Proforma-X APPLICATION FORM FOR CAREER ADVANCEMENT SCHEME-6 TH PAY ASSISTANT LIBRARIAN (AGP Rs. 7000) TO ASSISTANT LIBRARIAN (AGP Rs.

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Proforma-X APPLICATION FORM FOR CAREER ADVANCEMENT SCHEME-6 TH PAY ASSISTANT LIBRARIAN (AGP Rs. 7000) TO ASSISTANT LIBRARIAN (AGP Rs. 8000) 1 Name of applicant - 2 Designation - 3 Discipline - 4 Department - 5 Date of Birth - 6 Date on which M Phil / Ph D degree acquired (attach documentary proof) 7 Date of joining JNKVV - - 8 Date and place of joining at present place College / Research station / KVK 9 Date of joining present post (Assistant Librarian - Rs 15600-39000 + AGP Rs.6000/-) or its corresponding pre revised scale 10 - (i) (ii) Date of promotion as Assistant Librarian in the scale of Rs 15600-39000 + AGP Rs.7000/- or its corresponding pre revised. (enclose copy of administrative order) Date of completion of 5 years services in Assistant Librarian (Rs 15600-39000 + AGP Rs.7000/-) or its corresponding pre revised. 11 (a) Have you applied for promotion under CAS for Assistant Librarian Senior Scale (or its equivalent in revised scale) in VV Notification No Estt. I/ RC/ 13 th CAS/962-963 dated, the 8.12.2011? (b) If yes, date of eligibility in 13 th CAS 12 Details of work performance and other assignment ( Details be furnished in Annexure- I) 1 Signature & name of the applicant

13. Participation in methodology workshop, Training, Teaching Learning- Evaluation Technology Programmes, Soft Skill development Programme, Faculty Development Programme SN Title of the course Period From To Duration Name of Organizing Institute Enclosure proof) DECLARATION I declared that the entre made forgoing information supplied in this form are true and correct and complete to the best of my knowledge and belief and nothing has been concealed / distorted / exaggerated. If at any time, I am found to have concealed / distorted / exaggerated any material information, my appointment shall be liable to be summarily terminated without notice and / or I shall be subjected to disciplinary action. Date Signature of the Applicant 2 Signature & name of the applicant

VIGILANCE CLEARANCE CERTIFICATE [To be furnished and signed by the Controlling / Forwarding Officer] Certified that the undersigned has physically and personally verified that service record of the applicant and thereupon certified that: [i]* There is no vigilance case or departmental enquiry pending or contemplated against him/her. OR The vigilance case or departmental enquiry pending or contemplated against the candidate are listed hereunder. [ii]* No major / minor penalties have been imposed on him / her during his / her service at the Vishwa Vidyalaya. OR The major / minor penalties have been imposed on him / her during his / her services at the Vishwa Vidyalaya are listed hereunder. Dated: Signature of the Dean of the College / ADR / Incharge Research Station/ PC, K.V.K. Strike out which is not applicable CERTIFICATE OF CONTROLLING / FORWARDING OFFICER Certified that the entries made in this form have been verified from official record and found true and correct. This is also certified that applicant has enclosed all desired documents. Dated: Signature of the Dean of the College / ADR / Incharge Research Station/ PC, K.V.K. 3 Signature & name of the applicant

Annexure-I JAWAHARLAL NEHRU KRISHI VISHWA VIDYALAYA, JABALPUR PROMOTIONS UNDER CAREER ADVANCEMENT SCHEME 6 th PAY Assessment of ASSISTANT LIBRARIAN in the Pay Band of Rs.15600-39100 to move from AGP Rs7000 to AGP Rs8000 I. Library Services 1. Library Services: Services rendered in different sections of the Library like Acquisition, Periodicals, Technical, Circulation, Documentation, Computer, Reference etc., Maintenance, SN Activity Period Duration Enclosure 2. Specialized / Additional Services: Services rendered under the following section Binding section Institutional Repositories General T.B.B. Digital Library SC/ST, ST Book Bank Assisting Librarian in Photographic section Administration. 4 Signature & name of the applicant

SN Activity Period Duration Enclosure 3. Teaching offered for PG students (Non credit course) Name of the subject / course Class Academic Year Semester Enclosure (documentary 4. Innovative Library Activities: Conducting Library Usage survey, conducting Book Exhibition, Preparation of Reading list for Students, Creation of Databases OPAC. Attending as a member of University Committee, Special Lecture as a guest. Institution Building Activities SN Activity Period Duration Enclosure 5. Projects. S.N. Title of the project Funding Agency Durati on. a) Competitive projects by the individuals Total Outlay PI / Co-PI Enclosure (documentary b) Project funded by Govt. / University /ICAR * Certificate issued by competent authority 5 Signature & Name of applicant

II.Published Work during the Assessment Period a) For each full length article published in refereed journal SN Title Author(s) Journal name Vol. & Page Year Enclosure b) Book Published / Edited SN Title Author(s) / Editor(s) i Recognized publishers with ISBN ISBN no. Publisher Year Enclosure ii Chapters in standard books with ISBN iii Published individually iv Research/ Extension Bulletin c.) SN Title Author(s) / Editor(s) i Research note/ communication in a journal ISBN no. Publisher Year Enclosure ii Abstract in symposium/ seminar/ workshop/ training manual/ proceedings of the workshop Title of paper/article Author(s) Organizer Name of event Year Enclosure iii Popular article/ leaflet Title of paper/article Author(s) Publisher Year Enclosure 6 Signature & Name of applicant

III. Summer Schools/ Winter Schools/ Refresher Course/ Special Training/ Symposia/ Seminar/ Workshop/ Conference SN Activity Title Organizing Institute a For Organizing each activity as in the title Period Duration Enclosure evidence) b For participation in Summer School/ Winter School/ Refresher Course/ Orientation Course of more than 10 days duration c For participation in Special Training/ Orientation Programmes/ Symposia / Seminars / Conferences / Workshops / etc. (except Annual Workshop) d Involved as member in group meet organization of above activities IV. International Exposure- International visits/training/courses (outside India only) SN Exposure / event Country Period Enclosure evidence) V. Awards/ Distinctions Received SN Award Awarding Instt. Year Enclosure evidence) a International Award b c d e National Award State Award University Award Professional Society Award- Best paper award/best poster presentation award / Best paper presentation award in any journal/ conference/ seminar/ symposium etc. will be treated as Professional Society Award. 7 Signature & Name of applicant

VI. Corporate / Other Activities a) Activities performed as External Examination Coordinator Associate Coordinator/ Warden/ Staff Advisor/ Tour Leader and Co-Tour leader (State/ All India)/ NSS Programme Officer NSS / Indian Redcross Society Programme Officer/ Coordinator/ NCC Officer/ Farm Management/ Academic, General, Financial Management (as AO/ DAO/ AAO/ Dy.R/ AR/ DC/ AC/ Dy. Librairan/ Asst. Librarian etc.)/ Scrutinizing UG/PG grades/ PG coordinator/seminar incharge. Leader / member in monitoring team. SN Activity Period Duration Enclosure b) Activities performed as Member - Co-chairman Chairman of different committees of National International activities/ RAWE Assoc. Coordinator participation in RAWE camp/ Internship/ Tournament Organized/ Spl. Officer of SC-ST Cell/ Minority Cell/ Technical Assistant (Part-time)/ Students Counselor/ Leader for exposure visit of Farmers/ Liaison Officer for BOM/VIP s tours assigned by the University/ Participation in Melas/ Exhibitions as State, National, International levels representing University/ Member/ Co-Chairman in different committees of JNKVV activities/ Team Manager and Co-Team Manager to Sports/ Cultural Activities/ Stock verifying Officer/ Anti-ragging squad member/ grade point conversion work/ worked as Rapporteur/ Co- Chairman in the National/ International Conferences, Seminars, Workshops/ Symposium etc., Member of Class and Exam time-table committee, Member in monitoring team/ Press meet work/ participation in UG&PG admission/ member of monitoring team / member involve in organization, selection of Farmers / Teachers for nomination to various awards Any other activities duly signed by the controlling officer SN Activity Period Duration Enclosure VII. Out-Station Service SN Place of Posting Period Duration City Class- A/B/C/other Enclosure 8 Signature & Name of applicant