CVM UNIVERSITY Vallabh Vidyanagar-388120 Ta & Dist. Anand. Gujarat (India) 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: _________________________ Page 2 of 5 8. Research Papers/ Books/ Monograph/ and Articles published:(Furnish details): ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ 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. ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Page 3 of 5 ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ 12. Computer Knowledge. Yes / No (If yes, provide the details) __________________________________________________________________________ __________________________________________________________________________ 13. Are you convicted for any offence under any Civil / Criminal Law? Yes / No (If yes, provide the details) __________________________________________________________________________ __________________________________________________________________________ 14. Is there any Civil / Criminal Case pending? Yes / No (If yes, provide the details) __________________________________________________________________________ __________________________________________________________________________ 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. _______________________ Page 4 of 5 16. List of documents attached with the application: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ 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 Page 5 of 5 .