Jamia Millia Islamia: Jamia Nagar, New Delhi - 110025

IPO/DD No.
: ………………
Date: ……………………
Application Fee:
Affix For General: Rs. 500
For SC/ST: Rs. 250
recent passport size
photograph For office use only
here Application fee paid
JAMIA MILLIA ISLAMIA Call for Interview Yes

No
Jamia Nagar, New Delhi -110025 Received on……………….
Sign ………………………….
APPLICATION FORM FOR APPOINTMENT ON THE NON-TEACHING POSITION

(All the particulars must be filled in capital letters by the candidate in his / her own hand-writing)
1. Candidate’s Full Name
2. (i) Advt. No.: Dated:

(ii) Post applied for: …..…………………………………………………………………………………….
( i i i ) Department/Centre: ….………………………………………………………………………..………..
3. Father’s / Husband’s
name in Full
4. Address:
(i) Correspondence: (ii) Permanent:
………………………………………………….. …………………………………………………..
………………………………………………….. …………………………………………………..
………………………………………………….. …………………………………………………..
Pin: ……………Mobile No: ............…………. Pin: ……………Mobile No: ............………….
.
Email Address: …………………………………………………………………………………………………
5. Date of Birth: (Based on Matriculation/Hr. Sec. School Certificate)
Date Month Year
6. Whether S.C. S.T. O.B.C. PWD (LV/HI/LD) (Please tick the correct block)
`
7. Marital Status: Married Unmarried Widow
8. Educational Qualifications: (Enclose the self-attested copies of all the mark sheets, certificates, etc.)
S. No. Qualifications* Board / University Year Div. / %age Subjects

1 Matric/S.S.C.
2 Inter./Sr. Secondary
3 B.A./B.Com./B.Sc./B.E./B.Tech.
4 M.A./M.Com./M.Sc./M.E./M.Tech.
5 M.Phil.
6 Ph.D.
7 N.E.T.
8 Others
* Strike out which is not applicable (Attach enclosures, if necessary)
9. Details of Work Experience:-
Period of Service
Particulars of main Name and Address of the
S. No. Particulars of the Post
Total duties Employer
From To
Period
10. Research work / Published work / Scholarship / Fellowships (Attach enclosures, if necessary)
11. If employed presently, furnish the following details:-

(i) Basic Pay Rs. …………………. (ii) Level of Pay ............................ (iii) Allowances Rs………….……………..
(iv) Total Rs. : ……………………………………. (v) Date of next increment ……………………………………..
12. If appointed, time and notice required for joining the post:-
13. Name of two referees:-

Period for which the referee is
S. No. Name of Referee Address of the Referee
known to the candidate
1.
2.
* Applicant may send two testimonials from persons under whom he/she has studied or worked.
NOTE: Books, research papers and typescripts should be sent with the application and not separately.
DECLARATION
I hereby declare that the entries made by me in the above columns are true to the best of my knowledge and belief.
Place: …………………….
Date: ……………………. (Signature of the Candidate)
If employed, remarks of the Forwarding Authority.

Attach separate sheet, if required.
Signature…………………………………………….
Name ……………………………………………….
Designation………………………………………….
Address……………………………………………..
Place………………………
Date………………………
Jamia Millia Islamia
Jamia Nagar, New Delhi-110025
IMPORTANT Advt. No…………………….……………… Date ……………………..

Attach 05 duly filled in and signed copies of this proforma with the application form.
Particulars of Mr./Ms./Mrs. ……………………………………………..
For the post of …………………………………………..………………..
Date of Birth, Academic Qualifications Details of Work Experience

Name, Address and Contact Research and Published
Mother Tongue &
No. for correspondence Work
Other Languages Board / Division Total Post &
Exams. Year From-To Employer
University & %age Years Grade
School Cert.
Date of Birth:
……………
………………….. ……………
Age: ………Years Graduation
……………
Mother Tongue: Post
Graduation
…………………..
……………
Other
……………
Languages:
M.Phil.
……………………
Ph.D.
…………………… Others
……………………
hil. Ph. D.
Others
Date: …………………. (Candidate’s Signature)
JAMIA MILLIA ISLAMIA
Jamia Nagar, New Delhi -110025
ACKNOWLEDGEMENT
Received an application from Dr./Mr./Mrs./Ms.______________________________________
for the post of _____________________________________________________in response to the
Advt. No. ____________________________ Dated _________________ along with a D.D. / IPO
bearing No. ___________________________________________ Dated ____________________ for
Rs. ____________ drawn on _______________________________________ (Name of the Bank).
Date: (Signature of the Receiver)

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IPO/DD No.

JAMIA MILLIA ISLAMIA Call for Interview Yes

APPLICATION FORM FOR APPOINTMENT ON THE NON-TEACHING POSITION

1. Candidate’s Full Name

2. (i) Advt. No.: Dated:

5. Date of Birth: (Based on Matriculation/Hr. Sec. School Certificate)

Date Month Year

S. No. Qualifications* Board / University Year Div. / %age Subjects

11. If employed presently, furnish the following details:-

(iv) Total Rs. : ……………………………………. (v) Date of next increment ……………………………………..

13. Name of two referees:-

If employed, remarks of the Forwarding Authority.

IMPORTANT Advt. No…………………….……………… Date ……………………..

For the post of …………………………………………..………………..

Date of Birth, Academic Qualifications Details of Work Experience

Received an application from Dr./Mr./Mrs./Ms.______________________________________

for the post of _____________________________________________________in response to the

Advt. No. ____________________________ Dated _________________ along with a D.D. / IPO

bearing No. ___________________________________________ Dated ____________________ for

Rs. ____________ drawn on _______________________________________ (Name of the Bank).

Date: (Signature of the Receiver)

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Advt. No. ____________ Dated _ along with a D.D. / IPO

bearing No. _______________________ Dated for

Rs. drawn on ___________________________ (Name of the Bank).