JAWAHARLAL NEHRU UNIVERSITY New Mehrauli Road, New Delhi – 110067

APPLICATION FORM FOR NON-TEACHING GROUP-‘A’ POSTS CARRYING GRADE PAY OF Rs.5400/- AND ABOVE. Note: 1. Fill in all the information in block letters only. 2. Attach copies of the qualifying degree (s)/certificates only. 1. Advertisement No. : ……………………………………………….. 2. Post applied for : ……………………………………………….. 3. Name of the applicant :………………………………………………………………………..

4. Father’s /husband’s name :……………………………………………………………………….

5. Marital status :………………………………………………………………………..

6. Present address :……………………………………………………………………….

………………………………………………………………………. ………………………………………………………………………

7. (a) Telephone No. (with STD code) :………………………………………………………………………

(b) Mobile No. :……………………………………………………………………… (c) Email address :………………………………………………………………………

8. Permanent address :………………………………………………………………………

……………………………………………………………………… ………………………………………………………………………

9. Date of Birth (in figure) :………………………………………………………………………..

(in words) :………………………………………………………………………..

10. Nationality :………………………………………………………………………. 11. Religion :……………………………………………………………………… 12. Category (SC/ST/OBC/PH/GEN) :……………………………………………………………………….

(Please attach attested photocopy of certificate, in the proforma, prescribed for the purpose)

13. Educational Qualification starting with secondary education: (Please attach attested photocopies of certificates/mark sheet) Examination/ Degree

University/Board Year of passing % of marks/ Division

Subjects taken

Please affix a recent passport size photograph

14. Research Degree(s):

Degree University Specific date of submission of Ph.D. thesis

Specific date of award

Title of the thesis

15. Whether qualified UGC-NET/CSIR/JRF test: ………………………………………………………… (if yes, indicate the year and attach a photocopy of certificate) 16. Experience (please start with the latest):

Period Name of Employer

Post held From To

Pay Scale/Pay Band & Grade Pay with Basic Pay

Nature of work (Please attach separate sheet, if required)

17. Teaching/Research experience, :……………………………………………………………………….. if any. ………………………………………………………………………. 18. Number of publication (please attach one copy each of three publications which you

consider most important alongwith complete list of publications): Publication Capacity Published Accepted for

Publication Under preparation

Independently Books

Jointly

Independently Papers/Articles

Jointly

Independently Abstracts

Jointly

Independently Patents

Jointly

19. Attended training programme/seminar/ :…………………………………………………………….. workshop etc 20. Have you ever been discharged/ :……………………………………………………………..

suspended from any position? If yes, state reason:

21. Name & Address of two referees (should be familiar with your recent work)

I II Name Occupation or Position

Address with Pin Number

Fax (if any) Phone No. (with STD code)

E-mail 22. Any other information:

DECLARATION

I hereby declare that all the statements made in this application are true and complete to the best of my knowledge and belief. I understand that the Jawaharlal Nehru University has a policy against sexual harassment and is committed to providing an environment free from discrimination and harassment. I further understand that at any time I am found to have concealed/distorted any material information, my candidature/ appointment shall be summarily terminated without any notice/compensation. Place: Signature of the candidate Date: Name……………………………..