Proforma for application NATIONAL COUNCIL OF EDUCATIONAL RESEARCH & TRAINING SRI AUROBINDO MARG NEW DELHI 110

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Application form for faculty/teaching positions (Fill up separate form for each post)

Affix here a Recent Passport size Photograph

Note:

Please go through instructions given in the website www.ncert.nic.in (Announcement-notice and Recruitment) carefully before filling up the application form and self assessment API Score Card.

Advt. No . Post No.... Post applied for. 1. Name in full (In Block Letters) Dr./Mr./Mrs/Ms 2. Date of Birth .. (In words) 3. Fathers/Spouse Name 4. Mailing Address ........... Pin Code Telephone No (with STD code)..Mobile E-mail ID 5. Permanent Address . . Pin Code 6. Marital Status 7. Nationality 8. State of Domicile 9. Category: SC/ST/OBC/PWD/General.......................................
(In case of PWD category, please indicate PH-OH/PH-HH/PH-VH) (Please attach attested photocopy of Certificate)

10. Religion: Hindu/Muslim/Sikh/Christian/Neo/Buddhist/Zoroastrian/Others 11. Present Employer

12. EDUCATIONAL QUALIFICATIONS Sl. Examination/Degree Name of Board/ No. College/University Percentage of Marks/Final Grade Subject(s) Year of Passing/ award

(Please attach photocopies in support)

13. Whether Ph.D. awarded : Yes 14.

No

If Yes, indicate the year of award

Title of Ph.D. thesis awarded........

15.

Whether qualified UGC/CSIR NET/SLET/SET

Yes

No

(If yes, indicate the year, and attach a photocopy of NET/SLET/SET certificate)..

16. Details of Employment Experience:

Sl. No. Name of Employer/Status of Institute/University (Govt./Quasi Govt./Autonomous etc.)

(Attach separate sheet if necessary)

Period of Employment From To Basic salary last drawn, pay scale and Grade Pay Nature of duties

Post held/ Designation

17. Summary of experience/performance

Teaching Experience i. ii. iii. iv.. v. vi. Elementary/ Secondary/Senior Secondary Level Under Graduate Post Graduate Total Teaching Experience Participation in production of Educational Audio/Video/Multi From To Years Total Months

Media Short term/Continuing Education / Specialized Courses conducted Research Experience vii. Research Experience other than the period spent for obtaining M.Phil./Ph.D. Research Degree

Column numbers 18-24 are to be filled by applicants for the posts of Professor/ Associate Professor/Assistant Professor/Librarian only. 18. Co-curricular, extension and professional development related activities 1) Student related co-curricula, extension and field based activities (such as extension work through NSS/NCC and other channels, cultural activities, subject related events, advisement and counseling).
Description

Sl No.

2) Contribution to corporate life and management of the department and institution through participation in academic and administrative committees and responsibilities.

Sl No.

Description

3) Professional development activities (such as participation in seminars, conferences, short term, training courses, talks, lectures, membership of associations, dissemination and general articles, etc.)
Sl No. Description

19. RESEARCH PUBLICATIONS (a) Books- Self authored/co-authored/edited (Please attach separate sheet, if necessary)
Sl. No. Title of the Book (s) Whether Sole Author or Co-author Name of Publisher (with city/ country) Month& year of publication Refereed or Nonrefereed ISBN/ ISSN No.

(b) Chapters contributed in edited books (Please attach separate sheet, if necessary)
Sl. No. Title of Chapter (s) Title of the Book(s) Whether Sole Author/ Coauthor Name of Publishe r (with city/ country) Month & year of Publicatio n Refereed or Nonrefereed ISBN/ ISSN No.

(c) Research Articles/Papers published in Journals /Periodicals /Conference proceedings/ Newspapers (Please attach separate sheet, if necessary)
Sl. No. Title of research article / paper(s) Name of journal (with city/ country) Whether Sole Author/ Co-author Month & year of publication, volume, no. & page nos. Whether Refereed/ nonrefereed ISBN/ ISSN No. Level (Int./ Nat./ State/ Local) Impact Factor

20.
Sl. No.

Research Projects Undertaken (other than that for a research degree) (Please attach separate sheet, if necessary)
Title/Subject of Research Project(s) Whether major or minor project Date of Commen cement Date of Compl etion Total Grants / Funding received (Rs.) Name of Sponsorin g/ Funding Agency Whether Outcome / Outputs sent to Sponsoring Govt. Agency Whether final report published as monograph book

21.

Research Guidance: Number of scholars who have been awarded M.Phil/Ph.D. degree under your supervision both as Guide and/or Co-guide:
Submitted Awarded

Name of Degree (i) M.Phil Degree (ii) Ph.D Degree:

22.

Refresher Course, Methodology, Workshops, Training, Faculty Development Programs, etc. attended. (Please attach separate sheet, if necessary)
Name of Course attended Sponsoring Institution Duration From___ to___

Sl. No.

23.
Sl. No.

Papers presented in Regional/National and International Seminars/Conferences / Workshop/ Symposium. Indicate whether the Conference Proceedings are published. (Please attach separate sheet, if necessary)
Title/Subject of paper presented Subject of Conference / Seminar / Symposium / Workshop Organizing Institution/ and Name of City/ Country Duration From __ to__ Whether the proceedings published Yes/No

24.
Sl. No.

Lecture/Special Lectures in Institutions of repute within the country and outside. (Please attach a separate sheet if necessary)
Title/Subject of Lecture delivered Name and Place of Institution Date of Lecture Duration

25. Academic Performance Indicators (APIs) as applicable enclose separate sheet duly certified for each category. 26. List of Enclosures:
(a) (b) (c) (d) Copies of Mark-sheets & certificate of educational Qualification & certificate of clearing NET/SLET/SET etc. Copies of certificate of Teaching & Research experience. List of publications with details, reprints of papers published and acceptance letters (in case accepted papers/articles etc.) Copies of other relevant certificate & documents

27. DECLARATION TO BE SIGNED BY THE CANDIDATE I hereby declare that the information given by me in the Application is true, complete and correct to the best of my knowledge and belief and that nothing has been concealed or distorted. If at any time, I am found to have concealed/distorted any information or given any false statement, my application/appointment shall liable to be summarily rejected/terminated without notice or compensation.

Date: ____________ Place: ____________

____________________ (Signature of the Applicant)

28.

Forwarding letter from present employer of the applicant, if any Forwarded with the remarks that Shri/Ms.________________________________ is working in this organization in the capacity as__________________ from ____________ to _________ and the institution/ organization has no objection to the candidature of the applicant being considered for the post applied for as above.

Place:____________ Date:____________ Fax:_____________ E-mail:________________

Signature of Head of the Institution Name:_________________________ Designation:____________________ Address:_______________________ ________________________ (Rubber Stamp)