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LAKSHMIBAI NATIONAL UNIVERSITY OF PHYSICAL EDUCATION
rrt+a =oz, rtaz - =:= eez ( rrt+a =oz, rtaz - =:= eez ( rrt+a =oz, rtaz - =:= eez ( rrt+a =oz, rtaz - =:= eez ( rr rr rr rr) )) )
Shakti Nagar, Gwalior - 474 002 (Madhya Pradesh)

rrtrtr+ ( oz-rrtrtr+ r + ta r= > rrtrtr+ ( oz-rrtrtr+ r + ta r= > rrtrtr+ ( oz-rrtrtr+ r + ta r= > rrtrtr+ ( oz-rrtrtr+ r + ta r= >
APPLICATION FORM FOR TEACHING & NON-TEACHING POSTS
(Notice No. E-94/149 dated 29.8.2012)

Post applied for rta __________________________________________
LNUPE, Gwalior or NERC, Guwahati (Score out one)
a.zr.rrr.trr.t. rtaz rr s. .tr .+ -, or(ret ((+ +r +re )
Field of Specialization of post (applicable for teaching post)
+ trrrnar +r tr> (rrtrtr+ (a aro)
_______________________________________________________________
Applied under category Gen/SC/ST/OBC nrt t=+ -aoa r= t+r (
=rr-/=.r./=..r./.t.. ______________________________________





Particulars of fee Remitted rr-+ roar= +r tzr :
Amount zrtrr =. aee/- Bank Draft No. ++ sre ==r _______________________ Date t=r+ _______________________
Issuing Bank rzt+ar ++ _________________________________Branch rrr=rr ___________________________________



1. Full Name (in English in Block Letters) ___________________________________________________________________
zr =r (t(-t ) ___________________________________________________________________
2. (a) Father's/Husband's Name tar/ta +r =r ______________________________________________________
(b) Mother's Name rar +r =r ______________________________________________________________________
3. (a) Address for Correspondence >rrz + ta ar (b) Permanent Address [If different from 3(a)]
_____________________________________________ =rr; ar [t a(a) = tr-= (r ]
_____________________________________________ ______________________________________________
_____________________________________________ ______________________________________________
_______________________Pin Code______________ _________________________Pin Code______________
Tel. No_______________ Fax No. _________________ Tel. No_________________ Fax No. ________________
e-mail: _______________________________________ e-mail: ________________________________________
4. (a) Date of Birth - tatr ______________________ 5. (a) Sex: Male/Female tao =r/=>t
(b) Place of Birth - =rr= _____________________ (b) Category o
SC .r./ST ..r.
Age on the last date given in this advertisement OBC .t.o/General =rr- -------
;= tnr= t o; t-a tatr +r r Caste/rta--------------------



Affix Passport size
Photograph
r=re r+rz +r
+rer t+r
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(c) if person with disabilities Yes/No
t+aro (r= +t rrr (r/=(t
Years r _____________________________ VH t.(.
Months r( _____________________________ HH (.(.
Days t= _____________________________ OH r .(.
6. Marital Status : Married / Unmarried 7. (a) Nationality zretar ________________________
rt(+ t=rta trt(a/trt(a _______________ (b) Religion r ________________________________
8. State of Domicile =rr; t=r= +r rr 9. Whether registered with Employment Exchange? If yes,
___________________________________________ please indicate the Exchange, registration number and
validity +r zrorz +rr a t= ( t (r,
+r +rr a, t= +r+ rz rar rrr( 1
______________________________________________

10. Academic Qualification (Commencing with the High School or an equivalent examination)
rrtrtr+ rar ((r; =+a rr =+tr zttrr = rz-r +z)

Examination/ Degree
zttrr/srtr
Subject/
Specialization
tr/trrrnar
Year
r
Division
nrt
% of
Marks/
Grade
+ %/
os
No. of
Attempts
Subject-wise
trr==rz
r= ==r
University /
College /
Board
trtra/
+ra/+rs
Distinctions/
Scholarship
ttrrear/
cr>ta






Research Degree(s) rrrr srtrr

Degree srtr University's Name
trtra +r
=r
Date of submission of
research thesis
rrrr-+-r r +z= +t tatr
Date of award
srtr rta +t tatr
Title of the thesis
rrrr-+-r +r rrtr+
M.Phil. ( t+a


Ph.D.
t ( st

D.Sc./D.Litt.
st (=-=t/st tae


(i) Whether Ph.D. awarded as per UGC Regulation 2009 (If yes, Please give documentary proof) YES / NO
+r rrrr srtr .t.=t. zoarr= zees + == (1 t (r, ar =rt +t crrta =a= +z1 (r / =(t
(ii) Whether qualified NET conducted by UGC (Indicate the date and attach proof) YES / NO
+r .t.=t. rzr =rtaa zret r>ar zttrr satr ( (tatr ( rr =a= +z) (r / =(t

11. Summary of Teaching Experience with documentary proofs (Applicable for teaching posts)
=art rr =t(a rrtrtr+ =r +r =ttra tzr (rrtrtr+ r (a aro)
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t=r+ = t=r+ a+ +a r, r( rz t=
i. Under Graduate / ==ra+ _______ ________ _________
ii. Post Graduate / ==ra+raz _______ ________ _________
iii. Total Experience / + a =r _______ ________ _________

12. Teaching/Professional/Research/Administrative Experience with documentary proofs.
(Give particulars in descending order starting with the present post).
=art rr =t(a =art rr =t(a =art rr =t(a =art rr =t(a r=/=rt+/==rr=/r r=/=rt+/==rr=/r r=/=rt+/==rr=/r r=/=rt+/==rr=/rr rr rr rr r=+t =r =+t =r =+t =r =+t =r
(ar= = rz-r +z+ zr(t + tzr )

Employer
t=r+ar
*Status of
Institute/
University
==rr +t t=rta
Post Held

**Pay Scale/
Pay Band &
Grade Pay
a=r=
Basic Pay
a a=
Period of Employment
t=r= +t tr
Nature of
Duties/Work
+rr + ==



From = To a+
















* Govt./Quasi Govt./Autonomous/Private. =z+rzt/r=z+rzt/=rarrr=t/t=t1
** Mention whether revised or unrevised, if relevant. +r =rrrtra rr =rrrtra a=r= +r s-a=r +z, t
=oa (r1

13. (a) Has there been any break in your academic career? If so, give details.
() +r +rt r+t tr r = +r + ro ( r t (r ar +rzr =t(a tzr 1



(b) Have you been punished during your studies at college/University? If so, give details.
(+) +r +rt r+r tr r= + rzr= trtra/+ra rzr s tr or t (r ar tzr 1



(c) Have you been punished during your services or convicted by a court of law? If so, give detail.
(=) +r +rt =r+zt + rzr= r+r tsa t+r or ( r t+=t -rra rzr r+r rrt rtra t+r or
t (r ar tzr 1


(d) Where you at any time declared medically unfit or asked to submit your resignation or discharged or dismissed?
If yes, give details in a separate sheet.
() +r r t+=t = =r= zttrr r rr tra ( rr, r= ro> = + ta +(r or rr
r+r t+=t =r+zt = a r +=rr=a t+r or ( t (r ar r+ e z tzr 1

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(e) Do you have any case pending against you in any court of law? If yes, give details.
() +r r+ t= +r ; -rt+ rar trzrrt= ( t (r ar tzr 1



(f) Are you willing to accept the initial salary of the grade? (If no, state what is the minimum salary acceptable with
justification thereof).
(z) +r r+r rta a=r= +r -=a =t+r ( (t =(t, +rzr =t(a =e +z t+ t+a=r -=a a
a= =t+r ( )1



(g) If appointed, how much time would you require before joining the post?
(a) t= t+a (r= + t=rta +r o(r +z= = (a t+a= = +t rr+ar (



(h) Any other important information, if not given above:
() - +r; rr+ r=+rzt, t =z = t ot (r



14. Give names, designations and addresses
(Phone/Fax No./e-mail, if any, of two references not related to you. Reference should be of persons with or under whom you
have worked, or who have intimate knowledge of your work).
r =-r t+ar + =r, s=+ a r =-r t+ar + =r, s=+ a r =-r t+ar + =r, s=+ a r =-r t+ar + =r, s=+ a (+r=, ++= =. t () + =rr1 =-r t+a ( (r=r rt( t=+ =rr r
t=+ rt= rt = +r t+r (r r r rt + +r = rar oa (r ).
(i) (ii)






15. Declaration signed by the candidate rt rzr (=artrtza rrrrr > rt rzr (=artrtza rrrrr > rt rzr (=artrtza rrrrr > rt rzr (=artrtza rrrrr >
I hereby declare that the entries in this form are correct and true to the best of my knowledge and belief. If at any time, I am
found to have concealed/suppressed any material/information or given any false details, my appointment shall be liable to be
summarily terminated without notice or compensation.
(arzr ( rrrrr +zar/+zat ( t+ ;= r= t ot =rt ==r zt r r=+rzt ( trr= = =
(1 t t+=t = ( rr or t+ = +r; ==r tcrt ( rr z rzr t ot +r ; ==r = rt ot
ar zt t= t+a t+=r t+=t =rte= rr r + +=rr=a +z t rot1

=rr= Place :
Signature of Applicant/rt + (=artrz
t=r+ Dated :
Name/=r .............................................
Remark: Candidate already employed should submit application through his/her employer.
tert t=rta rt r= > = t=r+ar + r = r 1
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16. Forwarded with the remarks that the institution/organization has no objection to the candidature of the applicant
being considered for the post applied for, as above.
;= rrr + =rr otra t+ rt +t r+ar ( szr +ar==rz ;= z = (a trz (r= z = =rr +r
+r; rta =(t (1

Place =rr= Signature/(=artrz
Dated t=r+ (Head of the Institution/Organisation ==rr=/=oe= =r)
Telephone e at+r= Designation
Fax ++= Address ar
e-mail ;-a

17. List of Enclosures/=a= a=rr +t =t (Please tick in the box +r+= =(t +r t=rrr= aor )
(a) Bank Draft/Bank Cheque/Institute Receipt, if any
++ sre/++= +/==rr= z=t, t +r; (r
(b) Attested copies of all relevant mark sheets, documents, experience certificates, testimonials, NET etc. (Self-
attested or attested by Gazetted Officer)
==a +->r, =oa =arr, rr->r, zre t/r>ar zttrr ;rt +t rtra crrtar
(=-rtra rr zrt>a tr+rzt rzr rtra)
(c) Dully filled in, signed and verified API in the format developed by Institute (part of the application form) as per
UGC Regulations, dated 30.06.2010 and relevant certificates, testimonials and documents.
(Applicable for the posts of Professors, Associate Professors and Assistant Professors)
==rr= rzr t+t=a (.t.r; . r= et+ = rzr or, (=artrtza ( =rta > (r= > +r
rro) trtra =r= rro t=rat ae.c.ze+e + == ( =oa rr->, =ar
(rr, = +a rr ( =(r+ rr r (a aro)1
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GENERAL INSTRUCTIONS

1) The details contained in this application form are part of the advertisement issued for the
various posts.
2) The candidates must fill the application form in full. The envelope containing application
should be superscribed as "APPLICATION FOR THE POST OF _______".
3) The candidates must ensure that they possess the required minimum qualifications,
experience, etc. as on the date of submission of application form and should attach
copies of certificates and mark-sheets duly attested by self or gazetted officer with the
application.
4) The cut off date for upper age-limit will be the last date for submission of application.
Further, SC, ST and OBC candidates applying for un-reserved posts are not entitled to
any relaxation in age limit.
5) The qualifications, age etc. prescribed herein may be relaxed in accordance with the
provisions of LNIPE SBCSR and LNIPE Service (Recruitment) Rules.
6) Candidates belonging to SC/ST/OBC/PH/Ex-Serviceman are required to enclose copies
of certificate issued by the Competent Authority supporting their category and reservation
status.
7) Candidates serving in Central Government/State Government/Central or State
Autonomous Bodies should submit the applications only through proper channel, failing
which their candidature will not be considered.
8) The candidates must ensure that duly filled in application forms accompanied with a
demand draft of Rs.300/- (NIL for SC, ST and PH) in favour of Registrar, LNUPE, Gwalior
or receipt in original (paid in Institutes Accounts Section), are reached the Registrar,
LNUPE, Mela Road, Gwalior on or before closing date of the applications.
9) Incomplete applications and those received after the closing date due to any reason
including postal delay, shall be summarily rejected without making any reference to the
candidate.
10) The Institute reserves the right to fill or not to fill any of the posts.
11) These posts carry allowances, medical, LTC benefits etc. as are applicable to the
employees of LNUPE, Gwalior.
12) Institute reserves the right to conduct a written and/or practical test for all or any of the
post in order to judge the suitability of the candidates prior to calling for an interview.
13) The mere fact that a candidate has submitted application and apparently fulfilling the
criteria as prescribed for the purpose, would not bestow on him the right to be called for
in the selection process.
14) The posts are non-Government under the LNUPE, Gwalior and will be governed by the
New Pension Scheme introduced by Government of India w.e.f. 01.01.2004 as amended
and modified from time to time and adopted by LNUPE, Gwalior.
15) The merit lists of candidates for the posts of Associate Professor in Physical Education
and Assistant Professor in Physical Education shall be prepared sports-wise and
selection shall be restricted to one post in each sports based on overall merit.
16) No correspondence will be entertained from the candidates for selection
test/result/appointment.
17) The SC and ST candidates shall be given relaxation of 5% in qualifying/cut-off marks, if
any.
18) Canvassing in any form and trying to use influence or unfair means for appointment, will
be a disqualification.
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19) The appointments on the following posts made in pursuance to this selection process
shall be subject to the decisions in the Civil Appeals, Writ Appeals, Writ Petitions/Transfer
Applications presently pending before Hon'ble Supreme Court/High Court/Central
Administrative Tribunal, Jabalpur Bench, indicated against each of the posts, or
subsequent appeals, if any, before the Competent Courts of Law:-
a. Associate Professor in Physical Education WA No. 207/2007 (Dr. Ajay Singh Ruhal
Vs.UOI & Others).
b. Assistant Professor in Physical Education Appeal (Civil) No. 5744/2009 (LNIPE &
Others Vs. Sanjiv Yadav & Others) and Appeal (Civil) No. 5745/2009 (LNIPE &
Others Vs. Ram Gopal Arya & Others).
c. Deputy Registrar WA No. 78/2007 (Manoharlal Lodhi Vs. LNIPE & Others).
d. Assistant Registrar - Appeal (Civil) No. 7466/2009 (LNIPE & Others Vs. Amit Yadav).
e. Life Guard-cum-Instructor (Swimming) - OA No. 463/2011 (RBS Tomar Vs. UOI &
others).