RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
Application No.:………………………
(To be filled by RRU)
APPLICATION FORM FOR NON-TEACHING POSITION
(Note: Please go through the Advertisement, Essential and Desirable
Qualifications, General Conditions and Other Details given on the website
www.rru.ac.in carefully before filling-up the Application Form)
SECTION – A: GENERAL
Application for the post of :……………………..…………………………………………
1. Full Name (In Block Letters): Dr./Mr./Mrs./Ms.
………………………………………………………........
Affix here a
2. Field of specialization …………………………………………………………………. Passport
Recent
size
Photograph
3. Date of Birth: ……..…………… (In words) ………………………………………………….…
4. Place of Birth ………………………………………………………………………….
5. Father’s/Spouse’s Name:
……………………………………………………………………………………
6. Gender: Male/Female
……………………………………………………………………………………..
7. Mailing Address:
…………………………………………………………………………………………
……………………………………………………………….....................................
………………………………………………………………....................................
………………………Pin Code
Tel. No (with STD code): …..…………………………. Mobile:
………………………………………………..
E-mail ID:……………………………………………………………………………………………………….
8. Permanent Address:…………………………….……………………………………………………
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
1
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
………………………………….……………………………………………..….
………………………………………………………………....................................
……………………… Pin Code
9. Marital Status:……………………
10. Nationality:………………………………………………
11. Category: General / OBC/ SC/ ST/EWS - ………………….
12. Physical disability, if applicable ………..
…………………………………………………………….
SECTION B:
CATEGORY I:
13. Educational Qualifications (Use separate sheet if required):
Percentag Year
S. Name of
Examination/ e of of
No Board/ Subject(s)
Degree Marks/Fin Passin
. University
al Grade g
1 SSC (10th Standard)
2 HSC (12th Standard)
Bachelor's Degree
3
(…………….)
Master's Degree
4
(…………….)
5 Ph.D.
Any other
6
qualification
7
(Please attach self-attested photocopies of the mark sheet in support)
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
2
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
14. Whether Ph.D. awarded: Yes No If Yes, indicate the year of
award…………….
15. Title of Ph.D. thesis awarded……………………........………………………….
……………
……………………………………………………………………………………………….….
16. (a) Teaching professional/Research employment/Administrative
(give particulars in
descending order starting with the present post):-
(Attach supporting document of each entry and use separate sheet
if necessary)
*Status Period of Total Part Nature of
Pay
of Employm Period Time/ duties
Scale(
Name of Institu ent (In Contract
Please
Office/ tion/Fi (from - years) Basis/
Sr. Post specify
Institution rm/Uni to) Ad-hoc/
No. held revised
/ Firm/ versity Regular/
or
University Tempora
unrevis
ry/Perma
ed)
nent
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
3
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
Total Experience: Year(s)…………….Month(s)…………Day(s)
……….
16. (b) Post- Doctoral research experience:
Position Emoluments Name of Period of Years Remarks
Held (Per month) University/ work If any.
Institution (from - to)
17. Contribution in organizing Training
Course/Conference/Seminar/Workshop (If Any) :
S. No. Particular Institution
18. Participation in Training Course/Conference/Seminar/ Workshop (If
Any) :
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
4
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
S. No. Particular Institution
CATEGORY II: OTHER MISCELLANEOUS INFORMATION(S)
19. (a) Other activities/Institutional Responsibilities including membership of
institutional
Committees:
(b) Any other relevant information, if not given above:
20. Justify yourself in 100 words for the mentioned post :
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
5
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
21.
a.) Have you been punished during your service or convicted by a
Court of Law/ Organization?
Yes/ No : …………
If yes, give details:
b.) Is any case/inquiry pending against you in any Court of Law/
Organization/ or by law enforcement agencies?
Yes/ No : …………
If yes, give details:
c.) Whether you were denied NOC by your previous or current
employer for applying to other jobs?
Yes/ No : ………….
If Yes, give details:
d.) Whether you have been issued memo/show cause/warning by your
previous or current employer?
Yes/ No :…………..
If Yes, give details:
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
6
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
e.) Whether any disciplinary proceedings are
pending/initiated/conducted against you by your previous or
current employer
Yes/ No : ………….
If Yes, give details:
f.) Whether you were given any major/minor penalty by previous or
current employer in any form pertaining to your employment
Yes/ No : …………..
If Yes, give details:
g.) How you and your performance was assessed by your supervisors in
last three years (If serving in government institution, please
furnish the documentary evidence)
Year-I (Average/Good/Outstanding/Not upto the mark) :
………………………………..
Year-II (Average/Good/Outstanding/Not upto the mark) :
……………………………….
Year-III (Average/Good/Outstanding/Not upto the mark) :
………………………………
h.)If selected for appointment, the minimum period required for
joining the post:
i.) Have you been declared medically unfit by any organization?
Yes/ No : …………..
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
7
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
j.) Have you at any time been asked to submit your resignation or
discharged or dismissed on any ground by employer? If yes, give
details
Yes/ No : ……………
k.) How do you come to know about the said post at RRU:
l.) Do you know any RRU employee or student?
Yes/No : …………..
If Yes give details:
Name :
Relation :
For how long you are known…………….
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
8
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
22. Name and Addresses of Two Referees (Other than RRU) with phone
and email ID
1. Name :
Occupation :
Email :
Phone :
Address :
2. Name :
Occupation :
Email :
Phone :
Address :
23. List of Enclosures: (Should be properly marked with annexure
number, and use separate sheet if required)
Yes/No Total No. Annexure
No.
(a) Copy of Marksheet(s) &
certificate of educational
Qualification
(b) Copy of Experience
Certificate(s)
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
9
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
24. DECLARATION TO BE SIGNED BY THE CANDIDATE : (if candidate is
from Government employee or employee working with autonomous body)
I hereby, declare that the information given by me in the Application is true,
complete and correct to the best of my knowledge and belief and that nothing
has been concealed or distorted. If at any time, I am found to have
concealed/distorted any information or given any false statement, my
application/appointment shall be liable to summarily rejection/termination
without notice or compensation.
I hereby declare that I possess the minimum qualification criteria for the post
applied as per the advertisement.
Date: ____________
Place: ____________ (Signature of the
Applicant)
---------------------------------------------------------------------------------------------------
------------------------
For use of applicant in employment (Certificate to be given by the
present employer of the applicant).
Forwarded with the remarks that Mr./Ms.________________________________ is
working in this organization in the capacity as__________________ from
____________ to _________in pay scale_____________and grade pay____________. The
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
10
RASHTRIYA RAKSHA
UNIVERSITY
(An Institution of National
Importance)
Pioneering National Security and Police
University of India
________________________________________________________________
institution/ organization has no objection to the candidature of the applicant
being considered for the post applied for as above.
He/ She will be relieved as per the rules, if selected for the said post. Further, it
is also certified that no vigilance case or disciplinary proceeding or criminal
proceedings is either pending or contemplated against the candidate applying
for the post. His / Her integrity is beyond doubt.
Place:____________ Signature of Head/Registrar of
the Institution
Date:____________ Name:_________________________
Fax:_____________ Designation:____________________
E-mail: ________________
Address:_______________________
_______________________________
(Office Stamp)
----------------------------------------------------------------------------------------------------------------------------------
Name of the Applicant:-_________________________________
Signature with date:-____________________________________
11
