Application form for Recruitment to Various Posts by Visva Bharati Santiniketan-April 2010
D.D./CASH COUPON NO. FOR Rs. DATE
VISVA-BHARATI
APPLICATION FORM FOR EMPLOYMENT
1. _____________________________
2. _____________________________________
Advertisement No. Post (Name and Serial No.)
3. _____________________________
Scale of pay
4. _______________________________________________________
5. ____________________
Applicant’s Name (in block letters) with contact phone number(s) Date of Birth
( Evidence to be enclosed)
6. _______________________________________________
Present address (in full) with Telephone Number / E-mail I.D.
7. ___________________________ 8. _________________
Nationality Whether belonging to Scheduled Cast / Scheduled Tribe / O.B.C. /
PH /Ex-Servicemen / Meritorious Sports Persons ;
9. ___________________________ ( Copies of evidence to be enclosed )
. Religion
10. ______________________
Father’s / Husband’s Name, Address and Occupation (if dead, state last address and occupation before death)
11. ______________________ Permanent address (in full) with nearest Railway Station
_____________________________________
12. Educational qualification
Name of the School with Board / Council, College and University
Examination passed
Total Marks
Marks Obtained
Class or Division
Marks obtained in percentage
Year
Subject of studies
13. Details of publication
Date of Publication
Title
Name of the Co-authors, if any
Name of the Journal
Volume and Pages
Remarks
14. Particulars of previous Experience
Name of Organisation/Institution
Position Held
Scale of pay
Duration
Nature of work
Reason for leaving
From
(Date)
To
(Date)
15. Details of Present Employment
Name of Organisation/Institution
Position held
Scale of pay
Remuneration :
Basic pay,other pay, if any, D.A.,
other allowances
Total
Date of Joining and Duration of Service
Nature of Work
16. Specify additional qualifications / experience
( Sports, Music, Literary and Social Activities etc. )
___________________________________________________________________________________________________
17. Special interest or hobbies, if any
_____________________________________________________________________________________________
18. Give names of two referees, not related to you, with full address.
Name Name
Occupation Occupation
Address Address
Phone No. Phone No.
Fax Fax
email email
_______________________________________________________________________________________________
19. Are you a past student / worker of the Visva-Bharati? (pl. indicate the dates and other details)
_______________________________________________________________________________________________
20. Have you any relations already serving in the Visva-Bharati ?
_______________________________________________________________________________________________
21. Would you be prepared to live with the students in their dormitories ?
( Only in case of an applicant for a teaching post )
_______________________________________________________________________________________________
22. What other voluntary work may be expected from you, if appointed ?
_______________________________________________________________________________________________
23. Are you married ? If so, have you any children ? Give details.
_______________________________________________________________________________________________
24. Are you free from debt ?
_______________________________________________________________________________________________
25. Are you willing to accept the minimum initial
pay, if offered ? If no, state what is the lowest
initial pay that you would accept.
In case of pay protection submit L.P.C.
____________________________________________________________________________________________
26. If appointed what notice period you require for joining the post. ?
_______________________________________________________________________________________________
I declare that the above particulars are true and correct. Should any of the informations / documents / statements turn out to be incorrect or false, the appointment is liable to be terminated.
Dated …………………………… _____________________________________________
Signature of the Applicant
1. Where the space provided in the form is found to be inadequate, annexures may be given quoting the numbers under which additional information is supplied.
2. The Visva-Bharati does not hold itself responsible to fill up the post advertised.
3. One set of true copies of academic certificates, mark-sheets, and two copies of recent photographs (passport size ) and testimonials should accompany the application, in all cases (in case of 9 copies of application forms, one set of true copies of academic certificates, mark-sheets etc., should be accompanied).
4. The University may raise the standard of qualification, experience etc. at its discretion