For Office Use Only ANNEXURE – II
Entry No:
Paste 1(one)
passport size
MIZORAM UNIVERSITY : AIZAWL colour photograph
(Application form – Prescribed format) (Do not staple)
1. Name of post applied with code no:
2. Name of Department applied for :
(For Academic Departments Only)
3. Category of post applied for :
4. Advertisement No. & Date : No.1/1/2010-RC(T)/21464 – ‘559 dt. 25.01.2011
5. Demand Draft No.____________________ Date:______________ Amount: Rs.___________
6. Name of the applicant (in block letters):
7. (a) Sex: (b) Religion:
8. Father’s Name :
9. Date and Place of Birth :
10. Whether belongs to SC/ST/OBC :
11. State of Domicile :
12. Permanent address :
13. Address for correspondence (with Phone No./Fax No./E-mail):
contd. 2/-
…2…
12. Academic records beginning with High School Examination:
Sl. Examination Division (with Subject(s) Year Board / Distinction
No. Passed % of marks) University Achieved if any
13. Technical qualifications, if any:
14. Work experience, with particulars of posts held:
Sl. Post Held Employer Last Basic Pay Drawn Nature of Period with dates
No. with pay scale work From: To:
contd. 3/-
…3…
15. Teaching Experience:
(a) Post Graduate : ________ Years
(b)Under Graduate : ________ Years
16. Research Experience :
(a) No. of years after Ph.D. :
(b) Research Guidance :
i) Completed : Ph.D. ______ nos. [Link]. ______ nos.
ii) On-going : Ph.D. ______ nos. [Link]. ______ nos.
(c) Research Projects :
i) Completed : ______ nos. (with amount & funding agency)
ii) On-going : ______ nos. (with amount & funding agency)
(d) Publications* :
i) Research papers : ______ nos.
ii) Books : ______ nos.
iii) Articles : ______ nos.
* Citation index and impact factor should be provided.
17. Specialization :
18. Other relevant experience :
(a) Seminar, Symposium, Conference attended / organized.
(b) Administrative Experience / Experience of University Corporate Life.
(c) Contribution to Design of Curriculum.
(d) Extra Curricular Activities.
(e) Any other.
contd. 4/-
…4…
19. Names and addresses of two referees (one may be the present employer):
(a)
(b)
20. List of Enclosures :
Note: All particulars should be supported by relevant documents.
I certify that the foregoing information is correct and complete to the best of my
knowledge and belief. I am not aware of any circumstances which may impair my fitness for
employment in the Mizoram University.
Date :
Place : Signature of the Candidate
Applicants are required to submit completed Datasheet (for Assistant
Professor) and API Scoresheet (for Associate Professor, Professor, Deputy
Librarian and Librarian) along with their application