ADAMAS UNIVERSITY

BARASAT
KOLKATA - 700126

Application Form for Teaching Posts

(Please read the instructions given in the Advertisement carefully)
Affix recent
Post applied for: passport size
photograph
Subject:

Area of specialization:

1. Personal Information (In CAPITAL LETTERS):

Name of the applicant
Date of Birth(DD/MM/YYYY) Age (In Years)
Gender (Male/Female/Transgender) Marital Status
Nationality Religion
Category
(SC/ST/OBC/EWS/General/PWD/Minority)
Mother’s Name
Father’s Name
Particulars of Physical
Disability, if applicable

2. Address (In capital letters):

Mailing Address Permanent Address

PIN CODE : PIN CODE :

Email ID:

Phone No:

Mobile No:

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3. Educational Qualifications(Class X and onwards) Specialization
Name of the University/ Year of Percentage Division/ Subjects (if any)
Degree exam Institution/ Board Passing of Marks Class/CGPA

Please add additional sheet, if required, retaining the above tabular format.
NET Exam: Rank/Percentile

Degree Awarded [ ] Thesis [ ]

Ph.D.(Mark √ in Submitted
appropriate box) Regular mode [ ] Part time [ ]
mode

4. Title of Thesis/Dissertation(If published, Name of the Name of Supervisor

give details on a separate sheet) University / Year of
Award
Ph.D.
M.Phil.

5. No. of Publications:
Refereed Published Accepted Book Chapters
Journal only
Books (only with ISBN or similar Conference Proceedings
identification mark) (full papers only)

6. Academic Distinctions (Award/Scholarship/Rank, etc.)

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7. Membership/Fellowship of learned/accredited bodies (Give details)

8. Present Position:
Designation University/ From Basic Pay Scale Gross Pay/ Next Nature
Institution Date Pay(BP) (PS)/Pay Band Total Salary Increment of
(PB)(Rs.) P.M.(Rs.) Date duties

9. Experience (Enclose additional sheet, if required, in the same format):

Post Held, Basic Period
Pay & Pay band Nature of work
with Grade Pay/
University/ From To No. of years
Institution / months
Academic Grade
Pay

9.(A) Post-Doctoral Fellowship

University/ From To
Institution/Country

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10. Competence in Computer Application:

11. Additional information, if any (please attach additional sheet, if required):

12. Name and Complete postal address of 3 referees(In capital letters):

Reference 1 Reference 2 Reference 3

PIN CODE: PIN CODE: PIN CODE:

Email: Email: Email:
Mobile No: Mobile No: Mobile No:
Mobile No: Mobile No: Mobile No:

13. Teaching preference. Applicants are requested to write down their current and future
academic plans in about 200 words. (if required separate sheet may be enclosed)

14. Do you have a near relative among the staff of this University? YES /NO

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If YES, Please furnish the details given below:

Name & designation of the Person:

Relationship with the candidate:

15. Any vigilance / Disciplinary case is pending against you? YES / NO

If YES, Please furnish the details given below:

Name & designation of the person:
Relationship with the candidate:

16. Any legal case (including FIR) is pending against you in any of the court(s) / Police station?
YES /NO

If YES, Please furnish the details given below:

Name & designation of the person:
Relationship with the candidate:

17. Time required for joining / reporting for duty :

(in case of selection)

18. Declaration:
I hereby declare that all the entries are made by me in this application are true to the best of my
knowledge and belief. I also certify that I have not suppressed/hided any of the details on the
date of submission. I aware that, if anything is found false at any stage (screening, selection,
etc.), my candidature shall be cancelled without assigning any reason whatsoever.

Date:________________ Signature of the applicant

19. Annexure-I attached herewith to be filled up.

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 Annexure-I

(Please fill in the details as applicable)

(The details that are not relevant may be mentioned as “Not Applicable”)
1. Educational Criteria(Please attach self-attested copies)
Under-graduation Post-graduation M. Phil Others
(Specify the degree (Specify the (Specify title of M. Phil (specify)
major here) degree major Dissertation here,
here) University/ Institute,
Research Supervisor)
Percentage of
Marks

2. Competency in National /State level tests

Tests/ NET NET with National GATE or others SLET/ SET,
Fellowship: JRF or Fellowship etc.,
Equivalent

Yes /No
(With Year)

3. Details of Ph.D
Title of the thesis

Year of joining

Institute

Year of submission

Name of Research
Supervisor (Mention details
of co-supervisor if any, with
affiliation)
Year of Award

4. Awards
Period Level:
Sl. Awarding
No. Name of Awards International/Natio
Agency From To nal

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5. Details of Post-doctoral and equivalent experience
(Provide details of Institute/University where post-doc was position was held, Date of joining and
Date of Relieving, Name and affiliation of the research supervisor; enclose self-attested relevant
certificates)
6. Details of teaching experience
(Provide details of Institute/University where teaching was carried out, Date of joining and Date of
Relieving, Courses handled and level of the course (UG/PG, etc.,); enclose self-attested relevant
certificates)
7. Research Papers in Peer-Reviewed or UGC listed Journals

Title of the paper, with Journal’s name, Impact

Sl. Author-
No. Year of publication, Vol. No., Page Nos., ISBN/ISSN No. Factor, if
ship**
etc. any*

* Impact Factor as per JCR-Thomson Reuter as on year 2019

** For Authorship: Kindly indicate whether you are (i) Single Author (ii) First and
Principal/Corresponding author/Supervisor/Mentor or (iii) Other Author/Co-author. This should be
as per standard definition of the respective terms as applicable to the concerned discipline.
i. Total H-index (if any) ____________
ii. Total i-10 index (if any) ____________

8. Publications (other than Research papers)

(a) Books authored

Title of the Book
Chapter/Book/ Conference Level
Sl. Publication ISBN/ Author-
No. Proceeding, with year of International/
Type* ISSN No. ship**
publication and other National
publication details.

(b) Translation works in Indian and Foreign languages by qualified faculties

Title of the Book
Chapter/Book/ Conference Level
Sl. Publication ISBN/ Author-
No. Type* Proceeding, with year of International/
ISSN No. ship**
publication and other National
publication details.

* For Publication Type: Kindly indicate whether the publication is (i) Text/Reference/Subject Books,
(ii) Edited/Translated Books, (iii)Chapters in Books/Full Paper in Conference Proceedings. For
Conference Proceedings only full Papers will be considered, abstracts will not be considered.
** For Authorship: Kindly indicate whether you are (i) Single Author/Editor/Translator (ii) First and
Principal/Corresponding author/supervisor/mentor, (iii) Other Author/Co-author (iv) First
Editor/translator or (v) Co-editor/Co-translator. This should be as per standard definition of the
respective terms as applicable to the concerned discipline.

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9. Research Guidance/Research Projects
(a) Research Guidance
Thesis/Dissertation
Number Degree Awarded
Level of Guidance submitted
Enrolled
Period Number Period Number
Ph.D.
M.Phil dissertation
P.G. dissertation

(b) Research Projects Completed

Sl. Funding PI/Co-PI/
No. Title of Research Project Period Amount
Agency Joint PI

(c) Research Projects Ongoing

Sl. Funding PI/Co-PI/
No. Title of Research Project Period Amount
Agency Joint PI

(d) Consultancy
Sl. Funding
No. Title of Consultancy Project Period Amount
Agency

10. Patents/Policy Document

(a) Patents
Level:
Sl. Date of
No. Brief Description Patent No. International/
Award
National

(b) Policy Document submitted to an International body/organization like

UNO/UNESCO/World Bank/International Monetary Fund etc. or Central Government or
State Government
Level:
Sl. Name of Body/ Date of
No. Title of Policy Document International/
Organization Submission
National/State

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11. Invited Lecture/Papers presented in Conferences/Seminars/Refresher/Orientation/FDP
(Paper presented in Seminars/Conferences and also published as full paper in Conference
Proceedings will be counted only once. Accepted full paper must be presented during the
Conferences/Seminars/FDP to qualify).

Title of the
Title of
Sl. Invited Organised
No. Conference/ Date of Presentation Level
Lecture/Paper by
Seminar etc.
presented

NOTE: Level shall be, International (Abroad)/ International (within India)/ National/State/
University

OTHER RELEVANT INFORMATION

(Attach self-certified evidence, wherever possible)

(a) Academic awards and distinctions:

(b) Membership/Fellowship of Learned bodies/Societies:
(c) Literary, cultural or other activities (e.g. attainment in sports etc.) in which the applicant is
interested and distinctions obtained:
(d) Please give details of any other credential, significant contributions, awards received,
responsibilities, etc. not mentioned earlier:
(e) Future Plans (In approximately 150 words):

I certify that the information provided in the duly filled proforma is correct as per records
enclosed.

Date :
Place : Signature of the applicant

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