For Office Use Only ANNEXURE – II

Entry No:
Paste 1(one)
passport size
MIZORAM UNIVERSITY : AIZAWL colour photograph
(Application form – Prescribed format) (Do not staple)

1. Name of post applied with code no:

2. Name of Department applied for :

(For Academic Departments Only)

3. Category of post applied for :

4. Advertisement No. & Date : No.1/1/2010-RC(T)/21464 – ‘559 dt. 25.01.2011

5. Demand Draft No.____________________ Date:______________ Amount: Rs.___________

6. Name of the applicant (in block letters):

7. (a) Sex: (b) Religion:

8. Father’s Name :

9. Date and Place of Birth :

10. Whether belongs to SC/ST/OBC :

11. State of Domicile :

12. Permanent address :

13. Address for correspondence (with Phone No./Fax No./E-mail):

contd. 2/-
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12. Academic records beginning with High School Examination:

Sl. Examination Division (with Subject(s) Year Board / Distinction

No. Passed % of marks) University Achieved if any

13. Technical qualifications, if any:

14. Work experience, with particulars of posts held:

Sl. Post Held Employer Last Basic Pay Drawn Nature of Period with dates
No. with pay scale work From: To:

contd. 3/-
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15. Teaching Experience:

(a) Post Graduate : ________ Years

(b)Under Graduate : ________ Years

16. Research Experience :

(a) No. of years after Ph.D. :

(b) Research Guidance :

i) Completed : Ph.D. ______ nos. M.Phil. ______ nos.

ii) On-going : Ph.D. ______ nos. M.Phil. ______ nos.

(c) Research Projects :

i) Completed : ______ nos. (with amount & funding agency)

ii) On-going : ______ nos. (with amount & funding agency)

(d) Publications* :

i) Research papers : ______ nos.

ii) Books : ______ nos.

iii) Articles : ______ nos.

* Citation index and impact factor should be provided.

17. Specialization :

18. Other relevant experience :

(a) Seminar, Symposium, Conference attended / organized.

(b) Administrative Experience / Experience of University Corporate Life.

(c) Contribution to Design of Curriculum.

(d) Extra Curricular Activities.

(e) Any other.

contd. 4/-
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19. Names and addresses of two referees (one may be the present employer):

(a)

(b)

20. List of Enclosures :

Note: All particulars should be supported by relevant documents.

I certify that the foregoing information is correct and complete to the best of my
knowledge and belief. I am not aware of any circumstances which may impair my fitness for
employment in the Mizoram University.

Date :

Place : Signature of the Candidate

Applicants are required to submit completed Datasheet (for Assistant

Professor) and API Scoresheet (for Associate Professor, Professor, Deputy
Librarian and Librarian) along with their application