BIRSA MUNDA TRIBAL UNIVERSITY, RAJPIPLA

Vocational Training Centre(VTC), Near RTO Office,

Vavdi Road, Vavdi, Rajpipla, Dist.Narmada,Gujarat-393145
Office No.02640-299682, Website : https://bmtu.ac.in/

General Information, Instruction and Application Form for the Post of

Personal Assistant to Vice Chancellor /
Personal Assistant to Registrar cum office superintendent

 Please read the instruction given below carefully before applying.

1. Visit the website https://bmtu.ac.in/
2. Separate application should be made for each post.
3. Documentary proof in support of previous experience and academic qualifications indicated in the
application should invariably be sent along with the application, failing which believe that you do
not possess the experience and qualification mentioned therein and the application shall be treated
as incomplete and thus get rejected.
4. Clearly write the complete name of post for which applying. Please note that where the name of
post is not written, it may not be possible for the university to entertain such application form.
5. A recent signed pass-port size photograph should be pasted on the application in the space
provided thereof.
6. Application fees of Rs.500/- for General Category candidates and Fee Waiver For Reserved
Category Candidates- SC/ST/SEBC/PH/NT/DNT/EWS(provide caste certificate/Non Creamy
Layer certificate / EWS Certificate as per G.O.G. Norms) by way of Demand Draft of any
nationalized bank in favour of Registrar, Birsa Munda Tribal University, Rajpipla payable at
Rajpipla should be submitted along with the filled in application form. The fee is non-
refundable/non-transferable in any case.
 It is mandatory for candidates to write details of full name, post which a candidate is
applying for, address with PIN code, etc. behind demand draft.
7. Before submitting the application form you are advised to go through the qualifications prescribed
for the post and make sure that you possess the same.
8. Please make sure that all entries in this form are to be entered neatly.
9. The candidate is required to submit the following documents (self-attested) with the application
form as checklist.
a. SSC Certificate (which mentions date of birth)
b. Certificate of Educational Qualifications.
c. Experience certificates including appointment and relieving letter and proof of Grade Pay
to be provided. (as per instruction no.49)
d. NOC of present employer (If applicable)
e. Demand draft of fees.
f. Any other documents, if necessary in support of any claim.
g. CCC/CCC+ level certificate.
10. Incomplete Applications shall not be considered.
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11. The application should reach the Registrar, Birsa Munda Tribal University, Rajpipla on or before the
last date prescribed
i.e. 07/02/2025 Applications received after the last date shall stand rejected automatically.
12. The candidate shall have to undergo such selection process/ written-oral examinations and shall
have to get Cut off marks as Prescribed in syllabus Decided by concerned authority.
13. If the candidate is employed in another government/private organization and if he/she has to send
the application form through his/her employer organization, then all the liabilities will be of
candidate. It is desirable that the application form should be reached on or before the last date of
application.
14. Minimum criteria for eligibility of age, qualification and experience for all categories, will be
considered as the last date of the advertisement.
15. The candidate selected for the post shall be required to serve at any place notified as the campus of
Birsa Munda Tribal University.
16. The candidate who has been awarded degrees from foreign universities should enclose
“Equivalence Certificate” issued by the Association of Indian Universities, New Delhi.
17. Age of superannuation for all the positions shall be as per university/GOG norms.
18. A relaxation of 5% of Marks at the Master‟s Level for SC/ST Category is applicable.
19. The candidate should have passed the Course on Computer Concept (CCC level) exam as per
Government of Gujarat rules.
20. Person serving and willing to be considered for appointment on deputation basis can also apply.
21. It is the responsibility of the candidates to assess his/her own eligibility for the post for which
he/she is applying in accordance with the prescribed qualification, experience etc. and submit
his/her application duly filled-in along with the desired information, documents and other
supporting materials as per the advertisement, suppression of factual information, supply of
fake documents, providing false or misleading information or any other undesirable action by the
candidates shall lead to cancellation of his candidature. In case, it is detected at any point of time in
future even after appointment that the candidates were not eligible as per the prescribed
qualification, experience etc. Which could not be detected at the time of interview due to whatever
circumstances, his/her appointment shall be liable to terminate forthwith as per this case.

22. The selected candidates will be required to perform duties as per the rules of University as
amended from time to time. The University is free to assign any duty as per the exigency of the
situation at any time even during non-working hours/holidays which the employee has to perform
without fail to avoid disciplinary action in this regard.
23. The selected candidate will be governed by the National Pension System: (earlier known as „New
Pension Scheme‟) of the Government of Gujarat as applicable w.e.f. 01/04/2005 (Wherever
applicable).
24. The selected candidates including in-service candidates shall be governed by the Act / Statues /
Page 2 of 16
 Ordinances/ Regulations / Rules of the university as amended from time to time and any other
Rules / Resolution prescribed specifically for maintaining the conduct of the employees by the
university.
25. Candidate should bring all original certificates relating to his/her age, qualification, experience and
cast etc. at the time of interview. In case the candidate fails to submit the original documents for
verification of certified / Xerox copies of the enclosure to his/her application, he/she will not be
allowed to appear at the interview and his/her candidature shall be treated as cancelled without any
further communication in this regard.
26. (i) The University reserves the right to fill or not to fill up or partly fill up the posts advertised for
whatsoever reasons.
(ii) The University reserves the right to withdraw the advertisement either partly or wholly at any
time without providing any reason to this.
(iii) The University reserves the right to reject any application without providing any reason
thereof.
27. Interim enquiries shall not be entertained.
28. Canvassing in any form shall disqualify the candidature of candidate.
29. Applicants are required to apply on separate form for each post/cadre. Each application without the
required application fee by way of demand payee draft shall be rejected. The application form with
insufficient payment of fees will be rejected. (Cheque(s)/Cash/IPO shall not be accepted under any
circumstance).
30. No TA/DA shall be paid to the candidates.
31. Application shall summarily be rejected without necessary supporting documents, duly self-
attested clear Xeroxed copies of degree certificate/marksheet/experience certificate/category
certificate (if applicable) issued by the respective Competent Authorities and Incomplete
applications shall be rejected.
32. In case the last date of receiving applications is declared a holiday, next working day shall be
deemed to be the last date for receiving the application.
33. If the space provided in application form is insufficient then separate sheet should be attached as
per duly signed by the candidate.

34. Candidates are advised to attach a duly signed sheet having list of enclosures with page numbers
with the application form.
35. The eligibility of the candidates will be determined as on the last date of application.
36. The University will not be responsible for any postal delay.
37. Any change of postal address given in the application form should at once be communicated to the
University.
38. In case of any dispute, any suite or legal proceeding by or against the university. Courts within
whose local jurisdiction, Headquarter of the University is situated shall have the jurisdiction.
39. The required qualification and experience are minimum and the mere possession of the same will
not entitle candidates to be called for the interview.
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40. The University reserves the right to call the candidates for interview to a limited number on the
basis of skill/ written/screening exam or by conducting personal interview immediately after last
date of receiving the application. No correspondence will be entertained with the applicants who
were not short-listed to be called for interview.
41. The envelope should be super scribed as “Application for the post of ……....”
42. The University shall verify the antecedents and documents submitted by a candidate at any time at
the time of appointment or during the tenure of service. In case it is detected that the documents
submitted by the candidate are fake or the candidate has undesirable clandestine
antecedents/background and has suppressed the said information, his/her services shall be liable to
be terminated.
43. In case of any inadvertent mistake in the process of selection which may be detected at any stage
even after the issuance of appointment letter, the university reserves the right to
modify/withdraw/cancel any communication made to the candidate including termination of
appointment.
44. Candidates must write their e-mail address neatly and correctly for mailing interview/appointment
letter as attachment. The date on which e-mail is sent to the candidate, will be considered as the
official date of dispatch and receipt of communication.
45. If any documents/evidences represented by the candidate will be found wrong/fake/misleading at
any phase, then the candidature of the candidate will be cancelled and legal actions will be taken
by authorities.
46. The prescribed application form is of page no.10 to 16. It is requested to fill up all the information
of all the pages very carefully. It is compulsory to attach prescribed documents/evidences and to
send application form in stipulated time.
47. Educational qualification/experience/age will be counted as per the last date of application.
48. It is compulsory to give page numbers to each attached enclosure. If any application will be found
without given page numbers and if it gets cancelled then no arguments will be heard.
49. The candidates are required to fill details in experience certificate attached with application.
 A candidate must have to attach documents of Salary/Duration of experience (years-months-
days)/Type of experience- academic or administrative, etc. If a candidate fails to provide
mentioned details of experience, it shall not be considered as academic or administrative
experience.
50. Birth date will be considered as per SSC certificate. Candidates must have to attach S.S.C.
certificate in which birth date is mentioned.
51. If any discrepancy will be found during procedure of recruitment, the Vice Chancellor has final
authority to change it.
52. If recruitment process got cancel fees will not be refunded.
53. There is an instruction to all candidates to visit website: https://bmtu.ac.in/ to check updates for
more details regularly.

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 ANNEXURE – XI
Cadre –
K Personal Assistant to Vice Chancellor / Personal Assistant to Registrar cum office
superintendent – Class-2- Pay Scale Rs. 9,300-34,800 (GP- 4600)
K-1 Educational Qualification and Other Details;

No Name of the Pay No. of Post

Post Scale Qualification
1 Personal 9300- Total- 2 (1) A Bachelor degree of
Assistant to 34800 any of the Universities
Vice GP- 1- General, established or incorporated
Chancellor / 4600 2-General by or under the Central or
Personal Assistant to State Act in India.
Registrar cum office
superintendent (2) Possess a degree or
diploma or certificate in
computer course equivalent
to CCC+ level as
determined by the
Government from
Government recognized
university or polytechnic or
training institution.

(3) Possess adequate

knowledge of Gujarati or
Hindi or both.

(4) Desirable: Proficiency

in English and good
communication skills.

AGE: Not be less than 18

years and not be more than
40 years.

K -1.1 The selection of the Personal Assistant to Vice Chancellor / Personal Assistant to Registrar
cum office superintendent cadre will be done based on Interview/Face to Face meeting.

Sr. Marks to be considered during

Markings/Selection Procedure Total Marks
No. selection procedure
1 Interview/Face to Face Meeting 100 100

K -2
ANNEXURE – A Syllabus of written exam and marking scheme. 2 Hours

1 History and Culture of Gujarat, Gujarati Grammer, English Grammer, Current Affairs of
India Gujarat, General Science, Aptitude Quantitative, Computer Theory with reference to 200
the basic knowledge of Computer application, Birsa Munda Tribal University Act- Marks
15/2017,Public Administration and Constitution of India
Total Marks 200
Note :
1. The Objective type written test shall consists of multiple Choice Question (MCQ) and O.M.R system.
2. Every Question shall be of 1 mark.
3. The candidate shall have Compulsory to attempt all questions.
4. Every attempted question with incorrect answer shall carry a negative mark of 0.25.
5. If the candidate has not selected any of the option given in the question, then it shall carry a negative
mark of 0.25

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K -3 Candidates who possess the eligibility for Personal Assistant to Vice Chancellor / Personal
Assistant to Registrar cum office superintendent will have to apply in prescribed application with
evidence and proofs.

K -4 Candidates are expected to write their E-mail id and mobile number in an intelligible (neat and
clean) manner. If e-mail id and mobile number are not intelligible properly, the university is not
liable for any aftermath.

K -5 All the eligible candidates having qualification as per K-1 (as mentioned in ANNEXURE-A) will
be called for Oral (Personal) Interview. Written exam will be conducted as per the syllabus
mentioned in ANEXURE-A to short-list the number of qualified candidates for Personal Assistant
to Vice Chancellor / Personal Assistant to Registrar cum office superintendent if number of
qualified candidates are more. Top 6 candidates in terms of merit in written exam will be given
opportunity to appear in Interview/Personal Interview based on their merit. The merit count of
written exam will not be considered in final selection.

K -6 The recruitment procedure of Personal Assistant to Vice Chancellor / Personal Assistant to

Registrar cum office superintendent cadre is to be done considering the criteria of oral examination,
yet in case number of candidates is more, top 6 candidates based on their merit in written exam are
to be called for an interview. If in case of the same/equal merit/marks of candidates after the last
candidate, all the candidates possessing equal score will be given opportunity for an interview.

K -7 In the recruitment procedure of Personal Assistant to Vice Chancellor / Personal Assistant to

Registrar cum office superintendent cadre, if any administrative or any other discrepancy comes to
the notice, exam committee or honorable vice-chancellor, Birsa Munda Tribal University, Rajpipla
can take all decisions and that will be final and abiding for one and all.

K -8 In the final selection, If more than one candidate obtains the same/equal marks, the date of birth of
the candidate will be taken into the account and whosoever is older/elder in terms of age will be
given priority. If such candidates have equal merit and same date of birth, his/her academic merit
will be taken into account and given priority accordingly. The decision of honorable vice-
chancellor, Birsa Munda Tribal University will be considered final in this regard.

K -9 Candidate‟s educational qualification, computer knowledge, age, gender, caste (Category-EWS,

SC, ST, SEBC, NT, DNT) Ex-army, sports, physical disability, and filled information in the form
etc., will be considered final based on the original certificates provided by the candidates along
with the forms. In support of information provided by the candidate, candidates are bound to
provide/produce the original certificates along with the photocopies as and when demanded by
Birsa Munda Tribal University. If candidates fail to produce/present original documents/certificates
or any discrepancy found between the certificates and information provided, his/her application will
be treated as „Cancelled‟ from the respective stage and his/her candidature/ selection/appointment
will be „cancelled‟.

K -10 The request to change/modify any information in the application form will not be entertained under
any circumstances in case of any discrepancy or mismatch of the information.

K -11 The candidates cannot claim the appointment on the respective post by just being short listed in the
merit list, selection list/ recommendation list. If the recruitment official finds that the candidate is
not fulfilling the recruitment criteria of Birsa Munda Tribal University of respective cadre, the
selection/appointment of such candidates can be „Cancelled‟ and get delisted. The decision of
honorable vice-chancellor of Birsa Munda Tribal University, Rajpipla Dist-Narmada will be
considered/treated as final for appointment.

K -12 The vice-chancellor of Birsa Munda Tribal University, Rajpipla holds/reserves full right to cancel
or make changes in this advertisement in case of need to be aroused and Birsa Munda Tribal
University is not bound to be answerable to anyone in this regard. Moreover, in case if the
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 advertisement needs to be put on hold or get cancelled, filled applications will be considered as
Cancelled and fees will not be refunded.

K -13 The finally selected candidates are tend to get appointments under the conditions as decided by
Birsa Munda Tribal University.

K -14 The application of the following mentioned nature will be considered as cancelled. (This list is
given just for an example; it is not complete).

1. Not applied as per the advertisement.

2. Information provided in the application is incomplete or irrelevant, one or more than one
provision of the advertisement is not obeyed.
3. The candidate has not provided photograph or signature in the application.
4. Applications are sent through e-mail, fax, or courier.
5. Candidates have not paid the mentioned or decided fees fully.
6. If candidates belonging to SC/ST/SEBC/EWS/PH or Ex-army category and does not hold the
required certificate of their cast/category, (if the benefit of fees waiver is needed or belongs to
reserved category).
7. If the candidates belonging to socially and educationally backward category do not hold the Non-
creamy layer certificate of valid period as indicated in the advertisement Annexure – (4) (in
Gujarati) of State Government for not belonging to reserved category.

K -15 The candidates are advised to check their E-mails regularly.

K -16 If any of the following details come to Birsa Munda Tribal University's notice, Birsa Munda Tribal
University will take legal action against that candidate including cancellation of candidature.
1. To seek any support for his candidature i.e. to attempt to involve directly or indirectly any
member or officer of Birsa Munda Tribal University.
2. For disguising the name of someone else.
3. For making other disguise his/her name.
4. For presenting the false or manipulated documents or any sort of misconduct in documents.
5. For making false declaration or hiding important information.
6. For taking help of inappropriate equipment in exam for his/her candidature.
7. For using inappropriate equipment like doing misconduct during exam like copying from answer
sheet of other, book, digest, piece, or any hand written material or copying by oral talk or copying
other candidate or Candidates to make copies through communications or otherwise.

K -17 Candidates must have obtained the educational qualification from recognized
university/institutions. Candidates have to present original certificates, mark sheets of every
year/semester and degree certificates of recognized university/institutions for verification as and
when demanded by the university.

K -18 In case of any discrepancy aroused in regards to the validation of certificates of eligibility, approval
of university/institutions and validation of respective course as mentioned in the form in future, the
decision of Birsa Munda Tribal University, Rajpipla Dist-Narmada will be considered/treated as
final.

K -19 Cut-off Date for Educational Qualification/Additional Qualification: -

for the candidates of all categories as mentioned in the advertisement, the last date to apply date:
07/02/2025 as mentioned in the advertisement will be taken into the consideration as the cut-off
date for required qualification/other required additional qualification/experience.

K -20 Cut-off Date for Age Limit:-

The last date to receive the application as mentioned in the advertisement will be considered as the
Page 7 of 16
 Age limit. It means in the case of all the candidates, the last date to receive the application as
mentioned in the advertisement date: 07/02/2025 will be considered.

K -21 As per the above-mentioned provision, all the candidates including Ex-army candidates like female
candidates of unreserved and reserved category, physically disabled candidates as per the rules and
candidates of reserved category, the maximum relaxation of age at decided date must not be more
than 55 years
K -22 The disability benchmark is decided vide circular no. બમય/૨૦૨૦૨૪/૫૨/ગ., dated 23/05/2024
of Tribal Development Department, Gujarat State, Gandhinagar- for direct recruitment of the
following mentioned cadre as per the rights of handicapped person act, 2016.
Handicapped Percentage of
Name of the post Type of Disability
Section Reserved Post
A 1% B, LV
Personal Assistant to B 1% D, HH
Vice Chancellor /
OA, OL, BL, OAL, CP, LC,
Personal Assistant to C 1%
Dw, AAV, SD, SI
Registrar cum office d) ASD, SLD, MI
superintendent (d & e) 1% e) MD involving
(a) to (d) above
In the case of direct recruitment of the said cadre where seats are not reserved for handicapped
candidates, The Handicapped candidates possessing benchmark disability can apply their
candidature based on their merit and can get appointment.
(CATEGORY ABBREVIATIONS USWD:B=Blind, LV=Low Vision, D=Deaf, HH= Hard of Hearing,
OA=One Arm, OL=One Leg, BA= Both Arms. BL=Both Leg, OAL=One Arm and One Leg, BLOA=Both
leg & one arm , BLA=Both Legs Arms, CP=Cerebral Palsy, LC=Leprosy Cured, Dw=Dwarfism,
AAV=Acide Attack Victims, MDy=Muscular Dystrophy, ASD= Autism Spectrum Disorder(M=Mild,
MoD= Moderate), ID= Intellectual Disability, SLD= Specific Learning Disability, MI=Mental Illness,
MD=Multiple Disabilities, SD=Spinal Deformity, SI= Spinal Injury
K -23 Method of Applying and paying fees of application:-

All the eligible candidates will have to get prescribed application form and all instructions from
http://bmtu.ac.in/and pay decided fees Rs.500/- and present it along with the application form and
must submit it through RPAD/Speed Post AD. The application should be submitted with required
checklist/demanded documentary evidence to the Registrar, Birsa Munda Tribal University,
Rajpipla in due time. Applications not submitted beyond the prescribed limit, in the prescribed
medium and in the prescribed format will be automatically rejected.

K -24 Birsa Munda Tribal University, Rajpipla Dist.-Narmada reserves rights/authority to change the
method/form of written, oral examination or any other matter considering the number of
applications/candidates in the category, the decision of Vice Chancellor Birsa Munda Tribal
University, Rajpipla Dist.- Narmada will be treated as final.

MAILING THE APPLICATION FORM:

1. The application form should be sent to the Registrar, Birsa Munda Tribal University, Rajpipla,
Vocational Training Centre(VTC), Near. RTO Office, Vavdi Road, Vavdi, Rajpipla, Dist.
Narmada – Gujarat - pin code - 393145

2. It is mandatory for all candidates to send application by RPAD or Registered Speed Post AD,
application sent by another means will be cancelled automatically.
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 3. Applicants are advised to submit the applications to the University well in advance without waiting
for the last date to avoid postal delay or any other unforeseen problems. The University will not be
responsible for any postal delay at any stage.

4. Canvassing in any form on behalf of or by any candidate will disqualify him/her from being
considered.

5. The duly filled-in and completed application in all respect should reach the University on or before
the due date mentioned in this Advertisement.

Date: 10/01/2025 Registrar

Place : Rajpipla

Copy forwarded for information to:

1. Joint secretary, Tribal Development Department, Gujarat State, Gandhinagar by E-mail
2. Commissioner, Tribal Development, Gandhinagar by E-mail
3. The Registrars of all Central/State Universities in Gujarat state for wide publicity by E-mail
4. The Director, Information, Govt. of Gujarat, Gandhinagar for wide publicity and to publish in Gujarat Rojgar
Samachar by E-mail and RPAD

Page 9 of 16
 BIRSA MUNDA TRIBAL UNIVERSITY, RAJPIPLA
Vocational Training Centre(VTC), Near RTO Office,
Vavdi Road, Vavdi, Rajpipla, Dist.Narmada,Gujarat-393145
Office No.02640-299682, Website : https://bmtu.ac.in/

APPLICATION FORM FOR

DEPUTY REGISTRAR/CAMPUS DIRECTOR/ENGINEER CIVIL/
ASSISTANT DIRECTOR PHYSICAL EDUCATION/
ASSISTANT REGISTRAR/WARDEN (GIRLS/BOYS)/
P.A. to V.C – P.A. to REGISTRAR cum OFFICE SUPERINTENDENT POSTS

Advertisement No: Tri.Uni./Narmada /F.No.473 / Registration No:

Affix Recent
Notification/160 to 179/2025 (For Office use Only)
Passport size
Dt.:10/01/2025 Colored
Photograph
Last Date of Receipt Application Form :07/02/2025 With
Signature
Details of Bank Payment
DD Number & Date Amount Name of the Bank issuing DD Candidate Category
(with Branch’s Name) General/SEBC/SC/ST/
NT/DNT/EWS

Application for the Post of:

Note: (i) The applicant should fill this form either in type or in neat hand Writing and all information must
be mentioned both clearly and correctly.
(ii) Applications received without self-attested copies of certificates, marksheets and not
through proper channel are liable to be rejected.
(iii) Wherever the space provided in the application form is insufficient, please attach separate sheet.

1 Full Name of Applicant :

2 Address for Correspondence

(With Pin Code) :

3 Contact Numbers : (i)

(ii)

Page 10 of 16
4 Email ID :

5 Permanent Address
(With Pin Code) :

6 Date of Birth Date Month Year

:

Age as on Last date of Number of Number of Number of Days

7 Application : Years Months

8 Place of Birth :
Village / Town /City:___________Taluka:__________District: ______________

9 Nationality :

10 Category :
General/SEBC/SC/ST/NT/DNT/EWS _____________________________
(Attach Cast Certificate / Non Creamy Layer Certificate/
EWS Certificate as per GoG Norms)

11 If physically challenged,
indicate relevant particulars Type of disability :

Percentage of disability :

12 Gender : M / F :

13 Marital Status : Married / Unmarried : _________ Widow/Divorcee: ___________

Page 11 of 16
(14)Details of Educational Qualifications:
Class
Year & Subject Offered
Exam/ Examining body/ obtained
Degree Month of (Main & Remarks
university with
Passing Subsidiary)
percentage

SSC

HSC

Bachelor’s Degree

……………………
( Name of Degree)

Master's Degree

…………………
( Name of Degree)

Ph.D.

Basic knowledge
of computer
CCC+ /CCC level

* Details if possessing additional qualification

(15) Special academic achievements, if any:

(1)

(2)

Page 12 of 16
(3)

(16) Information regarding Post Graduate Teaching and Administrative Experience: ________

I. Date of recognition as a Post-graduate teacher : ________________________

II. Name of the University Granting recognition : _________________________

III. Total number of years of experience as a post graduate teaching &

Administrative Experience : _____________

(17) Details of Teaching / Administrative Experience :

Name of the Designation Nature of Date of Date of Nature Last Basic Reason for leaving
College/ University/ employment Joining Leaving of work Pay & Pay
Organization Full Time/ Scale
Part Time/
Contractual

Page 13 of 16
 i) Total Number of years of Teaching & Administrative
Experience:_________________
ii) Experience as on last Date of application: Year(s)____ Month(s)______ Day(s)___
iii) Research and other publications
(write ona separate sheet) :
(In case of Research articles, please state the
names of the authors, title of the Journals, year
and page numbers. For books please give names
of the authors, title, publisher and year)

iv)Total Number of years of research experience : ______________________________

v) Title of the Ph.D Thesis : _____________________________________________

_____________________________________________
(18) If appointed how much time you would require to join?:_____________________
(19) References :

1 2
Name

Designation

Address

E-Mail

Mobile No.

(20) Any special information (for example

seminars, symposia, workshops, summer
institutes conducted) which the applicant
wishes to give.

Page 14 of 16
 Declaration

I, undersigned, Shri /Kum./Smt. _________________________________________

declare that the information furnished above is true and I agree to furnish any further
information pertaining to this application , as and when asked for.

I also hereby agree that if any information furnished by me, as above is found
incorrect or false or bogus , my application shall be liable to be cancelled at any time.

Place :
Date : Signature of Candidate

F.W.B.C.
To Registrar,
Birsa Munda Tribal University,
Rajpipla(Gujarat).

I declare that to the best of my knowledge and belief, the information given by the
candidates is correct.

Place :

Date : Signature and designation

( with stamp )

Page 15 of 16
 ----- Checklist of Enclosed Documents -----

Candidate name:

Post :
Sr. Certificate Attached (Yes / NO)
Documents Page No
No If Yes then Write Certificate No./Date/Serial No etc.
DD for the application fees
1.
(in original)
School Leaving Certificate
2.
(L.C.)
Matric / Secondary / High
3. School (10th Class)
Marksheet
SSC Certificate
4.
(which mentions birth date)*
Sr.Secondary/ Intermediate
5.
(12th Class) Marksheet
Bachelor's Degree Marksheet
6.
( If Required )
Bachelor‟s Degree Certificate
7.
( If Required )
Master's Degree Marksheet
8.
( If Required )
Master's Degree Certificate
9.
(If Required )
Ph.D. Notification
10.
(If Applicable )
Ph.D. Degree Certificate
11.
(If Applicable )
Caste certificate
12. (If Applicable )
Non- Creamy layer
13. Certificate(For SEBC)
Physically Handicapped
14. Certificate
(If Applicable )
Experience Certificate(s)
15. from previous employer
( If Required )
Endorsement from the present
16.
employer (If Required )

17. CCC

18.
Any other (Please specify)
19. Any other (Please specify)
20. Any other (Please specify)
* Mandatory enclosures .
Signature of Candidate
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