S.
No
UNIVERSITY OF LUCKNOW
APPLICATION FORM FOR TEACHING POST
(to be filled by candidate in his/her own hand writing, blind or physically disabled candidates are however exempted from this requirement. Applicants in employment should enclose a No Objection Certificate from the employer or bring the same at the time of interview)
For office use only : Date of receipt of application :
IMPORTANT : USE ONLY BLOCK LETTERS TO FILL THIS PAGE
(i)
POST APPLIED FOR FACULTY OF
In the subject/Deptt. of Lucknow University, Lucknow. DATED
(ii)
(iii)
ADVERTISEMENT No.
DETAILS OF FEE PAID : Fee to be paid is Rs.500/= by means of a Demand Draft Favoring the Finance Officer, Lucknow University & Payable at Lucknow.
(Name of the issuing Bank)
1.
Demand Draft No.
(First Name)
Date
(Middle Name)
Amount
(Surname)
FULL NAME (as recorded in the Matriculation or equivalent certificate) PRESENT POSTAL ADDRESS WITH PHONE NO. PERMANENT POSTAL ADDRESS (if any)
2.
3.
4.
4A. 5. 6.
7.
FATHERS NAME (as recorded in the Matriculation or equivalent certificate) MOTHERS NAME MALE/FEMALE (Strike-off whichever in not applicable) SEX DATE OF BIRTH (as recorded in the Matriculation or (Date) (Month) (Year) equivalent certificate) PLACE OF BIRTH
(District) (State) (Country)
(1)
8. 9. 10.
NATIONALITY
MARRIED/UNMARRIED(Strike off whichever is not applicable) MARITAL STATUS YES/No (Strike off whichever is not applicable) WHETHER BELONG TO SCHEDULED CASTES/TRIBE. OTHER BACKWARD CLASSES CANDIDATES MOTHER TONGUE WHAT OTHER LANGUAGES (S) (if any) THE CANDIDATE SPEAK, READ AND WRITE FLUENTLY DATE OF PASSING DIFFERENT EXAMINATIONS AND CLASS OBTAINED :
11. 12.
13.
Sl.. No.
EXAMINATION
YEAR OF PASSING
NAME OF INSTITUTION
NAME OF THE UNIV./BOARD
SUBJECTS (S)
MARKS/GRADE OBTAINED &%/Percentile
1.
Matriculation/High
School/Senior or
Cambridge/I.C.S.E./C.B.S.E. equivalent examination
2.
Intermediate/ I.S.C. or equivalent examination
3.
B.A./B.Sc./B.Com/BCA/B.P.Ed/ equivalent examination
or
4.
B.A./B.Sc./B.Com/BCA/B.P.Ed/ (Hons.) or equivalent examination
5.
LL.B. or equivalent examination M.A./M.Sc./M.Com./MCA/M.P.Ed/ or equivalent examination
6.
7.
LL.M or equivalent examination M.Phil. Ph.D./D.Phil. D.Litt..D.Sc. or equivalent Diplomas
8.
9.
10.
11.
N.B. :
Strike off alternatives, which do not apply in your case. (2)
14.
WHETHER THE CANDIDATE HAS CLEARED ANY ONE OF THE FOLLOWING TEST : U.G.C.- J.R.F. Examination YES/NO C.S.I.R.-J.R.F. Examination YES/NO NET UGC/CSIR YES/NO (Strike off which is not applicable and attach Self-attested copy of the award letter) ANY OTHER SCHOLARSHIP/ FELLOWSHIP AWARDED (attach self-attested proof thereof)
15. 16.
RESEARCH PUBLICATIONS (give the subject/topics of the paper published together with the name of journals. Reprints of all paper stated here should be enclosed with the application)
BOOKS/MONOGRAPHS/ PUBLISHED (attach proof thereof) REVIEWS
(Please attach separate sheet, if necessary )
17. 18.
ANY POSITION OF AUTHORITY HELD OR DISTINCTIONS (other than Scholarship) GAINED AT SCHOOL & COLLEGES INCLUDING GAMES AND SPORTS AND OTHER SOCIAL ACTIVITIES APPOINTMENTS (if any) SO FAR HELD
19.
S.No.
Nature of Posts
Date of Joining
Date of Basic Salary Reasons for Name & Address Leaving Last Drawn Leaving the of Employer Posts
20.
ANY OTHER QUALIFICATION (S) RELEVANT TO THE POST APPLIED FOR
(3)
21.
LIST OF SELF ATTESTED TESTIMONIALS ATTACHED HEREWITH
(Original to be produced at the time of Interview)
(Please tick(
) the ones, applicable)
Matriculation Marksheet Matriculation Certificate Intermediate Marksheet Intermediate Certificate B.A./B.Sc./B.Com. /BCA/B.P.Ed/B.B.A. (Final) Marksheet B.A./B.Sc./B.Com./ BCA/B.P.Ed/ B.B.A. Degree. M.A./M.Sc./M.Com./ MCA/M.P.Ed/M.B.A. (Final) Marksheet M.A./M.Sc./M.Com./ MCA/M.P.Ed/ M.B.A. Degree. LL.B. Final Marksheet LL.B. Degree. LL.M. Marksheet LL.M. Degree. M.Phil. Degree. Ph.D./D.Phil. Degree D.Litt., D.Sc., LL.D. Degree NET, UGC-JRF, CSIR-JRF, Award Certificate
(i) (ii) (iii) (iv) (v) (vi) (vii) (viii) (ix) (x) (xi) (xii) (xiii) (xiv) (xv) (xvi)
(xvii) Any other Degree. (xviii) Cast Certificate issued by the competent authority (OBC/SC/ST)
(xix) (xx) Total Number of Self attested testimonials attached -----------------(in words) -----------------------N.B. : Applications without the above self attested testimonials (applicable to the candidate) will not be entertained. DECLARATION I,-------------------------------------------------------------- Son/Daughter of --------------------------------------------hereby declare that all statements and entries made in the application are true, complete & correct to the best of my knowledge and belief. In the event of any information being found false or incorrect or ineligibility being detected before or after the Selection Committee and Executive Council meetings, my candidature / appointment may be cancelled by the University.
Signature of the candidate*
*Name as signed (in BLOCK LETTERS) *Application not signed by the candidates is liable to be rejected.
(4)
PRECIS (To be filled in duplicate, A and B) A
NAME AND SIGNATURE DATE OF BIRTH EXAM PASSED YEAR PASS% NET/JRF (YES/NO) RESEARCH PUBLICATION NS(No) Ph.D. Guide Teaching Exp.(Yrs.) RESEARCH Exp.(Yrs.)
PRECIS (To be filled in duplicate, A and B) B
NAME AND SIGNATURE DATE OF BIRTH EXAM PASSED YEAR PASS% NET/JRF (YES/NO) RESEARCH PUBLICATION NS(No) Ph.D. Guide Teaching Exp.(Yrs.) RESEARCH Exp.(Yrs.)
