Bhakta Kavi Narsinh Mehta University, Junagadh-362 263

BHAKTA KAVI NARSINH MEHTA UNIVERSITY, JUNAGADH-362 263

APPLICATION FORM FOR TEACHING POSITIONS-PROFESSOR,

ASSOCIATE, PROFESSOR & ASSISTANT PROFESSOR

(DIRECT RECRUITMENT)

Full Name of the Candidate:______

Specialization (Master Degree) with:______

Name of the post applied for ______

Advt.No______Date:______

Total API Score calculated

Important Notes:

1. The above posts are sanctioned by Department of Education, Gandhinagar with letter no. NMY/1215/79/Kh, Sachivalay, Gandhinagar dated 13/07/2016.
2. One can download application form and eligibility criteria from BKNMU website from 22th July,2016.
3. This application form is an editable word format, and the applicants should fill up by typing the same using 12 point Times New Roman/Arial fonts.
4. Complete and correct information against each item should be entered. Incomplete applications may result in rejection of the same.
5. Employed persons should forward their applications through proper channel. They should have to produce NOC at the time of interview.
6. Applicants should sent ten printed copies of the application (A 4 size paper). Please do not attach original documents. Print outs should be taken only on one side of the paper.
7. All candidates will have to make a presentation of minimum ten minutes for teaching skills. Candidate can select the relevant topic for presentation.
8. The qualifications for teaching posts shall be strictly as per the UGC Regulations, 2010 & 2016: Minimum Qualifications for Appointment of Teachers and Academic Staff in Universities. Amendments with regard to qualifications made by the UGC & State Government shall be binding to the candidates.
9. The API score claimed by the applicant under category II and III shall be used only as an eligibility criteria. Scrutiny committee’s decision regarding calculation of API score will be final.
10. As per Government of Gujarat, General Section notification no. GS-2006-31-KHTP/102005/1519-K dated 30th September,2009, for direct recruitment, applicants should have passed CCC+ for class-1 & 2 and CCC for Calss-3.
11. SEBC category candidates should attach Caste Certificate of competent authority. They candidates should submit Non Creamy layer certificate which should be issued after 31st March, 2016.
12. Attach DD of Rs.1000/- alongwith the application. SC/ST candidates should submit DD of Rs.250/-. DD should be in favour of ‘Registrar, Bhakta Kavi Narsinh Mehta University, Junagadh’.
13. Application should be submitted as per given proforma only. Incomplete/without attaching necessary testimonials/without DD of prescribed fee or application received after last date would be rejected.
14. If information provided in the application is found incorrect at any stage, the applicant is liable to be rejected. Decision of Bhakta Kavi Narsinh Mehta University would be final.
15. Financial norms will be applicable as per state government's Rules & Regulations.

PART A: GENERAL INFORMATION AND ACADEMIC BACKGROUND

1 / Full Name (in CAPITAL letters)
2 / Father’s / Mother’s Name
3 / Date and Place of Birth
4 / Gender
5 / Marital Status
6 / Nationality
7 / Indicate whether belonging to General /SC/ST/SEBC/PH category (Please tick in the relevant box) / SC ST SEBC General PH
Relevant certificate from the competent authority to be attached
8 / Full address for correspondence
(with PIN code)
9 / Permanent Address
(with PIN code)
10 / Contact Land-line / Mobile Number
11 / E-mail
12 / Name of the Present Employer, if any
13 / Current Designation & Salary /Grade Pay

14. Academic Qualifications (Matriculation onwards):

Examination / Examining Board/University / Year of Passing / Marks / Percentage
/CGPA & Rank if any. / Subject
Offered
Obtained / Out of
Matriculation/ S.S.C.
Intermediate/H.S.C. or equivalent
Bachelors’ degree
Masters’ degree
M. Phil.
Ph. D.
NET/SLET
CCC/CCC +
Any other Degree/
Diploma

• An attested copy of all the certificates and/or the result notifications should be attached.

15.

A.Record of previous employment (please attach relevant certificate/s)

Name of the Institution / Designation / Essential qualifications for the post at the time of appointment / Nature of
appointment (Permanent/ Fixed term/
Temporary/ Ad hoc) / Nature of
Duties / Pay
Scale / Date of Joining / Date of Leaving / Reasons for Leaving

B. Present Employment:

Designation / Organization / Date of Joining
(dd/mm/yyyy) / Nature of Appointment (Ad hoc / Temporary/Permanent/ Contractual)
Basic Pay p.m. (in Rs.) / Pay Band (Rs.) / Grade Pay/AGP
(in Rs.) / Gross Salary p.m. (in Rs.) / Increment (in Rs.) with date
Important/distinctive contributions(s) made in the present employment:

16.Period of teaching experience: P.G. classes (in years)

U.G. classes (in years)

17.Research experience

i.Total number of years : ______

ii.Years spent in M. Phil. / Ph.D.: ______

iii.Years of guiding Ph.D. / M. Phil.: ______

iv.Total No. of papers published in

i. International Journals ______

ii.National Journals ______

iii. Conference Proceedings ______

(Not as abstracts but as full papers)

v.Total No. of Conferences/Seminars/Workshops attended

i.International ……………

ii.National ……………

iii. State-Level ……………..

1. Details of Awards / Prizes/ Honours / Recognitions Received:

19.Fields of specialization under the Subject/Discipline

a)

b)

20.Orientation /Refresher Courses / FDP attended (Attach relevant certificates):

Nature of the Course/ Programme / Place / Duration / Organizing Agency

21. Details of publications:

(A)Journal Articles / Chapters in Books:

Sr. No. / Title / Name of the Journal, Vol. No., Year with ISSN No. / Title of the book along with name of the editor, place of publication, publisher, year of publication and ISBN No / Name of co-author/s

(B)Books:

Sr. No. / Title of the Book / Whether author or editor / Name of the publisher, place of publication, year of publication and ISBN No. / Name of the co-author/s or co-editor/s if any

22.Language Proficiency:

Mother tongue: ______

Other languages known: ______

Sr. No. / Language / Read & Write only / Read, Write and Speak / Examination/s passed, if any
(a) / English
(b) / Gujarati
(c) / Any other Language/s

1. Names, designations, addresses, e-mail and contact Landline/Cell Phone numbers of three references:

1.

2.

3

1. FUTURE PLANS:

(A): Your vision for the Department/Institution in which you have applied:

______

(B):Your academic contributions to the Department / Faculty / University / Institution you have served so far:

______

(C): Future academic development plan for your own self:

______

25. Any other information relevant for the post applied for:

______

DECLARATION

I hereby solemnly affirm that the information given in this application form is true and correct to the best of my knowledge and belief. I also affirm that I have never been convicted by any court of law or suspended / dismissed by any employer/organization from job. I understand that if any of the information given by me in this form is found incorrect, my candidature is liable to be cancelled at any stage without assigning any reason. I confirm that I shall abide by the decision/s of the University with regard to my application.

______

Name and Signature of the Candidate

Date :______

Place :______

Forwarded through:

(For employed candidates only)

I herewith forward the application of Mr./Ms./Dr./Prof. ______for the post of ______at the Department of English/Sociology, Bhakta Kavi Narsinh Mehta University, Junagadh.. He/she is working as a ______in our organization on a temporary / permanent / ad hoc / contractual basis. We have "No Objection" to his/her application being considered and, if selected, for his/her appointment to the concerned post in your University.

______

Name and signature of the authority competent to forward with seal

Place:

Date:

List of Enclosures:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

Page 1 of 16

(Part – B)

CATEGORY – II: PROFESSIONAL DEVELOPMENT, CO-CURRICULAR AND EXTENSION ACTIVITIES

Based on the teacher’s self- assessment, category II API scores are proposed for Professional development, co -curricular and extension activities; and related contributions. A list of items and scores is given below. The self-assessment score should be based on objectively verifiable criteria supported by the documents and shall be finalized by the screening/scrutiny committee.

Category-II / Nature of Activity / Maximum
API Score / Actual hours spent
per academic year / Score claimed by
the applicant
a. / Student related co-curricular, extension and field based activities.
(i)Discipline related co-curricular activities (e.g. field work, study visit,student seminar and other events, career counseling, etc)
(ii)Other co-curricular activities (Cultural, Sports, NSS, NCC, etc)
(iii)Extension and dissemination activities (public/popular lectures/ talks/seminars, etc). / 15
b. / Contribution to Corporate life and management of the department and
institution through participation in academic and administrative committees
and responsibilities
(i)Administrative responsibility (including as Dean/ Principal/Chairperson/ Convener/ Teacher-in-charge/ similar other duties that require regular office hrs for its discharge)
(ii)Participation in Board of Studies, Academic and Administrative Committees. / 15
c. / Professional Development activities (such as participation in seminars conferences, short-term training courses, industrial experience, talks, lectures in refresher/ faculty development courses, membership of associations, dissemination and general articles and any other contribution) / 15
d. / Grand Total / 45

(Attach sub-criterion wise (a, b & c) Activity list)

CATEGORY III:

RESEARCH,PUBLICATIONSACADEMICCONTRIBUTIONS

(A) (i) Published PapersinJournals:

S.N. / Titlewith pageno. / Name of Journal / ISSN/ ISBN No. / Whether peer reviewed. Impact factor,
ifany / No.of Co- authors / Whether youare themain author / API Score
Claimed / Annexure No.of Proof Enclosed
1
2
3
4
5
6

(B) Publications other than journal articles (Books, chapters in Books)

(i) Text/reference books published.

S.N. / Title of the book / Name and address of the publisher &
year of publication / ISSN/ ISBN No. / Level of publication:
International
/National / Text
/Reference book / No.of Co- authors / Whether youare themain author / API Score
Claimed / Annexure No.of Proof Enclosed
1
2
3
4
5

(ii)Articles/Chapterspublished inBooks:

S.N. / Titleof Article/Chapter / Title of the Book, Name of the
EditorPublisher / Dateof Publication / ISSN/ ISBN No. / Level of publication
International
/National / No.of Co- authors / Whether youare themain author / API Score
Claimed / Annexure No.of Proof Enclosed
1
2
3
4
5

(C)Research Projects:

(i)OngoingResearch Projects:

S.N. / Title / Minor
/Major / Funded by / Period / Principal Investigator or Co-PI / Grant/Amount
Mobilized
(Rs.InLakhs) / API Score
Claimed / Annexure No.of Proof Enclosed
1
2

(ii) Ongoing Consultancy Projects:

S.N. / Title / Funded by / Period / Grant/Amount
Mobilized
(Rs.InLakhs) / API Score
Claimed / Annexure No.of Proof Enclosed
1
2

(iii) Completed Research/Consultancies Projects:

S.N. / Title / Minor
/Major / Funded by / Period / Grant/ Amount
Mobilized
(Rs.In
Lakhs) / Date of Completion / API Score
Claimed / Annexure No.of Proof Enclosed
1
2

(iv)Project outcome / outputs:

S.N. / Title / Funded by / Period / Grant/ Amount
Mobilized
(Rs.In
Lakhs) / Output in
Policy
Document
Level of output / API Score
Claimed / Annexure No.of Proof Enclosed
1
2

(D) ResearchGuidance:

Number of Students
Enrolled / Thesis
Submitted / Degree
Awarded / API Score
Claimed / Annexure
No.of Proof Enclosed
M.Phil
Ph.D.

(E)Fellowship, awards and invited lectures delivered in conferences/seminars

(a) Details of Fellowship and Awards.

S.N. / Name of the fellowship
/Awards / Year / International/ National/ State/ University Level / Name of the Fellowship/Award conferring Academic Body / API Score
Claimed / Annexure No.of Proof Enclosed
1
2
3

(ii)(a) Invited Lectures

S.N. / Subject of the Invited Lecture / Level
International/ National/State/University / Date(s)
ofthe event / Invited/Organized by / API Score
Claimed / Annexure No.of Proof Enclosed
1
2
3

(b) Papers presented

S.N. / Titleofthe paper presented / Title of the Conference/Seminar / LevelofConference, Seminar,etc. (Whether International/ National/State/Regional/ Uni.or CollegeLevel) / Date(s)
ofthe event / Organized by / API Score
Claimed / Annexure No.of Proof Enclosed
1
2
3

(F) Development of e-learning delivery process/materials

S.N. / Title of e-learning Module / Target Audience / Year / Level
(International
/National/State) / Remarks,
if any / API Score
Claimed / Annexure No.of Proof Enclosed
1
2

List of Enclosures :-

(Please attach copies of certificates, Sanction Orders, Papers, etc. wherever necessary in sequence)

1)5)

2)6)

3)7)

4)8)

Declaration

I certify that the information provided by me is correct as per records available with me/college/institute/University and/or documents enclosed along with this filled in Proforma.

Name and Signature of the Candidate

Date:

Place:

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