APPLICATION FOR THE POST OF ---------------------------------------------------- 1. Name in full (in capital letters) 2. Full address to which communications may be sent 3. (a) Age (completed years) (b) Date of birth by Christian Era 4. Place of birth (Village, Taluk, District & State) 5. Name of community / Caste /Tribe (where community claimed in the application is not proved by school records certificates issued by Tahsildar or Municipal Commissioner will be accepted as proper proof of community) 6. Are you (a) citizen of India by birth and / Or by domicile ? or (b) a person migrated form Pakistan ? 7 Father's name Address Occupation (If dead, state last address & occupation before death) 8. Qualifications Name of examination passed Name of University Year of passing Class, Rank, etc Subject of examination in the several parts with main and subsidiary (copies of mark list to be attached) (a) B.A/B.Sc/B.Com (b) M.A./M.Sc./M.Litt./ M.Com.etc. (c) Research Degree (Give full details with subject of specialization, name of Institute or University and Professor under whom you worked etc.) 9. Research work done since taking the first research degree (add full details on a separate sheet if necessary) 10. *List of Publications (If necessary add a separate sheet listing the papers and enclose one copy each of all available reprints) 11. What languages (including Indian languages) can you read, write or speak ? Give particulars and state examination passed in each: Read only Speak only Read and speak Read, write and speak Examination passed 12. EMPLOYMENT SINCE LEAVING COLLEGE (Give full particulars) Name of employer Date of joining Date of leaving Nature of Employment Salary *Reference, if any, to the research done by the candidate in standard books or in journals of standing may be given on a separate sheet. 13. (a) Present employer's full address (b) Has the consent of the employer been obtained for submitting this application ? 14. Name and address of three persons who are not relatives of the applicant and who know the applicant well and to whom references may be made 1. 2. 3. 15. Character & conduct certificate from a person who knows the applicant personally, obtained not earlier than six months prior to the date of application Name and address of the person 16. Character and Conduct certificate from the Principal of the College in which the applicant studied last or from the most recent employer. (Additional testimonials may be added) Name and address of the persons from whom certificates are attached 1. 2. 3. 17. Extra-curricular activities in school & college days (i) Social Service (ii) N.C.C (iii) Sports and games (iv) Student organizations (v) Any other 18. Foreign Qualifications 19. Travels outside India 20. Any additional information which the candidate wishes to give in support of his application 21. Particulars of documents produced to Prove payment of application fee 22. Particulars of documents produced to prove age, qualification etc. 23. List of enclosures i. ii. iii. iv. v. vi. vii. I certify that the information given above is correct to the best of my knowledge and belief. I agree to bind myself to the conditions of service of Kerala University that may be drawn up from time to time under Section 73 of Act 17 of 1974 or any amendments thereto. Place----------------------- Signature of the applicant----------- Date----------------------- Name in block letters---------------- N.B. All applicants are informed that canvassing in any form, if proved, will lead to their applications being rejected. If the space provided in the application form is insufficient, separate sheets of paper may be attached and pinned to the main application form and reference to the same made in the relevant column.
