Annexure 1 (A)

RAJMATA VIJAYARAJE SCINDIA KRISHI VISHWA VIDYALAYA, GWALIOR

(M.P.) 474002

APPLICATION FORM
(Details of application fee)
DD/IPO No. _________________
Amount _________________ Passport
Date _________________ size photo

Name of the post : _______________________________________________

Advertisement No. : _______________________________________________

1. Name in full : _______________________________________________

2. Fathers Name : _______________________________________________
3. Address
a) Present address (for correspondence) ________________________________

________________________________________________________________

b) Permanent home address _________________________________________

________________________________________________________________

c) Phone/ Mobile No. ______________________________________________

4. Date of birth : ___________________ Age _______________________
5. Nationality : _______________________________________________
6. Examinations passed : (Please enclose copies of certificate/ degree & mark sheet
Transcript etc. of each of the examinations)
Name of the Percentage of
Year of Subject (s)
Examination University or other marks/ Division/
passing (Major)
examining body OCGA obtained

(i) High School

Higher Secondary/
(ii) Intermediate/ Pre-
University

(iii) B. Sc.

(iv) M. Sc.

(v) Ph. D.

Any other
(vi) examination (s)
7. Scholarships/ Fellowships/ Awards: _________________________________________

_________________________________________________________________________

_________________________________________________________________________

8. Experience: ____________________________________________________________
9. Publications:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

10.Present/ previous employment:

Name of Post Address of Date of Pay and scale of Present pay Dearness allowance
present appointment pay at the time of and scale of and other allowances
employer appointment pay if any

11.Additional Remarks, if any________________________________________________

_________________________________________________________________________

_________________________________________________________________________

(Note: Please add separate sheet if the space is insufficient)

UNDERTAKING

I have carefully read the terms and conditions of the advertisement for the post
applied. I shall have no claim for absorption under the Vishwa Vidyalaya service on
termination of the above scheme/ project. In the event of any information, being found false/
incorrect or ineligibility being detected before or after the walk in interview my candidature
will stand automatically cancelled.

Place. ..

Date. .. Signature of the candidate