ACADEMIC STAFF COLLEGE

UNIVERSITY OF CALCUTTA

(UGC-ASC, CU)

92, Acharya P.C. Road, Kolkatq-700 009

Phone and Fax : (0330 2351-9754, E-mail : dutta_asc@vsni,net

Web page : www.oocities.org/ugc_asc_cu

APPLICATION FORM FOR PARTICIPATION IN

 

O.P.No : -----------------R.C. in----------------------Duration : ------------------- to -------------------

 

 

 

1. Full Name of the Applicant            :

 

2. Male/Female                                   :

 

3. Address for communication           :

    with Phone No. & E-mail

 

 

4. Category                                         :      General/SC/ST/OBC

 

5. Age                                                 :

 

6. Date of Birth                                   :

 

7. Name and address of the College/                                                                                                          

    University/Institution with Ph.         :

 

8. The type of College/University/

    Institution                                        :     Govt./Govt. Sponsored/Autonomus/Private

 

9. Current position/post held               :

 

10. Nature of the post (substantive/

      temporary/part time etc.)               :

 

11. Date of appointment to a

      substantive post                             :

 

12. Teaching experience in a

       substantive post                            :

 

 

 

 

 

 

 

13. Academic Qualifications               :

______________________________________________________________________________

Degree                             Subject     Year    Class/Div   Marks (%)         University/College

______________________________________________________________________________

B.A/B.Sc/B.Com

______________________________________________________________________________

M.A/MSc/M.Com

______________________________________________________________________________

M. Phil/Ph.D.

______________________________________________________________________________

 

14. (i) Is the College/Institution

          affiliated to a University?            :     Yes/No

 

      (ii) If yes, name of the affiliating

             University                               :

 

15. Details of OP/RC attended before :

      Program                               Duration                                Name of the Academic Staff College

 

 

 

16. Whether accommodation is required:  Yes/No

 

 

 

 

 

       Declaration : I hereby declare that the information given above is true to the best of my knowledge and that I shall abide by the rules and regulations of the Academic Staff College, University of Calcutta.

 

Place :

Date :                                                                                           ----------------------------------------

                                                                                                           Signature of the Applicant

 

                  RECOMMENDATION OF THE FORWARDING AUTHORITY

       

 I recommend Dr./Mr./Mrs-------------------------------------------------------------------------for

 

participation in O.P.No : -----------------R.C. in-----------------------Duration : -------------to ----------

 

He/She will be released from the College/Institution/University for the duration of the above course.

Place :

Date :                                                                                        

                                                                                                      

                                                                                               Signature of the Principal/Teacher-

                                                                                                    In-Charge/Registrar/Head of the

                                                                                                    Institution (with official seal)

 

 

 

 

 

 

 

 

Instructions to the applicants :

 

1.       The form should be filled out completely; please keep a photo-copy with you.

2.       A candidate should submit only one application indicating the particular OP/RC. However, if she/he is not selected and if she/he wishes to be considered for any subsequent OP/RC, a letter(duly forwarded by the authority) may be sent to ASC-CU to that effect enclosing a copy of the original application.

3.       The envelop containing the application should bear the name of the OP/RC applied for and the duration.

4.       All communications should be addressed to The Honorary Director, UGC-Academic Staff College, University of Calcutta, 92, Acharya P.C. Road, Kolkata-700 009.

 

Note 1 : The ASC-CU, has a very limited number of accommodation available to the participants; the applications, if selected, should be prepared to arrange their accommodation if the ASC-CU hostel is full.

Note 2 : Any incorrect statement may cause cancellation of the application.