CVM UNIVERSITY

Vallabh Vidyanagar-388120 Ta & Dist. Anand. () Affix Recent Application for the Post of: ______Passport size Photograph

at ______

Read the following Instructions carefully before filling in the form. i. A hard copy of duly filled in application should be submitted along with self-attested copies of the relevant certificates, mark sheets, testimonials etc. to the Registrar, CVM University, Nr. BVM College, Vallabh Vidyanagar-388120, Dist. Anand (Gujarat). ii. Also submit a soft copy (PDF) of application at [email protected] iii. Additional sheets of paper may be attached if the space provided against any item is insufficient. iv. Candidate should be proficient in English. v. Candidate should apply separately for each subject / post. vi. Minimum Qualifications, Experience as per AICTE/UGC/CVMU rules. vii. Candidate is required to mention correct E-mail address and Mobile number.

1. Name in full (in Block Letters):

Shri/Smt./Kum./Dr.______(SURNAME) (NAME) (FATHER’S/HUSBAND’S NAME)

2. Full address for correspondence:

Present Permanent

______Pin: ______Pin: ______

E-Mail ID: ______

3. Date of Birth: ______Age: ______

Nationality: ______Mother Tongue: ______

Category: (Open/SC/ST/OBC/SEBC/PH): ______Page 1 of 5

4. Place of Birth: Town / Village: ______Tal. :______

Dist.: ______State: ______

5. Languages Known:

Read Write Speak

6. (a). Educational Qualifications: (Beginning with HSC Exam.)

Examination Year of Subjects / University / Board Percentage Passed Passing Discipline

7. Details of Teaching/ Research/ Industry Experience including the present: (In chronological order) Name & Period of Service Total Salary Reason Nature of Address of the Designation drawn p.m. for Service Institution From To (Rs.) Leaving

• Salary Expected: ______

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8. Research Papers/ Books/ Monograph/ and Articles published:(Furnish details):

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9. Number of Students Guided for their:

M. Phil.: ______Ph.D.: ______

10. Patents if any: ______

11. Details of any other innovations / Activity during professional career, if any.

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12. Computer Knowledge. Yes / No (If yes, provide the details) ______

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13. Are you convicted for any offence under any Civil / Criminal Law? Yes / No (If yes, provide the details) ______

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14. Is there any Civil / Criminal Case pending? Yes / No (If yes, provide the details) ______

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15. Name and Address of two persons for reference who are not related to the candidate but who are acquainted with the work and character of the candidate:

(1) (2) ______Pin: ______Pin: ______

M./Phone No. ______M./Phone No. ______

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16. List of documents attached with the application:

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I, hereby, declare that the information given above is true and correct to the best of my knowledge, information, and belief.

PLACE: ______DATE: ______Signature of the Candidate

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