Professional Documents
Culture Documents
Application Form (Templet)
Application Form (Templet)
Post Applied: Assistant Professor in the School of Physical Education & Sports
1|SUOH
(Signature of the Applicant)
Village/City: DIWANA, PANIPAT
District: PANIPAT
State: HARYANA
Pin code: 132103
18 Administrative Post Hold, if any Athletics Coach, Dept. of Sports & Youth affairs Panipat
(Name the Post(s) with the Haryana
institution/University/College etc.)
19 UG Teaching Experience NA
20 PG Teaching Experience NA
21 Academic and sports distinction in Athletics
any
22 Have you ever been disqualified from NA
appearing in any university
examination/ assigning university
work?
23 Have you ever been dismissed from NA
the job?
24 Has any criminal case been registered NA
against you?
25 Have you ever been charged-sheeted NA
for any criminal offence?
26 Have you ever been convicted by any NA
court of law for a criminal offence?
Other if PG Dip. In Sports Management (Alagappa University) 400 236 59.00% Second
any
2|SUOH
(Signature of the Applicant)
28. Experience as per UGC regulation 2018 clause (10) and adopted by DGHE Haryana on 11.11.2022
(Start from Present Position)
Sr. Post and Details Date of Pay Band / Basic Total Nature of Job/ Date of Reason
No. of Organization Appointment Grade Pay Emolument Appointment Leaving for
Pay / Pay Leaving
Level
1
2
3
4
Sr. No. Book Title with the name of Volume, Book/ International/ ISBN No. Research Score
the author(s) as appearing in Year Chapters / National
the publication Research publishers
Paper
A.
B.
C.
Sr No Academic/Research Activity
3. Creation of ICT mediated Teaching Learning pedagogy and content and development of new and
innovative courses and curricula
Sr No (a) Development of Innovative pedagogy Research Score
A.
B.
Sr. No. (b) Design of new curricula and courses Research Score
A.
4|SUOH
(Signature of the Applicant)
B.
(c) MOOCs
Sr. No. Development of complete MOOCs in 4quadrants (4 credit course) (In case of MOOCs Research Score
of lesser credits 05 marks/credit)
A.
B.
Sr. No. MOOCs (developed in 4 quadrant) per module/lecture Research Score
A.
B.
Sr. No. Content writer/subject matter expert for each module of MOOCs (at least one quadrant) Research Score
A.
B.
Sr. No. Course Coordinator for MOOCs (4 credit course) (In case of MOOCs of lesser credits02 Research Score
marks/credit)
A.
B.
(d) E-Content
Sr. No. Development of e-Content in 4 quadrants for a complete course/e- book Research Score
A.
Sr. No. e-Content (developed in 4 quadrants) per module Research Score
A.
Sr. No. Contribution to development of e-content module in complete course/paper/e-book Research Score
(atleast one quadrant)
A.
Sr. No. Editor of e-content for complete course/paper /e-book Research Score
A.
Sr. No. No. of Students No. of thesis degree No. of thesis Submitted Research Score
awarded
Ph. D.
M.
Phil./P.G.
Dissertati
on
Ongoing NIL
PhD/ M
Phil
(b) Research Projects Completed
Sr. No. More than 10 lakhs Less than 10 lakhs Funding Research Score
Agency
A.
5|SUOH
(Signature of the Applicant)
B.
C.
D.
Sr. No. More than 10 lakhs Less than 10 lakhs Funding Research Score
Agency
A.
B.
C.
D.
(d) Consultancy
A.
B.
C.
5. (a) Patents
Sr. No. International National Research Score
A.
B.
A.
B.
(c) Awards/Fellowship
Sr. No. International National Research Score
A.
B.
6|SUOH
(Signature of the Applicant)
C.
Sr No Academic/Research Activity
Sr. No. Title of the Presented Title of the Date of International (Abroad)/ Research Score
Paper By conference/ seminar Event International (within the
Presented country)/ National/ State//
University
A. Stress and Mahipal International March University 2
its conference on 09-10-
Managemen Positive Psychology 2018
t for Health and Well
Being
B. Shin Splints Mahipal UGC Sponsored 3rd Aug University College of 2
(Medical National conference 20-21- Medical Sciences New
Tibial on Latest Trends in 2019 Delhi
Stress Health & Physical
Syndrome) education
in athletes
C. Benefits Mahipal Dr. International 13 Nov Jabalpur India 2
Need and Kunal A conference on 2022
Importance Desai Physical education
of Regular and Sports Sciences
Exercises in
Modern Era
D. Swiss ball Mahipal Dr. National Conference 25-26 Muslim University Aligarh 2
its uses role Kunal A Feb
and benefits Desai 2023
for
individual
E. Sports Mahipal DGHE Sponsored 27 Feb S.D College Ambala Cantt 2
Injuries, National Seminar 2018 Haryana
causes,
Symptoms
Treatment
and
Prevention
7|SUOH
(Signature of the Applicant)
*For office use only.
Note: Every claim has to be supported by the signed documentary/certified proof(s).
32. List the Name of Universities where you are academically associated as a paper setter/
UGBOS/PGBOS member etc.: NA
33. International Academic Exposure (Name the countries): NA
34. Professional and Academic Bodies Membership: NA
35. ICT/ Digital Knowledge Creation, if any: NA
36. Names, Addresses, Phone Numbers and Email ID’s of two referees who are familiar with
Applicant's academic work:
Sr.No Name Address Phone Email ID
. Number(s)
1 Dr. Manohar Lal Associate Professor of 9915449322 1981.msone@gmail.com
Phy.Edu, H.P University
Shimla
2 Dr. Naresh Kumar Associate Professor, Arya 9416655354 naresharya@gmail.com
P.G. College Panipat
38. DECLARATION
I Mahi Pal S/O Sh. Roshan Lal declare that the information in this application form and the enclosed
documents are accurate and that nothing has been concealed. I know that if the information I provided is
proven false/not true, I will have to face criminal proceedings per the Law’s provision. All the benefits I
Date: 09-09-2023
8|SUOH
(Signature of the Applicant)
(Signature of the Applicant)
CHECKLIST
(TO BE ATTACHED WITH THE HARDCOPY OF THE ONLINE APPLICATION FORM)
Sr Name of document Page
No Number (As
Per the
chronological
order of
documents)
1 10th Certificate 1
2 10+2 Certificate 2
3 Graduation Certificate 3
4 Post-Graduation Certificate 4
5 NET/SET/SLET Certificate 5 to 12
6 Research Degree Certificate/Ph.D. -
7 Category claiming certificates, if any -
8 Domicile Certificate 39
9 NOC (No Objection Certificate) of the Employer -
10 Documents in support of the claim of Research 13 to 37
Papers/Publications/
Books/Journals/Seminars/Conferences/Orientation Programmes/
Symposiums/Workshop/Training Programmes etc..attended/
participated.
11 Teaching Experience/Research Experience, if claimed by the -
applicant
12 Documents in support of the claim of Administrative/Industry 38
Experience, if any
13 Professional and Academic Bodies Membership: -
14 Additional Information, if any, may be specified. -
Important Note: Applicant may add rows as per requirement in the above application form. After filling
out this application form, candidates are required to submit the hard copy of this application form along with
all documentary proof to the following address:
Registrar
Sports University of Haryana
9|SUOH
(Signature of the Applicant)
Near 20th Mile Stone (Biswa-Mile) NH-44/ (MNSS)
Rai, Sonipat, Haryana-131029
Important Note: (Candidates are advised not to make changes in the application form except by inserting rows in respective claims)
1.
2.
3.
Signature of Screening Committee:
10 | S U O H
(Signature of the Applicant)