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गुजरात केन्द्रीय विश्‍वविद्यालय

(भारत की संसद के अधिनियम सं. 25, 2009के तहत स्थापित)
CENTRAL UNIVERSITY OF GUJARAT
(Established by an Act of Parliament of India, No 25 of 2009)
Sector - 29, Gandhinagar - 382 030,
Ph. No.079 23977407, Fax: 079 23260076
e-mail: , website:
FOR OFFICE USE ONLY
Inward No.
Inward Date

APPLICATION FORM FOR NON-TEACHING POSITION / OTHER ACADEMIC STAFF

Employment Notification No. ………………..……………..… , dated ………….
Post Applied For …………………………………………….… ,Sl. No. ………
DEMAND DRAFT PARTICULARS
Name of the Bank / D.D. No. / D.D. Date / Amount`.
/ PASTE HERE A SIGNED COPY OF YOUR RECENT PASS-PORT SIZE PHOTOGRAPH
  1. PERSONAL DETAILS (FILL IN CAPITAL LETTERS ONLY)

1 / Name of Applicant / :
2 / Father’s / Spouse Name / :
3 / Date of Birth
(As recorded in the Matriculation or equivalent certificate) / :
4 / Place of Birth : / : City / Village: State: Country:
5 / Religion / :
6 / Nationality / :
7 / Aadhaar No. / :
8 / Gender /
: Male /
: Female
9 / Marital Status /
: Married /
: Unmarried
10 / Category (SC/ST/OBC/General) / :
11 / If physical challenged, indicate relevant particulars / Type of disability / :
Percentage of disability / :

(Please tick √ wherever applicable)

  1. EDUCATIONAL QUALIFICATIONS: (Attached self-attested photocopy of marks sheet & degree of each examination)

Degree / Name of the Board / University / Year of passing / %age of marks / CGPA with %age marks / Division / Class / Subjects studied / Remarks
Matriculation (10th)
Higher Secondary / Intermediate (10+2)
Bachelor’s Degree
……………………
( Name of Degree)
Master's Degree
…………………
( Name of Degree)
M.Phil. in
......
Title :
Ph.D. in
......
Title :
Any other
  1. TECHNICAL QUALIFICATIONS

Diploma/ Certificate / Name of the Institute / Year of Passing / % of marks/CGPA / Subject(s)
  1. CURRENT POSITION

Designation / Employer(Name of theOrganisation) / Date of Joining(Date / Month / Year) / Nature of Appointment(Ad hoc / Temporary / Permanent / Contractual)
Basic Pay (p.m.) / Pay Band / GP / AGP / Gross Salary (p.m.)
  1. PAST WORK EXPERIENCE :

Designation / Name of Organization / Pay
Scale /
Band / Basic Pay (p.m.) / Nature of appointment / Period of service
From / To / Total Experience inYears/Months
  1. RESEARCH EXPERIENCE

Position held / Emoluments (p.m.) / Name of the University / Institute / Period of work
From / To / No. of years
  1. REFERENCES: Please provide names of three persons who are not related to you and are familiar with your work / professional experience / accomplishment

1 / 2 / 3
Name and address
Contact Address
e-mail
Phone (landline)
With STD Code:
Mobile Phone No.
Fax with STD Code
  1. CONTACT DETAILS OF THE APPLICANT

ADDRESS FOR CORRESPONDENCE / PERMANENT ADDRESS
Name:
House No:
Street:
City:
State:
Pin Code: / Name:
House No:
Street:
City:
State:
Pin Code:
e-mail :
Phone No. (with STD code) :
Mobile No. :
Fax No. :
  1. DECLARATION

I, ______son / daughter of ______hereby declare that all entries made by me in this application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found false, incomplete or incorrect, my candidature / appointment is liable to be cancelled / terminated by the University without assigning any reason thereof.
Signature of the applicant: ______
Name in Capital letters: ______
Date: ______
Place: ______
Note:
1. Unsigned application is liable to be rejected and no correspondence will be entertained.
2. The University shall not be responsible, if any column is not filled up properly and legibly.
  1. ENDORSEMENT BY THE EMPLOYER

(In case of in-service candidates, whether in permanent / contract / temporary capacity, the application must be endorsed / forwarded by the Head of the Department / Employer, failing which application is liable to be rejected.)
Forwarded to the Registrar, Central University of Gujarat, Sector-29, Gandhinagar, Gujarat, India-382030
The applicant Dr./Mr./Mrs/Ms.______, who has submitted this application for the post of ______in the Central University of Gujarat, has been working in this organization namely ______as ______(name of the post), in a temporary / contract / permanent capacity with effect from ______in the Scale of Pay/Pay Band of `______. He / She is drawing a basic pay of ______His / Her next increment is due on______.
Further, it is certified that no disciplinary / vigilance case has ever been held or contemplated or is pending against the said applicant. There is no objection for his / her application being considered by the Central University of Gujarat.
(Signature of the forwarding officer)
Name: ______
Designation: ______
Place: ______
Date: ______
(Seal)
  1. CHECKLIST OF DOCUMENTS ENCLOSED

Sl. No. / Documents (submit in copy only) / Tick (√)
1 / Demand Draft (if applicable)
2 / Matric / Secondary / High School (10th Class) Marks Sheet
3 / Matric / Secondary / High School (10th Class) Certificate
4 / Sr. Secondary / Intermediate (12th Class) Marks Sheet
5 / Sr. Secondary / Intermediate (12th Class) Certificate
6 / Bachelor's Degree Marks Sheet
7 / Bachelors' Degree
8 / Master's Degree Marks Sheet
9 / Master's Degree
10 / M. Phil. Marks Sheet
11 / M. Phil Degree
12 / Ph. D. Degree
13 / API Score Sheet (for Librarian and Deputy Librarian only)
14 / Experience Certificate(s) from previous employers
15 / Endorsement from the present employer
16 / SC / ST / OBC / Handicapped Certificate
17 / Others, if any:

Note: List of Documents be checked & ticked properly. Any lapse on this account is liable for rejection of your form.