(UGC-ASC, CU)
92,
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
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
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
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,
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.