Central University of Jammu

Rahya-Suchani (Bagla), District: Samba – 181143, Jammu (J&K)

Ph No: 7051522075 & Website: www.cujammu.ac.in

FOR OFFICE USE ONLY

SERIAL NO.
APPLICATION FORM FOR LIBRARY POST
Name of the post applied for ………………………………...................................…………..
Department……………………………………………………...........................................………..
PASTE HERE
Employment Notification no 23 Dated 01.03.2019 COLOURED DULY
DEMAND DRAFT PARTICULARS SIGNED PASS-PORT
Name of the Bank D.D. Number Date Amount SIZE PHOTOGRAPH
NOT MORE THAN
SIX MONTHS OLD

PART – A
1. Name in Full………………………………………………………………………...........................................…………………….
(IN BLOCK LETTERS)
2. Father’s Name……………………………...................................………………………………….………………………………..
3. Mother’s Name …………………………………………………………………………………………………………………………….
4. Date of Birth: Day……….........….....…………..Month…….……....….....……....….Year…….....…………….….……..
(As recorded in the Matriculation or equivalent certificate)
5. Age (as on the last date fixed for the receipt of application)…………........…..years ……….……… months.
6. Nationality…………………………………………….………. 7. Religion……………………………………………….
8. Marital Status: Married [ ] Unmarried [ ]
9. Sex: Male [ ] Female [ ] Transgender [ ]
10. Do you belong to any reserved category?: Yes [ ] No [ ] (if yes, specify the category
(SC/ST/OBC) [ ]
11. Whether Handicapped?: Yes [ ] No [ ]
If yes, indicate whether Physically/Visually/any other………………………………….................…………………..
12. Aadhaar No (Optional). ………………………………………………. 13. PAN No (Optional).…………………………………………..
14. Language Known: Spoken……………................……………………Written….………………....................…………..
15. Foreign Visits
Duration
Countries visited Purpose of visit Period
From To Total

Page | 1
16. Awards/Honours/any other academic distinction:
………….……………………………………………………………………...................................................……………………..
………….……………………………………………………………………...................................................……………………..
………….……………………………………………………………………...................................................……………………..
………….……………………………………………………………………...................................................……………………..

17. Permanent Address ..……………………………………………................................................………………….………

....………………………………………………………….................................................………………………….………………
PIN Code…...............…………………Phone No……….............…………….. Mobile No(s).………...................……
Address for Correspondence………......................................……………………………………………………………...
.............................................………………………………………………………..PIN Code…….…..……...……..…………..
Email ID (Mandatory) …………………………..........................................…………………………..…………………….

PART – B
18. Educational Qualifications:-

Board/ Year of Marks Screening Committee

Examination Division Subject/s Page No.
University passing (%age) Remarks
Matric

Hr. Sc. II

Bachelors
Degree
Post-graduate
Degree
Any other

19. Research Degree/s:-

Name of Date of Date of Page Screening Committee

Degree Title University
Supervisor Registration award No. Remarks
M.Phil.

Ph.D.

DSc/DLitt

Page | 2
20. Details of JRF/NET/SLET/SET

Details of Year qualified Subject Page No. Screening Committee Remarks

JRF/NET/SLET/SET
JRF /
NET/SET/
SLET

21. Prior positions held:-

Designation Department/ Name of Date of Actual Joining Nature of

Centre/ Employer Appointment (Adhoc /
From To Temporary / Contractual /
Permanent)
(1) (2) (3) (4) (5) (6)

Note: Enclose letter of appointment and experience certificate.

Basic Pay Pay band GP/AGP Gross salary Increment Total Amount Reason for Page No.
(with evidence) (with evidence) (with (with evidence) date/month if Adhoc**/ leaving
evidence) (with evidence) temporary/
contractual/
Permanent
(7) (8) (9) (10) (11) (12) (13) (14)

** Please attach a certificate from the employer confirming and providing that the total gross emoluments paid
was not less than the salary of a regular appointed Assistant Librarian, Deputy Librarian and Librarian, as the
case may be, as per UGC notified pay scales. Please state break-up of salary.

22. Period of teaching experience (in Higher Education Institution):-

Level Regular/ Adhoc/ Experience Page No. Screening Committee Remarks
Temporary/ (in years)
Contractual
PG classes

UG classes

Page | 3
23. Research Experience :-

Research Position Before Ph.D.

Experience in Held Emoluments Name of From To No. of
years and month per month University years
(1) (2) (3) (4) (5) (6) (7)

After Ph.D. Page Screening Committee

From To No. Remarks
Emoluments Name of No. of
per month University years
(8) (9) (10) (11) (12) (13) (14)

24. Leave taken during the period spent in obtaining the M.Phil. / Ph.D. Degree:-

Programme Course Residency Period of leave Period of Order No. Page Screening
Work Period From To days & date No. Committee Remarks
(years/
months/
days)

Note: Documentary evidence of leave sanctioned be enclosed.

25. Field/s of specialization under the subject/discipline:-

Major

Minor

Page | 4
26. Academic Staff College/ HRDC : Orientation Programme, Refresher Course, Research
Methodology Workshop, Induction Programme, etc. attended:-

Name of the Course Place Duration Sponsoring Agency Page Screening Committee
With Dates No. Remarks

27. Evidence of innovative library services including integration of ICT in library:-

Nature of Library Role / Job Duration Level Page Screening Committee

Service Position With Dates College / University No. Remarks

28. Training /Seminar/ Workshop / Course on Automation and digitalization

Name of the Course Place Duration Sponsoring Agency Page Screening Committee
With Dates No. Remarks

29. Any other information, which the applicant wants to share ( Page No. ):-

State whether you have been at any time (a) dismissed, removed or debarred from Service or (b)
convicted by a Criminal Court. Please tick YES NO
I hereby declare that all entries 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 suppressed, false,
incomplete or incorrect, my candidature/appointment is liable to be cancelled/ terminated.

Place………………………………………… (Signature of the Applicant)

Date………………………………………….
……………………………………………………………………………………………………………………………………………………………….
(The endorsement below is to be signed and forwarded by the Competent Authority / Employer in the case of
the in-service candidates whether in permanent or temporary capacity failing which the application is liable to
be rejected).
ENDORSEMENT OF THE EMPLOYER
Ref. No………………………… Date………………………………
Forwarded

The applicant…………………………………......….(name) is holding the post of …………………………………………………

in this College / University / Institution / Department in a temporary /substantive basis since
…………………..........(date). His / Her present Pay is Rs…………............………………… in the Pay structure of
Rs……………….......…….with AGP / GP of Rs………………………………...…and he / she is drawing salary of

Page | 5
Rs…………………………………………..per month. His / Her next date of increment is we have no objection to
his/ her application being considered and he / she will be relived as per rules. It is also certified that
there is no Vigilance / disciplinary proceedings contemplated or pending against him/her.

(Signature of the Competent Authority)

(with office seal)

Page | 6
 DECLARATION/ UNDERTAKING
(for OBC Candidates only)
I, .................................................................................. son/daughter of Shri …………………………………………
………………………………………. resident of village/town/city ...........................................................................
district………………….……………………., State ..........................................hereby declare that I belong to
the community which is recognized as backward class by the Government of India for the purpose
of reservation in services as per orders contained in Department of Personnel and Training Office
Memorandum No. 360 12/22/93- Estt. (SCT), dated 8/9/1993. It is also declared that I do not
belong to persons /sections (Creamy Layer) mentioned in Column 3 of the Schedule to the above
referred Office Memorandum, dated 8/9/1993, which is modified vide Department of Personnel and
Training Office Memorandum No.36033/3/2004 Estt. (Res) dated 9/3/2004.

(Signature of the Candidate)

Place:-..............................................

Date:-...............................................

Declaration/undertaking not signed by Candidate will be rejected

False declaration will render the applicant liable for termination of registration at any time

(Signature of the Candidate)

Page | 7
 Checklist of Documents Enclosed
Sl. Documents Annexure No. Page Nos.*
No
1. Matric/ Secondary/High School (10th Class)
Marks Sheet

2. Matric/Secondary/High School (10th Class)

Certificate

3. Sr. Secondary/Intermediate (12th Class) Marks

Sheet
4. Sr. Secondary/Intermediate (12th Class) High
School Certificate

5. Bachelor's Degree Marks Sheet

6. Bachelors' Degree
7. Master's Degree Marks Sheet
8. Master's Degree
9. M. Phil. Marks Sheet
10. M. Phil Degree
11. Ph. D. Degree
12. NET/SET/SLET
13. Experience Certificate(s) from previous
employers:
14. Endorsement from the present employer
15. DD for the application fees (in original)
16. API Score Sheet
17. Any other ( Please specify)

I hereby declare that the all documents have been self attested and attached by me as per the Annexure
No. and Page Nos. mentioned against each.

Signature of the Candidate

Date:

*Note: Please ensure proper page numbering (serially) of the enclosures attached with the
application form.
Page | 8
 Annexure –I
(On the letter head of the University / Institute)

TO WHOMSOEVER IT MAY CONCERN

This is to certify that Mr./Ms (Reg.No _) has successfully

completed Ph.D. programme in the Subject , Faculty / Department of
during the year . The degree has been awarded in compliance of ‘UGC
(Minimum standards and procedure for awards of M.Phil/Ph.D degree) Regulation 2009’.

(Signature with Seal)

No………………………………………

Dated…………………………………..

Page | 9
 Annexure-II

Page | 10
 Annexure-III

Page | 11
 Annexure-IV

Page | 12
Page | 12