)Pay Scale. 79900 Fixed pay Rs....
(b) Total Teaching Experience (Year): 10Yrs. (i)UG. 10 Yrs. (ii)PG.; 00
13. Details of the Orientation Programme /Refresher Course attended:
Date and Duration Course Host Institution
15/03/2017 To Orientation Program UGC-HRDC, Ranchi University, Ranchi.
01/04/2017 (28 Days)
29/10/2018 To Refresher Course UGC-HRDC, University of Jammu, Jammu.
18/11/2018 (21 Days)
07/02/2022 To Refresher Course UGC-HRDC, Rani Durgawati University, Jabalpur.
19/02/2022 (13 Days)
21/07/2023 To Refresher Course UGC-HRDC, Madurai Kamaraj University, Madurai.
03/08/2023 (14 Days)
(Signature of the Applicant)
RECOMMENDATIONOFTHEFORWARDING AUTHORITY
I hereby certify that:
i) Our College/University is included in the list of institutions under section12 (B) of UGC Act.
ii) Our College/University is included in the list of Institutions under Sec 2 (f) of the UGC Act.
iii) Our College does not come in the purview of Section 12 (B) of the UGC Act, but has been affiliated to the University of Gondwana University, Gadchiroli
(Maharashtra) for .......years.
iv) The above applicant has not attended any Orientation/Refresher Course beside the ones specified above.
v) The application of the above mentioned teacher is forwarded with the recommendation that when selected he/she will be relieved in time to
participate in the course.
Seal &Signature of HOD/Principal
Encl. Trans. No………………………………………………..………………………,Dated.......................................Rs.1000/-,
A/cNo.20189224812, Indian Bank (Univ. Branch) IFSC Coad-IDIB000G616forRs.1000/-In favour of UGC-
H.R.D.C., D. D. U. G.U. Gorakhpur.
Please bring a relieving order from the appropriate authority. The RELIEVING ORDER is must for participation.
ALLCORRESPONDENCESHOULDBE MADE TOTHEDIRECTOR, Human Resource Development Centre, D.D.U.GORAKHPURUNIVERSITY,
