Affix recent stamp size otograph pho UGC C-HUMAN RESOURCE R E DEVELOPMENT CEN NTRE(HRDC C) UNIVERSIITY OF CAL LCUTTA 92, A. P.C. Road, R Kolkatta-700 009 Ph hone and Faxx : 033- 2351--9754; direcctorcuhrdc@ @gmail.com m Website: http:///www.calun niv.ac.in/AS SC App plication Forrm For Special S Sum mmer Schooll/ Winter Scchool /O.P.N No : ----------/R.C. in-----------------------/STC in ___________ _ _ Durration : --------------------- to ------------1. Fulll Name of thhe Applican nt (block letteer): 2. Adddress for com mmunication (block lettter): witth Phone Noo. & E-mail 3. Daate of Birth : 4. Cateegory : Geneeral/SC/ST/O OBC 5. Maale/Female 6. Religionn : 7. Naame and addrress of the College/: C Unniversity/Insttitution with Ph. 8. The type of Coollege/University/ Govt.//Govt. Sponssored/Autonnomous/Privaate 9. Designation & date of joining to currennt position: (Suubstantive/Temporary/Paart time/Conntractual) 10. Teaching experience : D of OP P/RC attended before : 11. Details 12. Whether W accoommodation is required: Yes/No 13. Weathher awarded Ph.D/ M.Phhil degree: 14. Prromotion duue on : Declaaration : I hereby declarre that the innformation giiven above is i true to the best of my knowledge k a that I shall and abidee by the ruless and regulattions of the UGC-Human U Resource Deevelopment Centre C , Univeersity of Callcutta. Placee : Date : _________________________________ __ Signatture of the Applicant A COMMEND DATION OF THE FORW WARDING AUTHORIT A TY REC I recoommend Dr.//Mr./Mrs---------------------------------------------------------------------------------------------------------------for paarticipation in i Summer School/ S Wintter School/ O.P.No O : ---------R.C. in------------------------/STC in------------i -Durattion :-------------------to ------------------ He/She will be releaseed from the College/Inst C titution/Univversity for thhe duratiion of the abbove course. Placee : Date : Signature of the t Principall/Teacher-Inn-Charge/ Registrar/Heaad of the Insstitution (witth official seeal)
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