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University of Mumbai
University of Mumbai
Affix Passport size Photograph Attested by Principal / Gazetted Officer
SYNOPSIS Candidate’ Name
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Department Post Applied for
Sr. No. of Post
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Category : SC/ST/DT-NT/OBC/SBC/OPEN (Pls. specify)
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Demand Draft
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Date of Birth : (in words) ________________________________________________
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Rs. ___________
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Date of Birth : (in figure) ____/____/____
DD No. ________
Age as on date
Years
Date : ______________
Months
Days
Educational Qualifications : Degree
University
Passing Year
% / Grade
Post held
From
To
UG PG
Ph.D NET/SET
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Teaching Experience College / Institution Present post
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Research Nos. of students successfully guided
8
Research Publications
9
Any other relevant information such as consultancies, patents, etc. (please be briefed and point-wise)
Notes:
Date:
Patents registered ( if any)
1) To be filled in by the candidate. 2) Ten Copies of synopsis are required to be submitted by the candidate. 3) All the information is is to be furnished on this sheet only & no addition sheet be used.
/
/ Signature of the candidate 1
University of Mumbai
University of Mumbai
Notes : Pls. Read the instructions given on last page, carefully before feeling application form. Application can be Handwritten or neatly typed on A4 paper. Pls. use prescribed format only. Fees once paid cannot be refunded, in any case. Pls. attach the separate sheet if required. * Strike off whichever is not applicable.
To, The Registrar, University of Mumbai, Fort, Mumbai - 400 032.
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Sir, I wish to apply for the post of
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Advertise No. : ______________ Date of Advt. : _____/____/ 2018 Serial Number of Post : ________
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in _________________ category
________
( purely on Temporary basis)
( * Open / SC / ST / DT / NT / OBC / SBC )
with *Subject / specialization : ___________________________________________ In the University Department of : University of Mumbai Law Academy My particulars are given below : 1. Full Name :
_____________________________________________________
(Beginning with Surname and in Block Letters)
2. Full Address for correspondence :
______________________________________ ______________________________________ ______________________________________ ___________________ Pin code ___________
3. Contact Details : Telephone No. (Residence)
(Office) ____________
Mobile No. : __________________ e-mail : _________________________________ 4. Date of Birth : _________________ Age as on date :
Years _______ Month/s
5. Place of Birth : _______________________________________________________ 6. Sex (Male/Female) : ____________ 7. Married / Unmarried : __________________ 8. Nationality : __________________ 9. Domicile : ____________________________ 10. Whether belongs to : __________________________________________________ ( Scheduled Caste Scheduled Tribes, De-notified Tribes, Nomadic Tribes, Other Backward Class, Special Backward Class )
11. Whether Physically Handicapped with minimum 40% disability (Yes / No) _________ If yes, state nature & percentage of disability : % _______________ Nature of disability : ___________________________________________________ 2
University of Mumbai
12. Educational Qualification :-
Examination
Month & Year of Passing
University / Board
Percentage Class / of Marks Division / obtained Grade
Subjects
Matriculation / S.S.C./ S.S.L.C.
Higher Secondary / Pre-University +
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Bachelor’s Degree +
Master’s Degree+
M. Phil. Degree+
Doctor’s Degree+
Any other Degrees / Diploma’s + Note : ( + Pls. state the Faculty )
13.
Account for breaks, if any in the academic career : _________________________ ___________________________________________________________________ ___________________________________________________________________
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University of Mumbai
14. Teaching / Technical / Professional Experience at UG and PG level :( Pls. attach the separate sheet if required ) Institution
Subject
Position held
Nature of Period of Appointment appointment with Dates Permnt./Temp. From To with dates
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15. Research work done : ________________________________________________
__
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16. Number of Students successfully guided : __________________________________ ( Please state degree/s )
17. Other qualifications and experience, if any __--------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------- -------
18. (i) No. of Publications in Journals of concerned subject : _____________________ ( with references )
(ii) No. of Books: _________
(iii)
No. of Articles : _______________
19. Patents, if any : _______________________________________________________ ____________________________________________________________________________________________________________________________________
20. (a)
Present Position held : ___________________________________________
(b)
Service : (Govt./ Aided/ Self Financed/ Private/ Public Sector ) ___________________
(c)
Name of the Institution employed : ________________________________ _____________________________________ __ Date of Appointment : ___________________________________________
(d)
(e) (i) Pay
Rs. _____________ Pay Band Rs.: __________________________
(ii) AGP Rs. _____________ (iii) DA
Rs. _____________
(iv) HRA Rs. _____________ (v) CLA
Rs. _____________
(vi) Other Rs. _____________ State the allowances, if any (vii) Total Rs. _____________ Attach last pay certificate (f)
Date of next increment : 4
University of Mumbai
21. Names of persons and Designations who have given testimonials a) ______________________________________________________________ b) ______________________________________________________________ c) ______________________________________________________________
22. Names and addresses of three persons from concerned field of studies / profession of candidate to whom references may be made
1.
Contact Nos.
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2.
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Contact Nos.
3.
Contact Nos. 23. Declarations : I hereby declare that all statements made by me in this application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found false, incomplete or incorrect my candidature / appointment is liable to be cancelled / terminated. I further understand that no notice period shall be taken of any request for withdrawal of my application. Place : Date:
Signature of candidate Name :
Notes : Please submit only one set of application format along-with all relevant documents. Please submit attested photocopies of all relevant certificates. Pls. attach the separate sheet if required. Please read all instructions carefully. Please turn over for “Instructions to candidate”.
5
University of Mumbai
DECLARATION TO TBE SUBMITTED BY APPLICANT WITH APPLICATION FORM --- A (See Rule 4)
Shri/Smt/Kum.
_______________________________________________________
Son/Daughter/Wife of Shri _______________________________________________
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Aged _____________ years, resident of ____________________________________
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_____________________________________________________________________ Do hereby declare as follows:
1) 2)
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That I have filled may application for the post of _______________________ I have ____________ (number) living children as on today. Out of which No. of
Children born after 28th March, 2005 is 1. ________________________________ 2. ________________________________
(mention dates of birth, if any). 3)
I am aware that if any total No. of living children are more than two due to the children born after 28th March, 2006, I am liable to be disqualified for the same post.
Place: ______________ Date: ___/___/_____
(Signature) Name:
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University of Mumbai
INSTRUCTIONS TO CANDIDATES 1.
Candidates who are employed shall send their application through proper channel.
2.
Candidates should send with their applications attested copies of the degree or diploma certificates and statements of marks and other certificates in support of their educational qualifications and experience; and of the Matriculation or equivalent certificate in support of their age.
3.
Candidates should also send along-with their application forms, the copies of the following documents:-
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(a) Caste Certificate and Caste Validity Certificate from the competent authority, if the candidate belongs to Scheduled Caste/ Scheduled Tribes/ De-notified Tribes / Nomadic Tribes / Other Backward Class/ Special Backward Class. The Other Backward Class, NT-C & NT- D category also should submit their Non-Creamy Layer Certificate from the competent authority;
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(b) Certificate from the employer stating the pay & allowances drawn at present. (c) Testimonials. 4. 5.
6. 7.
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If the space provided is insufficient, information may be given on a separate sheet duly signed by the candidates and the same may be sent with the application. Applications should be sent to Registrar, University of Mumbai, (Teaching Appointment and Approval section), 1 st Floor, Room No. 113, Fort, Mumbai - 32, so as to reach him on or before the last date prescribed. The University reserves the right of accepting / rejecting applications received after the prescribed last date. Candidate should send with every application a Crossed Demand Draft on a Scheduled/ Nationalized Bank for the amount drawn in favor of Finance and Accounts Officer, University of Mumbai, Payable at Mumbai :- Rs. 500/- (Rupees Five Hundred only) in the case of candidates belonging to general category and Rs. 300/- ( Rupees Three Hundred Only) in case of candidates belonging to reserved category.
8.
Candidates who apply for more than one post should send separate application/s along-with the requisite fee by means of a Crossed Demand Draft.
9.
Money Orders or Cheque or Cash will not be accepted by the University.
10.
The fee will not be refunded once an application has been received by the University.
11.
Any change of address given in column No. 2 of the application form should at once by communicated to the Dy. Registrar, Teaching Appointment and Approval section, University of Mumbai, Mumbai 400 032.
12.
Candidates are advised to satisfy themselves before applying that they possess the prescribed qualifications and it is for the candidates themselves to ensure that they possess the prescribed qualifications. No inquiry asking for advice as to eligibility will be entertained.
13.
Candidates called for interview will have to present themselves at their own
14.
Canvassing, direct or indirect will be disqualification.
15.
The Performance Based Appraisal System (PBAS) Performa based on Academic
expenses.
Performance Indicator (API) must be filled by the candidate. 16.
Incomplete applications considered.
and
applications
without
the
requisite
fee
will
not
be
----- x ----7
University of Mumbai
Check list A
Post applied
B
Category (Open/SC)
C
DD No. :
D
Candidate Name
E
Documents attached ( Pls. fill up the information whichever applicable )
No.
Particulars
Amount
1
S.S.C. Mark sheet
2
H.S.C Mark sheet
3
UG Degree Mark sheet
4
UG Degree Certificate
5
PG Degree Mark sheet
6
PG Degree Certificate
7
M.Phil Certificate
8
Ph.D Certificate
9
NET/SET Certificate
10
Any other
11
Any other
12
Patents Registered
13
M.Phil/ Ph.D Guide ship
14
Experience Certificate
15
Experience Certificate
16
Proof for Birth date
17
Cast Certificate
18
Cast Validity Certificate
19
Domicile Certificate
19
Declaration of small family in (form A)
20
Last pay Certificate
21
Testimonials
22
Signature Placed
Rs.
Yes / No
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(All Sem/Years)
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Remarks by University
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Signatures of Scrutiny committee
________________
_________________
__________________
Names : 8
