Application Form

UNIVERSITY GRANTS COMMISSION
UGC: HUMAN RESOURCE DEVELOPMENT CENTRE
Saurashtra University
Opp. Girnar Boys Hostel, University Campus,
Rajkot - 360 005. Gujarat - India
Phone: 0281-2577679 Fax: 0281-2585204
Website : www.hrdcrajkot.org
E-mail : [email protected], [email protected]
Affix
APPLICATION FORM FOR ORIENTATION / REFRESHER COURSE
your
recent
Passport size
To
The Director, UGC: Human Resource Development Centre,
Saurashtra University, Rajkot - 360 005.
photograph
Sir,
I wish to join the Orientation programme / Refresher course in
subject commencing from
to
. I shall abide by the terms and
conditions of the course/programme and will attend each and every session and will participate in every
possible way.
My Particulars are given below :1.
Name : Dr. / Mrs. / Miss. / Mr.
:
2.
College / Department
:
3.
Name of Affiliating University
:
4.
Official address
:
Phone No. :(
5.
Residential address
Fax : (
)
)
:
Phone No. : (
Mobile No. :
)
E-mail ID:
6.
Educational
Qualification
:
Name of Degree
7.
Designation
:
8.
Status
:
9.
Details of Joining on 1st
Subject
Specialization
On probation / Permanent
Lecturership appointment
at
Date
10.
Basic Pay as on this date
11.
Type of the College
:
12.
Caste :
13. Category : OPEN
College
Subject
Rs.
Grant in Aid / Self Finance
SC
ST
OBC
14.
Break-Up of Teaching Experience at degree level :
Name of University / College
15.
Full-time
Experience Total Y/M
From
to
From
to
From
to
Particulars of Orientation Programmes/Refresher Course completed by me so far
OP/RC
University
Date
to
From
16.
Details of DD :- DD No.
Date :
Name of the Bank:
The particulars given above are correct and I accept full responsibility for the same.
Yours Faithfully,
Date :
FOR THE USE OF THE COLLEGE PRINCIPAL / AUTHORITY
I hereby permit Mr./Ms. _____________________________________________________________
to join the above programme at the UGC: Human Resource Development Centre,Rajkot
and I allow him / her to be away from the Institute From __________________ to _________________
The particulars as stated by him / her are true to the best of my knowledge. More over the affiliation
No. of this college is ________________________________________ Date _____________________
Name and Address of Institution :
___________________________________
___________________________________
(Signature of the Principal or
Statutory Authority)
___________________________________
___________________________________
Pin :
SEAL
OF
INSTITUTION
Please Note : The form will not be considered, if...
(1) The information given above is incomplete in any respect.
(2) Recent passport photograph is not affixed.
(3) DD of Rs. 1000/= (non-refundable) is not attached.