UGC-HUMAN RESOURCE DEVELOPMENT CENTRE (HRDC) PANJAB UNIVERSITY, CHANDIGARH -160014 Ph: 0172-2541425, 2534031, 2534032, Fax: 2541425 E-Mail: hrdcpuchd@gmail.com; helpdesk.hrdc@pu.ac.in Application Form for Orientation Programme Course Name_______________________________________________________________________________ Attested Photograph Affix Here From________________________________________ to____________________________________________ (Dates) Incomplete Forms Will Be Cancelled Without Intimation Name: Dr/Mr/Ms._________________________________________________________________________________________ Date of Birth: _______________________________________Male/Female/Transgender______________________________________ Category (GEN./SC/ST/OBC): _____________________________State_______________________________Nationality_________________________ Name of College/University: __________________________________________________________________________________________________ With Phone/Fax No. __________________________________________________________________________________________________ Affiliating University: __________________________________________________________________________________________________ Residential Address: __________________________________________________________________________________________________ With Phone/Mob. No. /E-Mail: __________________________________________________________________________________________________ __________________________________________________________________________________________________ Qualification: __________________________________________________________________________________________________ Designation: Lecturer/Sr. Lecturer/Selection Grade Lecturer/Assistant Professor/Associate Professor Teaching Subject: ___________________________________________Specialization___________________________________________ Status of Appointment: Adhoc/Temporary/Permanent/Teacher Fellow or not_______________________________________________________ Date of Joining in Present/Earlier Service if any______________________________________________________________________________________ 1. I have not attended any Orientation Programme in my career. 2. I have attended 1/2/3 Refresher Course earlier. Accommodation required at HRDC transit hostel: ____________________________________________________________________________________ The above information is true to my knowledge and I shall be responsible for any false statement. Signature of the Applicant I certified that: Our college is included in the list of institution under section 2(f) of the UGC Act. Our college does not come within the preview of section 2(f) of the UGC Act but has been affiliated to the University of ______________________ for the last 5 years/more than 5 years. The information given above by the applicant is true, complete and correct and his/her selection has been approved by the concerned authority. The application is forwarded with the recommendation that when selected he/she will be relieved in time to participate in the course. Dated: ____________________ Signature Principal/Head/Registrar with Official Seal
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