APPLICATION FEE : Rs.250/- FOR NON-TEACHING POST

For Office Use Only
Inward No. / Est. No. / Sr. No.
Date / ___/06/2016 / Date / ___/06/2016
Section / Establishment
/ SARDAR PATEL UNIVERSITY
VALLABH VIDYANAGAR-388120
(Dist. ANAND - GUJARAT)
APPLICATION FORM FOR THE POST OF
The Newspaper in which you read the Advertisement ______
Advertisement No. B/S/1249 Dated : 02/06/2016 Last Date : 23/06/2016 / Affix the
3.5 c.m X 3.5 c.m. latest Photograph only on First Copy by
Self Attested
Demand Draft No. / Date:_____/06/2016 Rs.250/-
Name of Bank / Branch
Payable at Branch / City

IMPORTANT: Before filling in the form please read the form, Instructions and Qualifications carefully.

INSTRUCTIONS TO APPLICANTS :

(i) The candidate should submit One Copy of the application form neatly typed in prescribed form along with separate enclosures to reach the Registrar, Sardar Patel University, Vallabh Vidyanagar on or before the last date i.e.23-06-2016

(ii) Candidates are advised to satisfy themselves before applying, that they possess atleast, the essential qualifications laid down in the advertisement.

(iii) No correspondence & Phone inquiry will be entertained in respect of advertisement, Written Test, interview, selection and appointment etc. It will be display on S.P. University website www.spuvvn.edu/careers/

(iv) Sardar Patel University reserves the right not to fill up any of the vacancies & right to reject any application & right to alter the number of post in any cadre without assigning any reason.

(v) If the any column is not applicable to the candidate concerned in that column please write “Not Applicable” OR “NIL”.

(vi) Incomplete application shall not be considered & applicants may not be called for written Test.

(vii) The Post is Purely on Temporary basis for 11 Months with fix pay of Rs.7500/-

(viii) Written Test will be held on Dt.03/07/2016 Sunday 11.00 a.m. at Vallabh Vidyanagar.

Place & Roll No. will be display on website. Please see S.P. University website.

(x) No Oral Interview for class-III as per Gujarat Government G.R.(GAD) Resolution No.PRC-102015-1223-K Dt.06/11/2015.

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1. / (In Block letters) Name in full : Mr./Mrs./Ms./Dr.
Father’s/Husband’s Name
Surname / Mother’s Name :

2.(i) Please Tick mark (P) appropriate column. Please enclose Caste Certificate of appropriate authority, if applicable.

S.C. / S.T. / Baxi Punch / SEBC / General / Phy. Handi / Ex-Serviceman

(Attach a certificate from the competent authority with Caste validity certificate for S.C./S.T./ Socially and Educationally Backward Class (SEBC) and non- Creamy-layer Certificate.)

(i) / Caste Certificate No. / Issue Date
(ii) / Name of Issuing Authority
3. / Date of Birth / Age / Years / Months / Days

(A true copy of the Higher Secondary School Leaving Certificate in which the Birth Date is registered should be enclosed.)

A / Birth Place / Tal. / Dist. / State
B / Native Place / Tal. / Dist. / State
C / Race & Religion / Nationality / Mother tongue
D / Blood Group / Height (cms) / Weight (Kgs.)
E / Personal Marks of Identification
F / Pan Card No.
G / Election Card No. / City/District where Registered
4. / Please Tick mark (P) appropriate column / Married / Unmarried / Divorced / Widow
If married Name of Husband / Wife

5. Full Address for correspondence (In Block Letters)

Present
City / PIN
Tal. / Dist.
State
Phone No / Mobile No.
E-Mail
Permanent
City / PIN
Tal. / Dist.
State
Phone No / Mobile No.
E-Mail

6. Educational Qualifications : Examinations passed (Attested copies of all testimonials/ Certificates including Marks, Grade, Certificate should be attached) :

Sr. No. / Examination
Passed / Principal Subject / Subsidiary Subject / Name of the University or Examination Body / Total Marks with Class, Grade, Exact percentage (%) / Year & Month of Passing the Examination / No. of attempts for passing
each of the examinations / Language in which studies were carried out / Encl. at Page No.
1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10
1 / S.S.C
2 / H.S.C.
3 * / Bachelor’s (Specify Degree) / F.Y.
4 * / S.Y
5 * / T.Y.
6 / Post Graduation / Part-I
Part-II
11 / Others
12
13

* In case of semester system the candidate should change the table appropriately.

(7) Details of Typing/ Computer Course. (Please attached Certificate.)

W.P.M. Class / Grade / Month & Year of Passing / Examination Body / Encl. at Page No.
1 / English Typing
2 / Gujarati Typing
3 / Computer
4 / CCC
5 / CCC +

(8) Details of Experience : (Post held in Private or Public employment giving details of Work) (Teaching, Laboratory, Industry etc.)

Full Name & Address of the Employer where Employed / Designation (Type of work) / Date of joining / Date of Leaving / Grant-in Aid/ Self Finance/ Private / Full time/ Part time/ Ad hoc / Basic Pay & Pay Scale or Fixed pay / Reason for leaving Previous Employment / Encl at page No.
1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9

(9) Present Position :

Full Name & Address of the Employer where Employed / Designation / Work Done / Grant-in Aid/ Self Finance/ Private / Full time/ Part time/ Ad hoc / Basic Pay or Pay Band & A.G.P. OR Fixed Pay / Date of appointment / Encl at page No.

(10) Any other relevant information (Special experience/merits) not included above (Participation in curricular and co-curricular activities,NCC/NSS/Sports/Cultural Activities etc. enclose all Certificates)

Sr. No. / Activities / Institution / From / To / No. of Days / Encl. at page No.
1 / N.C.C.
2 / N.S.S.
3 / Sports
4 / Cultural activities

(11) Languages Known Tick mark (P) appropriately :

Sr. No. / Language / Read / Write / Speak
1 / English
2 / Gujarati
3 / Hindi
4

I, hereby declare that the information furnished above is true and correct to the best of my knowledge and belief and also that I have not concealed any fact or withheld any information regarding my past service and record. If any information is found to be false or incorrect or anything is found to have been concealed, I will be disqualified for selection or if appointed, will be liable to termination without any notice or compensation.

Place
Date / Signature of the Applicant

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Note : All Copies of Marksheet / Certificates should be self attested, List of enclosures attached by the applicant should be arranged strictly in the following order. Please tick (P)

Sr. No. No. / Details Enclosed with Application Form / (P) / Encl. at Page No.
1.  / Application Form with Photograph.
2.  / Caste Certificate (If necessary)
3.  / Higher Secondary School Leaving Certificate.
4.  / S.S.C. / H.S.C. all Marksheet.
5.  / F.Y.,S.Y. & T.Y. all Marksheet & Degree Certificate.
6.  / Postgraduate’s Degree -Previous & Final Year all Marksheet & Degree Certificate.
7.  / English Typing (If any)
8.  / Gujarati Typing (If any)
9.  / Computer Course Certificate (If any)
10. / CCC Passing Certificate (If any)
11. / CCC+ Passing Certificate (If any)
12. / Other Qualifications Certificates
13. / Pan Card & Election Card Copy
14. / Testimonials / Experience Certificates.
15.
16.

Please fill ALL the following ADDRESS SLIPS with typing neatly only one copy of this page should be submitted attached with your form with Full Name & Postal Address (With Pin Code) for further communication.

BY Registered Post / Courier / BY Registered Post / Courier
Name / Name
Address / Address
City / PIN / City / PIN
Tal. / Dist. / Tal. / Dist.
State / State
Mobile No. / Mobile No.

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