KARNATAK UNIVERSITY, DHARWAD
Application form, for the Career Advancement Scheme (CAS)
N. B.: If the space provided for any of the items is inadequate, additional sheet may
please be enclosed wherever necessary.
To,
The Registrar
Karnatak University,
DHARWAD – 580003
Sir,
I hereby apply for Career Advancement Scheme (CAS) as per Circular
No.____________________________ dated: __________ from the cadre of Assistant
Professor/Assistant Director of Physical Education/Assistant Librarian
(Academic Level) _______ to (Academic Level) _________/ Associate Professor to
Professor/Dy.Director of Physical Education to Dy.Director of Physical
Education/ Deputy Librarian to Deputy LibrarianDirector of Pd to Professor i.e.
(Academic Level) _______ to _____________ in the Department of
__________________________________ (UG/PG) Karnatak University, Dharwad.
I am furnishing the below mentioned information required for the purpose.
(A). Personal Information
1. Name in Full : __________________________________________________
(in capital letters beginning with surname)
2. Address : __________________________________________________
3. Date of Birth : __________________________________________________
4. Present Position
i. Date of appointment : _______________________________________
ii. Date of appointment/promotion in the present
position in the University: ____________________________________
iii. Date of appointment/promotion in the present position outside the
University (Please enclose certificate) : ______________________
5. Present Pay Band & Grade Pay : _____________________________________
1
6. Present Basic : _________________________________________________
7. Contact Number: ____________________, Email:.______________________
(B). Academic Qualification
(Relevant documents must be enclosed)
S.I. Examination Passed University/ Month Class Subject
No (P.G. and above) Institution & Year Obtained
1. Academic Distinctions:
2. Area of Specialization :
3. Membership of Professional Bodies :
(C). Teaching Experience
(Relevant documents must be enclosed)
Sl. Level of Teaching College Month Period Courses
No University/ & Year of Service Taught
Institution
1 Under-graduate
2 Post-graduate
3 Any other course/s
not covered by 1 to 2
Note: The candidates are informed to submit their details of performance in the
relevant criteria as per the tables as prescribed in the Annexures to Karnatk
University Statutes relating to Appointment and Promotion of Teachers and other
Academic Staff and Measures for the Maintenance of Standards in Higher
Education in the K.U.Dharwad as per the UGC Regulations 2018.
* Attach proof in the order.
Place:
Date: Candidate Signature
