RAI UNIVERSITY
SH. 144, Village-Saroda, Taluka-Dholka, Dist- Ahmedabad-
382260, Gujarat
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Advertisement No.:………………………
(To be filled by RU)
PERFORMA FORM FOR TEACHING POSITION(S)
(Note: Please go through the detail Advertisement for Qualifications, General
Conditions and Other Details given on the website www.raiuniversity.edu
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:……………………………….……………………………………………………
………………………………….……………………………………………..….
………………………………………………………………....................................
……………………… Pin Code
9. Marital Status:………………………
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Name of the Applicant:-_________________________________
Signature with date:-____________________________________
1
RAI UNIVERSITY
SH. 144, Village-Saroda, Taluka-Dholka, Dist- Ahmedabad-
382260, Gujarat
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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
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qualification
(Please attach self-attested photocopies of the mark sheet in support)
14. Whether Ph.D. awarded: Yes No If Yes, indicate the year of
award…………….
15. Whether CSIR NET, SLET, SET awarded Yes No If Yes,
indicate the year of award
15. Title of Ph.D. thesis awarded……………………........………………………….
……………
……………………………………………………………………………………………….….
16. Teaching professional/Research employment/Administrative (give
particulars in descending order starting with the present post):-
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Name of the Applicant:-_________________________________
Signature with date:-____________________________________
2
RAI UNIVERSITY
SH. 144, Village-Saroda, Taluka-Dholka, Dist- Ahmedabad-
382260, Gujarat
------------------------------------------------------------------------------------
(Attach supporting document of each entry and use separate sheet if
necessary)
Name of Period of Total Part Time/
Institution Employmen Period Contract
Sr. / Post Pay t (In Basis/ Ad-hoc/
No. University/ held Scale (from - to) years) Regular/
organizati Temporary/Per
on manent
Total Experience: Year(s)…………….Month(s)…………
Day(s)……….
17. Research (mandatory for teaching positions)
Seminar / Conference /
Paper Published Paper Presented Workshop
National International National International Attended Organized
CATEGORY II: OTHER MISCELLANEOUS INFORMATION(S)
22. Other activities/Institutional Responsibilities including membership of
institutional
Committees:
P.G / any project guided (Attach separate sheet):
Ph.D. research project guided / Govt. aided projects executed (Attach separate sheet):
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Name of the Applicant:-_________________________________
Signature with date:-____________________________________
3
RAI UNIVERSITY
SH. 144, Village-Saroda, Taluka-Dholka, Dist- Ahmedabad-
382260, Gujarat
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Research & Consultancy Experience (If any):
Collaborative/ Sponsored Research Projects (If any):
Academic Administrative Experience and Your Contributions (If any):
Professional Membership (If Any):
Other Achievements (If Any):
23.) Have you been punished during your service or convicted by
a Court of Law/ Organization?
Yes/ No:
If yes, give details:
24.) Is any case/inquiry pending against you in any Court of Law/
Organization/ or by law enforcement agencies?
Yes/ No:
If yes, give details:
25.) If selected for appointment, the minimum period required
for joining the post:
26. Names and Addresses of Two References with phone and email ID
1. Name :
Designation :
Email :
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Name of the Applicant:-_________________________________
Signature with date:-____________________________________
4
RAI UNIVERSITY
SH. 144, Village-Saroda, Taluka-Dholka, Dist- Ahmedabad-
382260, Gujarat
------------------------------------------------------------------------------------
Phone :
Address :
2. Name :
Designation :
Email :
Phone :
Address :
27. List of Enclosures: (Should be properly marked with annexure
number, and use separate sheet if required)
28. 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 form 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)
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Name of the Applicant:-_________________________________
Signature with date:-____________________________________
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