| 1. Name | |
| 2. Present designation along with discipline & scheme | |
| 3. Date of Birth | |
| 4. Detail of job/fellowship/training/conference etc. Being applied for and its duration | |
| i) Name of post/fellowship and duration (indicate dates) | |
| ii) Source of Advt. | |
| iii) Last date of submission of application | |
| iv) Complete address at which application is to be sent. | |
| 5. i) Date of joining in CCS HAU. | |
| ii) Date of joining the present post. | |
| iii) Whether probationary period cleared or not. | |
| 6. i) Whether the teacher was granted study leave/leave of the kind due for prosecuting Ph.D./Post-doctoral fellowships etc. during the last 3 years or so, give details. | |
| ii) If so, whether he was required to execute some bond and whether has done so? | |
| iii) Whether under bond, if so please mention | |
| a) Date up to which the bond is valid | |
| b) Purpose for which executed. | |
7. Detail of foreign assignment/conference attended in the entire past in Chronological order
| Detail of foreign assignment/conference | From | To | Name of the country in which posted/visited | Name of the foreign agency/employer |
|---|---|---|---|---|
| 8. Opportunities availed by the applicant in last 5 years for outside jobs, assignments, trainings, fellowships etc. give details. | |
| 9. Name, place & duration of the present conference/seminar. | |
| 10. Other liability, if any and registration fee etc. | |
| 11. Certificate to the effect that proposed visit shall not be combined with any other purpose. |
| 12. Is the teaching any course? | |
| 13. Alternate arrangement for teaching of the course proposed? | |
| 14. Programme (Job/fellowship) for which application of the incumbent have been forwarded in the last two years. | |
| 15. Whether in the event of selection (for jobs) the employee can be spared without any determent of University work, if yes, what alternative arrangements are proposed until the post is filled up on regular basis, if the employee resigns from the University service. | |
| 16. In case it is proposed to send the employee on deputation or on EOL, no substitute will be asked for. In that event too, please indicate how the work will be carried on. | |
| 17. Has the relevant circular been got noted from all concerned faculty members? | |
| 18. Financial liability involved on the part of the University, if any. | |
| 19. Are the funds required for the proposed visit available in the Dept. without any demand for additional funds? | |
| 20. Have the particulars given by the teacher been verified and found correct? | |
| 21. Whether persons possessing qualification prescribed for the post are available from the open market? | |
| 22. Other relevant information, if any. | |
| 23. Specific recommendations of the Head of the Department. |
Countersigned
Controlling officer