Application No..........................

V.B.S. Purvanchal University, Jaunpur (U.P.) -222203

(A NAAC Accredited University)

Fax.: (05452) 252344,252244

Email:[email protected] Web: www.vbspu.ac.in

APPLICATION FORM FOR THE TEACHING POSTS

(Advt. NO.: VBSPU-01/2017/Teaching, Date: 07/07/2017)
LAST DATE FOR RECEIPT OF APPLICATIONS: 8th August (Tuesday) at 5.00 PM, 2017
(For direct recruitment to the post of Assistant Professor/Associate Professor/Professor)

Received Bank Draf Amount (Rs.) Name of the Bank Issuing Branch Name
Draf
Date

Tick () the Category : UR SC ST OBC PWD

( Please attach certificate in support)

Affix a recent
Post Applied for passport size
coloured self
Name of Department : attested
...........................................................
photograph.
Specialization (if any) : ...........................................................
...........................................................
(Don't staple)
Reference of Post Advertised in : ........................ dated.......................
Advertisement No : ...........................................................

1. GENERAL INFORMATION
a. Name of the Applicant : ...................................................................................
(In block letters)

b. Father's/Husband's Name : ...................................................................................

c. Date of Birth : ...................................................................................

d. Present Postal/
Correspondence Address : ...................................................................................
...................................................................................
...................................................................................
e. Permanent Home Address : ....................................................................................
....................................................................................
....................................................................................
f. Applicant's Contact Details : TelephoneNo. ......................................................
MobileNo. ......................................................
E-Mail ......................................................
g. (i) Present Post/Designation With
Pay Band +AGP (If applicable) : ....................................................................................

1
 (ii) Present Basic Pay : ....................................................................................

(iii) Name of Institution/Organsation : ...................................................................................

h. Gender and Marital Status
(i) Male/Female : ....................................................................................

(ii) Married/Unmarried : ....................................................................................

(iii) If married, give the full name

of Spouse : ....................................................................................

2. ACADEMIC QUALIFICATIONS
a. Academic Background (From Matriculation onwards)
%age Encl
Examination Board/University/ Year of Subject (s)/ Division
Regular/ Private of .
Passed Institute Passing Specialization / Grade
Marks No.
High School
(10th)
Intermediate
(12th)
Graduation

Post
Graduation

M. Phil.

Ph.D.

D.Lit.

Others (if
any)
.
b Have you qualified NET/SLET/SET? : .........................................................................
.
(If yes, please give details)
c. Ph.D. Topic : .........................................................................

Date of Registration of Ph.D. Degree : .........................................................................

Date of viva-voce of Ph.D. Degree : .........................................................................

d D.Lit. Topic : .........................................................................

.
e. Technical Qualification, if any : .........................................................................

f. Area of Specialization/Field of Research : .........................................................................

2
g Academic distinction (e.g. any prize, medal, honour, award etc.)..
.

h Foreign visits for academic purpose (If any, please give details)..
.

i. Have you been punished during your

studies at College/University
(if so give details) : .........................................................................

3. TEACHING EXPERIENCE

a. Give the details of employment in chronological order on permanent/regular basis in UGC Scale or
equivalent
Designation/ Name of Exact Dates/ Period Scale of Pay Nature of Encl. No.
Post Held Institution From To + AGP duties

b Total Teaching Experience

.

(i) Under Graduate : .............................Years ............................ Months

(ii) Post Graduate : ............................Years ............................. Months

c. (i) Break in Service, if any : Period ...............................................

(Indicate the period giving reasons) Reasons ................................................

(ii) Have you been punished during your services? If so, give details. ..

(iii) Do you have any court cases pending as one of the parties?.............................
(If yes, give details)

d. Research Experience (Excluding full time Ph.D. or M.Phil enrolment period)

e. Administrative Experience, (if any) :

Dates/Periods Length of Experience Enc

Name of the Nature of
Designation l.
Institution Assignment From To Years Months
No

f. Details of Refresher Course/Orientation Course/Summer Institute Attended (Please enclose evidence)

S. Name of the Organizing Duration API Encl. No

No. Course Body/ Score
University

3
 g. Teaching, Learning and Evaluation Related Activities (Category-I): (Please enclose evidence)

S. Name/Nature of Duration Activity Conducting API Encl. No.

No. the Activity Body/ Score
University

h. Membership of Professional Bodies/Societies etc.:..

i. Period of Extra Ordinary Leave

without pay (If availed) : ..

4. CO-CURRICULAR, EXTENSION, PROFESSIONAL DEVELOPMENT RELATED ACTIVITIES

AND RESEARCH & ACADEMIC CONTRIBUTIONS
*Weightage point/API Score shall be given by the applicant for co-curricular, extension, professional development related
activities (Category-II) and research and academic contributions (Category-III) as per 3rd Amendment, Regulation
2016 of UGC (Minimum qualifications for appointment and other academic staff in Universities and Colleges and
measures for maintenance of standards in higher education circulated vide UGC Notification No. F.1-2/2016
(PS/Amendment) dated 4th May 2016 and Notification No. F. 1-2/2016 (PS/Amendment) dated 11th July, 2016 etc.

CATEGORY: II. CO-CURRICULAR, EXTENSION, PROFESSIONAL DEVELOPMENT RELATED ACTIVITIES (Attach

supporting documents)
Please mention your contribution on the following:
Category Nature of Activity Points/ Score* For Office Use
Only

a. Student related co-curricular, extension and field based activities

(i) Discipline related co-curricular activities (e.g.
field work, study visit, student seminar and other
events, career counselling etc.)
(ii) Other co-curricular activities (Cultural, Sports,
NSS, NCC etc.)
(iii) Extension and dissemination activities (public/
popular lectures/talks/seminars etc.)
b. Contribution to Corporate life and management of the department and institution
through participation in academic and administrative committees and responsibilities
(i) Administrative responsibility (including as Dean /
Principal/ Chairperson/ Convener/ Teacher-in-
charge/similar other duties that require regular
office hrs for its discharge)
(ii) Participation in Board of Studies, Academic and
Administrative Committees.
c. Professional Development activities (such as
participation in seminars, conferences, short term
training courses, industrial experience, talks,
lectures in refresher/faculty development courses,
membership of associations, dissemination and
general articles and any other contribution)

4
 Total Score (a + b + c) (Max: 45)

CATEGORY III: RESEARCH AND ACADEMIC CONTRIBUTIONS (Attach supporting

documents)

(A). Research Papers Published in Refereed Journals/Other Reputed Journals as notified by UGC
(Please enclose evidence)
S.N Title with Journal Refereed Impact No. of Main/ API Encl.
. page/volum Name / factor, Coauthor correspondin score No
e Nos. ISSN/ Reputed if any s g author
ISBN Journal/
No.

B (i)(a) Books Published (Please enclose evidence)

S.N. Book Type of ISSN/ Publisher Type of No. of Main/ API Encl.
Title Authorship ISBN (Whether Book Coauthor correspondin score No
No. International (Text/ s g author
/ Reference
National/ /
State/Govt. Subject
Publisher) etc)

B (i)(b) Articles/Chapters Published in Books (Please enclose evidence):

S.N Title of Article/ Boo ISSN Type of Publisher No. of Main/ API Encl
. Chapter with k / Book (Whether Coauthor correspondin scor .
Page Nos. Title ISBN (Text/ International/ s g author e No
No. Reference National/ State/
/ Govt.
Subject Publisher)
etc)

(C) (i). Research Projects (Sponsored Projects) (Please enclose evidence):

S.N. Title Agency Period Grant/Amount Mobilized API Score Encl. No.
(Rs. Lakhs)

(C) (ii). Research Projects (Consultancy Projects) (Please enclose evidence):

S.N. Title Agency Period Grant/Amount Mobilized (Rs. API Score Encl. No.
Lakhs)

(C) (iii). Research Projects (Projects Outcome/Outputs) (Please enclose evidence):

5
S.N Title Agenc Period Whether Patent/ Major Policy document prepared API Encl.
. y Technology for international bodies like WHO/ Score No.
transfer/Product/ UNO/ UNESCO/ UNICEF etc.
Process as outcome Central/ State Govt./ Local Bodies

(D) Research Guidance (Please enclose evidence):

S.N. Course Number Enrolled Thesis Degree Awarded API Score Encl. No
Submitted
M. Phil
Ph. D.
Others

E.(i) Fellowships/ Awards:

S.N. Fellowship/ Whether International/ Name of Year API Encl. No.

Award National/ State/ University Academic body/ Score
Name Level Association

E(ii) (a) Papers Presented in Conferences/Seminars (Please enclose evidence)

S.N. Title of the Title of the Organised by Whether International/ API Encl.
paper conference/ National/State/ University Score No.
Seminar etc. Level

E (ii)(b) Invited Lectures in Conference/ Seminars etc. (Please enclose evidence)

S.N. Title of the Title of the Organised by Whether International/ API Score Encl. No.
Lecture conference/ National/State/ University
Seminar etc. Level

F. Development of e-learning delivery process material:

S. No. Nature of Activity Module details Year API Score Encl. No.

Note: Attach detailed list for CATEGORY-II ( co-curricular, extension, professional development related
activities) and CATEGORY-III (research and academic contributions) in chronological order with
proper enclosure number along with relevant/supporting documents.

IV. SUMMARY OF API SCORE:

Categor Criteria API Score in Total API Score for
y Last Academic Assessment Period
Year (Claimed by Applicant)
I Teaching, Learning and Evaluation
related activities
II Professional Development, Co-
curricular and Extension activities

6
 Total (I+II)
III Research and Academic Contribution

Please give details of any other credential, significant contributions, awards received etc. not
mentioned earlier.

S.N. Details (Mention Year, Value etc. where relevant)

1.
2.

DECLARATION

I . S/O, W/O, D/O ..................................................... hereby declare that all the

statements and entries made in this application are true, complete and correct to the best of my
knowledge and belief. In the event of any information found false or incorrect or ineligibility being
detected at any stage, my candidature/appointment may be cancelled by the University.
I have never been convicted or penalised for any unlawful activity by any Institution/Court.

Place: Signature of the applicant

Date:

ENDORSEMENT BY THE PRESENT EMPLOYER:

Forwarded to:- The Registrar, V.B.S. Purvanchal University, Jaunpur-222003 (U.P.)

The applicant ............................................ S/o,W/o, D/o...............................................

who has submitted this application for the post of .......................................... in the V.B.S. Purvanchal
University, Jaunpur has been in employment ............................................. in a Temporary/Permanent
capacity with effect from ......................... in the Pay Scale of Rs........................ Presently He/She is
drawing a basic pay of Rs. ................... His/Her next increment is due on ................................

Further, it is certified that no disciplinary query has ever been held or pending against the said applicant.
There is no objection for his/ her application being considered by the V. B. S. Purvanchal University,
Jaunpur-222003, and in the event of selection, he / she will be relieved to join the V. B. S. Purvanchal
University, Jaunpur-222003 as per rules.

Date: Signature .........................................................

Name.
Seal of Head of the Institution

7
List of Enclosures: (Please attach attested copies of certificates, sanction orders, papers etc.
wherever necessary)

S.No. Detail Encl. No No. of sheets per enclosure

1.
2.
3.
4.

Total number of sheets enclosed .(please give sequential number to each sheet and signature with date).

(Signature of the Applicant)

Full Name: ..

8
 SUMMARY SHEET
1. Post applied for 2. Department

3. Name 4. Male/ Female/Transgender 5. Married/ Unmarried

(in Capital Letters)
6. Date of birth (DD/MM/YYYY) 7. Place of birth 8. Category: GEN/OBC/SC/ST/ PH

Name of the Name of the Month & Year % of

9. Educational Qualification Division Marks CGPA
course Board/University Passed/ Award
10th Class. / equivalent
10+2/Higher Secondary equivalent
Bachelor's Degree
Master's degree
M.Phil./ equivalent
Ph.D./D. Phil.
NET/SLET/SET for lectureship
10. Chronological List of Earlier Positions/Appointments
Designation & No. of years/ Nature of
Name & Address of Employer From date To date months Work/Duty
Scale of pay

11. Teaching Experience No. of No. of 12. Publications Published [ISBN/ ISSN] (Nos.)
years months
i) Under-graduate level Books
ii) Post-graduate level Research Publications
Post-doctoral Teaching/ Research Other Publications
13. Invited Lectures/ Paper presentation in Seminars/ 14. Research Guidance M. Phil./ Ph.D./D. Phil.
Conferences Equivalent (No.) (No.)
Total
National (No.) International (No.) Completed
(No.)
Under Supervision

15. Fellowship/ Awards 16. Research Projects

Total
National (No.) International (No.) Sponsored Consultancy Patent etc
(No.)

17. Present Gross /

Name of University/ Basic Pay (Rs.) Pay Scale (Rs.) Increment date
Designation Total Salary
Institutions (Date/ month)
P.M. (Rs.)

No. of Modules Any other Information

18. Development of e-learning delivery process/material

19. API Score (Category-III) IIIA IIIB IIIC IIID IIIE IIIF

9
(Signature of the Applicant)

10
 API Performa for Professor, Associate Professor & Assistant
Professor
ACADEMIC PEFORMANCE INDICATORS (API) FOR
CAREER ADVANCEMENT SCEME (CAS) AND DIRECT RECRUITMENT

CATEGORY I: TEACHING LEARNING AND EVALUATION RELATED ACTIVITIES

Based on the teachers self-assessment, API scores are proposed for (a) teaching related activities;
domain knowledge; (b) participation in examination and evaluation; (c) contribution to innovative
teaching, new courses etc. The minimum API score required by teachers from this category is different
for different levels of promotion. The self assessment score should be based on objectively verifiable
records. It shall be finalized by the screening cum evaluation/selection committee. Universities may
detail the activities, in case institutional specificities required, adjust the weightages without changing the
minimum total API scores required under this category.

Assistant Professor Associate Professor Professor API Score

Category
I Nature of Activity Max. Max. Max. claimed by
Actual Score Actual Score Actual Score
Score Score Score applicant
Actual hours Actual hours Actual hours
spent per spent per spent per
a. Direct teaching 70 60 60
academic academic academic
year 7.5 year 7.75 year 7.75
b. Examination duties
Actual hours Actual hours Actual hours
(question paper setting,
spent per spent per spent per
invigilation, evaluation 20 20 10
academic academic academic
of answer script) as per
year 10 year 10 year 10
allotment
c. Innovative teaching
Actual hours Actual hours Actual hours
learning methodologies,
spent per spent per spent per
updating of subject 10 15 20
academic academic academic
contents/courses,
year 10 year 10 year 10
mentoring etc.

# Supporting documents, wherever be attached.

Note:
1. Direct Teaching 16/14/14 hours per week include the Lectures/Tutorials/Practicals/Project Supervision/Field
Work.
2. University may prescribe minimum cut-off, say 75%, below which no scores may be assigned in these sub-
categories.
3. In consonance with established academic and teaching traditions, and with a view to reinforcing a student-
centric and caring approach the teachers are encouraged to work with students, beyond the structure of
classroom teaching. Indicatively, this could entail mentoring, guiding and counseling students. In particular
teachers would be the best placed to identify and address the needs of students who may be differently abled,
or require assistance to improve their academic performance, or to overcome a disadvantage. There are no
prescribed hours for such efforts, measured either in weeks or months, or in the context and calculation of
the API scores, these are nevertheless important and significant activities that could be carried out by
teachers.

11
 CATEGORY II: PROFESSIONAL DEVELOPMENT, CO-CURRICULAR AND EXTENSION
ACTIVITIES

Based on the teachers self-assessment, Category II API scores are proposed for Professional development,
cocurricular and extension activities; and related contributions. The minimum API required by teachers for
eligibility for promotion is fixed in Table II (A). A list of items and scores is given below. The self-
assessment score should be based on objectively verifiable records and shall be finalized by the screening
cum evaluation committee for the promotion of Assistant Professor to higher grades and selection
committee for the promotion of Assistant Professor to Associate Professor and Associate Professor to
Professor and for direct recruitment of Associate Professor and Professor.
The model table below gives groups of activities and API scores. Universities may detail the activities or,
in case institutional specificities require, adjust the weightages without changing the minimum total API
score required under this category.

Category Nature of Activity Maximu Actual Score API Score

II m API claimed by
Score
applicant
a Student related co-curricular, extension and field
based activities.
(i) (Discipline related co-curricular activities (e.g.
Actual hours
remedial classes, career counselling, study visit, student
spent per
seminar and other events.) 15
academic year
(ii) Other co-curricular activities (Cultural, Sports,
10
NSS, NCC etc.)
(iii) Extension and dissemination activities
(public/popular lectures/talks/seminars etc.)
Contribution to corporate life and management of the
department and institution through participation in
academic and administrative committees and
responsibilities. Actual hours
(i) Administrative responsibility (including as Dean/ spent per
b Principal/ Chairperson / Convener / Teacher-
15
academic year
incharge/similar other duties that require regular office 10
hrs for its discharge)
(ii) Participation in Board of Studies, Academic and
Administrative Committees
Professional Development activities (such as
Actual hours
participation in seminars, conferences, short term
spent per
c training courses, industrial experience, talks, lectures in 15
academic year
refresher / faculty development courses, dissemination
10
and general articles and any other contribution)

# Supporting documents, wherever be attached.

CATEGORY-III: RESEARCH AND ACADEMIC CONTRIBUTIONS

Based on the teachers self-assessment, API scores are proposed for research and academic contributions.
The minimum API scores required for teachers from this category are different for different levels of
promotion in universities and colleges. The self-assessment score shall be based on verifiable records and
shall be finalized by the screening cum evaluation committee for the promotion of Assistant Professor to
higher grades and Selection Committee for the promotion of Assistant Professor to Associate Professor and
Associate Professor to Professor and for direct recruitment of Associate Professor and Professor.

12
 Faculties of Languages API Score
Faculty of Sciences/ Maximum Score for
Category Humanities /Arts/ Social claimed
Activity Engineering/Agriculture/ University / College
III Sciences/ Library/ Physical by
Medical/ Veterinary Sciences teacher *
education/ Management applicant
Refereed journals as notified Refereed journals as notified
25 per publication
Research by UGC by UGC#
III A Papers
Other Reputed Journals as Other Reputed Journals as
published in : 10 per publication
notified by the UGC# notified by the UGC#
Text/Reference, Books Text/Reference, Books
published by International published by International
Publishers, with ISBN/ISSN Publishers, with ISBN/ISSN 30 per Book for
number as approved by the number as approved by the
Single Author
University and posted on its University and posted on its
website. The List will be website. The List will be
intimated to UGC. intimated to UGC.
Subject Books, published by Subject Books, published by
National level publishers, with National level publishers, with
ISBN/ISSN number or State / ISBN/ISSN number or State / 20 per Book for
Publications Central Govt. Publications as Central Govt. Publications as
Single Author
other than approved by the University approved by the University
journal and posted on its website. The and posted on its website. The
III B articles List will be intimated to UGC. List will be intimated to UGC.
(books, Subject Books, published by Subject Books, published by
chapters in Other local publishers, with Other local publishers, with
books) ISBN/ISSN number as ISBN/ISSN number as 15 per Book for
approved by the University approved by the University Single Author
and posted on its website. The and posted on its website. The
List will be intimated to UGC. List will be intimated to UGC.
Chapters in Books, published Chapters in Books, published
by National and International by National and International International 10
level publishers, with level publishers, with per Chapter
ISBN/ISSN number as ISBN/ISSN number as National 5 per
approved by the University approved by the University
Chapter
and posted on its website. The and posted on its website. The
List will be intimated to UGC. List will be intimated to UGC.
III C RESEARCH PROJECTS
III C Sponsored (a) Major Projects with Major Projects with
(i) Projects grants above Rs. 30 lakhs grants above Rs. 5 lakhs 20 per Project
(b) Major Projects with Major Projects with
grants above Rs. 5 lakhs up grants above Rs. 3 lakhs
to Rs. 30 lakhs up to Rs. 5 lakhs 15 per Project
(c) Minor Projects with Minor Projects with 10 per Project
grants above Rs. 1 lakh up grants above Rs. 1 lakh
to Rs. 5 lakhs up to Rs. 3 lakhs

10 for every Rs.10 lakhs

III C Consultancy Amount mobilized with a Amount mobilized with a
and Rs.2 lakhs,
(ii) Projects minimum of Rs.10 lakhs minimum of Rs. 2 lakhs
respectively
30 for each International
Major Policy document /20 for each national
prepared for level output or patent.
Projects
III C Patent / Technology transfer international bodies like Major policy document of
Outcome /
(iii) /Product / Process WHO/UNO/UNESCO/UN International bodies - 30
Outputs
CEF etc. Central / State Central Government 20,
Govt./Local Bodies State Govt.-10
13
 Local bodies 5
Project Major Policy document of 30/each national level
III C Patent/Technology
outcome Govt. Bodies at Central output or patent/50/each
(iv) transfer/Product/Process
/Outputs and State lavel for International level
III D RESEARCH GUIDANCE
III D (i) M.Phil. Degree awarded Degree awarded 5 per candidate
Degree awarded/ Thesis Degree awarded/ Thesis
III D (ii) Ph.D 15/10 per candidate
submitted submitted
III E Fellowship, Awards andInvited Lectures delivered in conferences / seminars
International Award/ International Award /
15 per Award / 15per
Fellowship from academic Fellowship from academic
Fellowship
bodies bodies/associations
Fellowships/ National Award/ International Award /
10 per Award / 10
III E Fellowship from academic Fellowship from academic
(i) Awards per Fellowship
bodies bodies/associations
State/University level State/University level
Award from academic Award from academic 5 Per Award
bodies bodies
7 per lecture /
International International
5 per paper Presented
III E Invited lectures/ a) National level a) National level 5 per lecture /
(ii) Papers 3 per paper Presented
3 per lecture /
b) State/University level State/University level
2 per paper Presented
The score under this sub-category shall be restricted to 20% of the minimum fixed for Category III for
any assessment period

III F Development of e-learning delivery process/material 10 per module

*Wherever relevant to any specific discipline, the API score for paper in refereed journal would be
augmented as follows: (i) paper with impact factor less than 1 - by 5 points; (ii) papers with impact factor
between 1 and 2 by 10 points; (iii) papers with impact factor between 2 and 5 by 15 points; (iv) papers with
impact factor between 5 and 10 by 20 points: (v) papers with impact factor above 10 by 25 points. The API
for joint publications shall be calculated in the following manner: Of the total score for the relevant category
of publication by the concerned teacher, the First and Principal / corresponding author /supervisor / mentor
would share equally 70% of the total points and the remaining 30% would be shared equally by all other
authors.
# The University shall identify the journals subject-wise through subject expert committees and forward the
recommendations to UGC in the format prescribed by UGC for approval of the UGC Standing Committee.
The journals approved from this list, by the UGC Standing Committee, shall be included in the List of
Journals notified by the UGC. The UGC Standing Committee shall give its
recommendations within 60 working days of the receipt of the list from the University. The UGC Standing
Committee may also, suomoto; recommend journals for inclusion in the List of Journals. The clause 6.0.5
(i) will be strictly followed by the University
EDUCATIONAL QUALIFICATIONS
will be as per UGC/AICTE norms and VBS Purvanchal University statute

14