Application Form For ASSISTANT Posts

Affix your
recent
passport size
Photograph
UNIVERSITY OF AGRICULTURAL SCIENCES, BANGALORE
APPLICATION FORM FOR RECRUITMENT OF ASSISTANT POST

To be filled in by the applicant in his / her own handwriting
Name : ___________________________________________________
Post applied for : ___________________________________________
Advertisement No. and Date : _________________________________
DD No. with Date and Name of the Bank : ________________________
Note: 1. Please answer each question clearly and completely.
2. Eligibility and suitability of a candidate shall be considered based on the

information provided in the filled application with attested copies of
certificates by competent authority.
3. All claims mentioned in the application should be supported by relevant

and authorized documents.
4. Certificates for prescribed qualifications must have been obtained and

their attested copies are to be submitted on or before the last date for
submission of application.
5. Applications should be complete in all respects as on the date of

submission. Any additional documents / certificates / records provided
after the last date will not be considered for award of marks.
6. If a candidate has submitted more than one application for the same
post, the latest application submitted within the prescribed last date
shall be considered as valid for the purpose of recruitment.
7. Separate sheets may be attached wherever necessary.
8. Incomplete applications shall be rejected.
9. The selection procedure shall be in accordance with the Statutes and

the Cadre & Recruitment Regulations of the University.The Notification
along with detailed qualifications is available on website www.uas
bangalore.edu.in.
2
APPLICATION FORM
1. Name of the post
2. Name of the candidate in full

(in capital letters as appearing in the
degree certificate)
3. Address
(to which all communications are to be
sent) Telephone No. with STD code
Mobile No:
Email:
4. Are you an Indian Citizen? Yes No
5. a) Sex Male Female
b) Date of Birth Day Month Year

(to be supported by a copy of the valid
certificate / SSLC marks card)
6. Place of Birth , District and State to

which you belong
7. a) Do you belong to Scheduled Yes No

Caste or Scheduled Tribe?
If yes, please indicate the SC ST
category and enclose a certificate
in the prescribed format from the Name of the
competent authority. Sub Caste
b) Do you belong to any

Backward Class [Cat. I, II (A), Yes No
II (B), III (A) & III (B)] ?
If yes, please indicate the Cat-I IIA IIB IIIA IIIB
category and enclose a certificate
in the prescribed format from the Name of the
competent authority. Sub Caste
3
c) Do you belong to any

Horizontal Reservation
category [Women (W), Yes No
Rural Candidates (RC), Ex-
serviceman (Ex-ser), Kannada EX-
Medium (Kan.),Transgender W RC Kan.
ser
etc]?
If yes, please indicate the
category and enclose a certificate Phy. PDP TG
in the prescribed format from the Challenged
competent authority.
Do you belong to Kalyana

d) Karnataka Region. Yes No
Note: Claims under item 7 to be supported with valid certificate issued by the
competent authority.
8. a) Father’s Name, Address and

occupation
b) Income per annum.
9. Languages Known
Examination
Language Read Write Speak
Passed
10. Particulars of School Education (upto 10th Standard)
Name of School and Place Date of Entry Date of leaving

4
11(a) Academic Qualifications: Particulars of examination passed i.e., SSLC / PUC

/ Degree / PG Degree obtained including post graduate training, if any.
Marks College /
Examination / Year of
Subjects Studied obtained University /
Degree passed completion
(%) Institution
SSLC
PUC
Diploma
Bachelor’s Degree
Master’s Degree
PG diploma of not
less than one year
duration
Others
Any Training
Programmes
More than three
months duration
One month to three

months duration
Less than
one month duration
Note: 1. Field of specialization should be indicated clearly at the Master’s, Ph.D and
Post Graduate Diploma level.
2. The candidate shall furnish attested copy of the certificate of equivalent
percentage of marks in the case of declaration of result in the form Grade
points
11(b) Medals / Awards / Recognitions obtained, if any.
5
12. Experience in the concerned field and pay scale
Name of Designation Date of Date of Emoluments Reasons for

Employer / Cadre Joining Leaving Basic pay Leaving
(Rs.)
Note: Use separate sheet if necessary. Enclose certificate issued by the competent
authority.
13. List of Documents attached

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
6
14. Reference (furnish Name and Address of three persons not related to the applicant) :
1.
2.
3.
15. Additional Remarks, if any:
16. Did you reject the employment

offered by UAS, Bangalore in
the past? Yes No
If yes, indicate full particulars
of post with date of offer.
17. a) Was there any criminal

case against you in the
past? Yes No
If yes, give details.
b) Is there any criminal case

pending against you? Yes No
If yes, give details.
I hereby declare that the information furnished in this Application Form and the additional
information furnished above are true to the best of my knowledge and belief. In case the
information is proved to be false, I shall undertake that I may be punished in accordance
with law.
Place:
Date: Signature of the applicant
7
FORWARDAL CERTIFICATE FROM THE EMPLOYER
Certified that Smt. / Sri ___________________________________________
is working in this Department / Institution / Organization as
_____________________________ w.e.f. ______________________ in the scale of
Rs. ________________. He / She is at present, drawing a basic pay of
Rs. _________________ besides DA and other allowances amounting to
Rs. _____________________ .
We have no objection in forwarding his / her application for the post in
University of Agricultural Sciences, Bangalore. The Confidential Reports of the
employee for the past five years are *Satisfactory / Not Satisfactory. The regular
confidential reports will be mailed within 15 days.
*Strikeout whichever is not applicable.
Date :
Office Seal : Signature and Designation
FORWARDAL CERTIFICATE
(Applicable only to UAS Employees)
Certified that Smt / Sri ___________________________________who joined
this University on ____________ is working in this Office / College / Research Station
as _______________________________ w.e.f. _____________ in the scale of
Rs. _______________________ . His /Her present basic pay is
Rs. _____________________.
Date :
Place : Signature and Designation

Application Form For ASSISTANT Posts

Uploaded by

Application Form For ASSISTANT Posts

Uploaded by

Affix your

UNIVERSITY OF AGRICULTURAL SCIENCES, BANGALORE

APPLICATION FORM FOR RECRUITMENT OF ASSISTANT POST

Post applied for : ___________________________________________

Advertisement No. and Date : _________________________________

DD No. with Date and Name of the Bank : ________________________

Note: 1. Please answer each question clearly and completely.

2. Eligibility and suitability of a candidate shall be considered based on the

3. All claims mentioned in the application should be supported by relevant

4. Certificates for prescribed qualifications must have been obtained and

5. Applications should be complete in all respects as on the date of

7. Separate sheets may be attached wherever necessary.

8. Incomplete applications shall be rejected.

9. The selection procedure shall be in accordance with the Statutes and

1. Name of the post

2. Name of the candidate in full

4. Are you an Indian Citizen? Yes No

5. a) Sex Male Female

b) Date of Birth Day Month Year

6. Place of Birth , District and State to

7. a) Do you belong to Scheduled Yes No

b) Do you belong to any

c) Do you belong to any

Do you belong to Kalyana

8. a) Father’s Name, Address and

b) Income per annum.

10. Particulars of School Education (upto 10th Standard)

Name of School and Place Date of Entry Date of leaving

11(a) Academic Qualifications: Particulars of examination passed i.e., SSLC / PUC

One month to three

12. Experience in the concerned field and pay scale

Name of Designation Date of Date of Emoluments Reasons for

13. List of Documents attached

15. Additional Remarks, if any:

16. Did you reject the employment

17. a) Was there any criminal

b) Is there any criminal case

FORWARDAL CERTIFICATE FROM THE EMPLOYER

Certified that Smt. / Sri ___________________________________________

is working in this Department / Institution / Organization as

_____________________________ w.e.f. ______________________ in the scale of

Rs. ________________. He / She is at present, drawing a basic pay of

Rs. _________________ besides DA and other allowances amounting to

We have no objection in forwarding his / her application for the post in

University of Agricultural Sciences, Bangalore. The Confidential Reports of the

confidential reports will be mailed within 15 days.

*Strikeout whichever is not applicable.

Office Seal : Signature and Designation

Certified that Smt / Sri ___________________________________who joined

this University on ____________ is working in this Office / College / Research Station

as _______________________________ w.e.f. _____________ in the scale of

Rs. _______________________ . His /Her present basic pay is

Place : Signature and Designation

You might also like

_______ w.e.f. in the scale of

as ___________________ w.e.f. _ in the scale of