Dharmsinh Desai University, Nadiad

College Road, Nadiad-387001, Gujarat

FACULTY OF __________________
Application Form
Photo
Application received on (for office use only):

Note:
1. The application should be submitted along with true copies of the relevant certificates so as to
reach the Vice Chancellor, Dharmsinh Desai University, Nadiad-387001, Gujarat before the
last date prescribed in the advertisement/application.
2. Clearly super scribe the details of the post applied for on the top of the covering envelope.
3. Additional sheet may be attached, if the space provided against any item is inadequate.
4. The candidates already employed in Government /Semi-Government /Public sector organizations
should forward the application through their employer.

1. Name of the post applied for:

(Post) (Department)

2. Advertisement details: Source: ______________________ Date: ___________________

3. Name of the candidate in full (block letters):

(Surname) (Name) (Father’s/Husband’s Name)

4. Address for correspondence: e-mail: ______________________________________

Pin: Phone:

5. Permanent address:

Pin: Phone:

6. Date of birth: Age:

7. Nationality: Mother tongue:

8. Category: General/SC/ST/OBC/Handicapped

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9. Languages known:

Read Write Speak

10. Educational qualifications (starting from the highest degree)

Degree/
Month & Rank/
Examination Discipline/ University/ % Marks & Class
Year of Medal
Passed Major subjects Board awarded
passing (if any)

11. Details of professional & teaching experience (beginning with the present one)

Total monthly
Designation of the Period
Employer details Nature of service salary drawn
post From: to
in the last job
-
-
-

12. Details of research experience if any (including Master/Doctoral research)

Organization Area of Research Designation

13. Total teaching experience in years:

14. Total professional and research experience in years (excluding master/doctoral research):

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15. Details of research/technical publications (attach additional sheet if necessary)

Volume, Name of the

Title
Month/year Journal/Conference/Workshop/Book

16. Professional distinctions/Awards/Medals if any:

17. Details of any other innovation/activity involved during professional career.

18. Name and address of two persons who are acquainted with candidate’s work/profession.

Tel: No. Tel: No.

19. Declaration: All the information given above is correct to the best of my knowledge and
belief.

Date: Signature of the candidate:

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 DHARMSINH DESAI UNIVERSITY, NADIAD.
(to be filled up by the candidates applying for the post of Assoc. Professor/Professor)

Give your input for each point clearly. Candidate’s name: ___________________________________
Date :__________________

1. Innovation / Contribution in teaching

a. Design of curriculum
b. Teaching methods
c. Laboratory Development
d. Evaluation Method
e. Preparation of Resource Material
f. Remedial teaching

2. Extension work I Community service / Corporate life

3. Area of your technical / research activities (excluding teaching)

4. No. of technical publications

a. National conference / journal
b. International conference / journal
c. Articles in magazine

5. No. of publications as an outcome of project work done under your guidance

a. National
b. International

6. View for further academic development

a. at UG level
b. at PG level

7. Contribution in institutional / departmental activities (administrative)

8. Write a para (not more than 5 sentences on) why you think you are the best candidate for this job’?

9. Any other information not covered under 1 to 7.

Place : Signature of Applicant: ____________________