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									                                                                                            Form of Application for Appointment

                                                                                                                                         Recent passport
                                                                                                                                         size photograph of
                                                                                                                                         the candidate. (To
                                                                                                                                         be attested by the
                                                                                                                                         applicant.)
                        West Bengal State University
                                       (Barasat, North 24 Parganas)

                                                                                   (a) Post applied for........................................................
                                                                                                      (in block letters)

                                                                                     (b) Advertisement No.

Please note that the application fee for each post is Rs. 500/- or US$ 30/- for General category and
Rs. 250/- or US$ 15/- for SC/ST/BC categories. Draw the bank draft in favour of West Bengal State
University payable at Barasat or Kolkata.

Bank Draft No. of this application ................................................ drawn on West Bengal State
University payable at ..........................

Telephone number .....................................................................

Mobile No. ...................................................................................

e-mail address ...............................................................................




To
The Registrar
West Bengal State University

Sir,
With reference to your advertisement for the above-mentioned post, I present myself as an applicant
for the same. My biodata and other relevant documents are given below.
                                                                                   Yours faithfully

                                                                                                             ................................................
                                                                                                                (Signature of the Applicant)
Dated.........................20............




                                                                    BIODATA
     1. Name (in block letters)
        .............................................................................................................................
      2. (a) Present Position
         ...................................................................................................................................
         (b) Address for communication
         .................................................................................................................
         (in block letters)
      3. Permanent Address
         ...................................................................................................................................
         (in block letters)
      4. Date of Birth
         .............................................................................................................................................
      5. Name of Father/Mother
         ............................................................................................................................
      6. Nationality
         ................................................................................................................................................
      7. Marital Status :                   (a) Single/Married

                                (b) Name of Spouse
                                ..............................................................................................
8.         Whether belonging to Scheduled Caste/Scheduled
           Tribe/Other Backward Class (necessary documents to be attached).                                       Yes/No.

      9. Educational qualifications (arranged chronologically, starting from Matriculation/S.F./H.S.
         or equivalent,Graduation, specifically mentioning Honours or Pass, Post-graduate Degrees,
         Professional qualifications etc.:

School/College &           Examinations              Year of Passing           Class or Divn.            Percentage of              Subjects                Any other
Board/University           Passed                                                                        marks                      studied                 information




10.        If registered for Doctoral Degree, date of Registration             :
           (Ph.D./D.Sc./D.Litt. etc.)
11.        Research degree awarded :                            Year           :
           ( Ph.D./ D.Sc. / D.Litt. etc.)                       University     :
                                                                 Title of Thesis :
12.    Publications :        (a)      Total number of papers in peer reviewed research journals:
                              (b)     Books/Monographs etc. :
                              (c)     A list of total publications also should be attached. Mention
                      best 5 papers :
                                       (i)
                                       (ii)
                                       (iii)
                                       (iv)
                                       (v)
13.     Teaching Experience :         (a) Under-graduate Level : College/Univ./Institute/No. of
Years/Pass/Hons.
                                       (b) Post-graduate Level : Name of the Univ./Institute
14.     Administrative/Professional Experience : (State briefly the nature of work with No. of
years) :




15.    Details of employment in chronological order :
       (Gaps, if any, should be explained)

       16. Present Pay and Allowance         :
              (a) Post held                  :
              (b)    Scale of Pay            :
              (c)    Basic Pay               :
              (d)    Allowances              :
                      Gross amount drawn     :

17.    If selected, time required                    (a) Can join immediately..................................
       before joining                         :
                                                      (b) Can join after.............................................



18.    Particulars of extra-curriculum activities, if any:
19.    Any other information that may be considered relevant:


20.    (a)     Have you ever been dismissed/removed/                               (a) Yes/No
                asked to retire from service?
       (b) If so, give details:                                                               (b)


23. Mention the names and addresses of two referees to whom reference can be made
      (i)
      (ii)

(Original copies of all documents and testimonials to be presented at the time of interview)
I certify that the above statements are true.
I accept that in case any information is found to be incorrect or in case there is any suppression of
fact this application is liable to be rejected.




Date :
                                                       ...................................
                                                                   (Signature of the Applicant)




(The application should be routed through proper channel)

								
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