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UNIVERSITY OF AGRICULTURAL SCIENCES C¨sÀåyðAiÀÄ

EwÛÃa£À
RAICHUR – 584 102 (KARNATAKA) ¨sÁªÀavÀæ
(website: http://www.uasraichur.edu.in) ®UÀwÛ¸ÀĪÀÅzÀÄ

²PÀëPÉÃvÀgÀ £ËPÀgÀgÀ £ÉêÀÄPÁwUÁV Cfð

APPLICATION FORM FOR APPOINTMENT OF SERVICE PERSONNEL

ºÉ¸ÀgÀÄ
Name

AiÀiÁªÀ ºÀÄzÉÝUÉ Cfð

Post Applied for

eÁ»ÃgÁw£À ¸ÀASÉå ªÀÄvÀÄÛ ¢£ÁAPÀ : Advt.No.R/UASR/Rectt/Advt.3/2010 dt. 29.11.2010

Advertisement No. & Date

rr-¥ÉÆøÀÖ¯ï DqÀðgï ¸ÀASÉå ªÀÄvÀÄÛ ¢£ÁAPÀ

DD / Postal Order No. & Date

INSTRUCTIONS TO THE CANDIDATES - C¨sÀåyðUÀ½UÉ ¸ÀÆZÀ£ÉUÀ¼ÀÄ:

1. The application should be filled in by the applicant in his/her own handwriting.

1. CfðAiÀÄ£ÀÄß C¨sÀåyðUÀ¼ÀÄ vÀªÀÄä PÉʧgÀºÀ¢AzÀ ¨sÀwðªÀiÁqÀ¨ÉÃPÀÄ.
2. Please answer each item clearly, legibly and completely.
2. CfðAiÀÄ°ègÀĪÀ J¯Áè PÀ®ªÀÄÄUÀ¼À£ÀÄß ¸ÀàµÀÖªÁV ¥ÀÆtðªÁV GvÀÛj¸ÀĪÀÅzÀÄ.
3. Incomplete applications are liable to be rejected.
3. C¥ÀÆtð CfðUÀ¼À£ÀÄß wgÀ¸ÀÌøvÀUÉƼÀĪÀªÀÅ.
4. The application form downloaded from the website should accompany the requisite fee
(i.e. for SC/ST Rs. 250/- & for others Rs. 500/-) in the form of IPO / DD (Drawn in
favour of “The Comptroller, UAS, Raichur”) at the time of submission of filled-in
application, or else, the application will be rejected.
4. Cfð £ÀªÀÄÆ£ÉUÀ¼À£ÀÄß ««AiÀÄ ªÉ¨ï¸ÉÊn¤AzÀ qË£À¯ÉÆÃqÀ ªÀiÁrzÀ £ÀAvÀgÀ CªÀÅUÀ¼À£ÀÄß ¨sÀwð
ªÀiÁr gÀÆ.500/- rr CxÀªÁ L¦M (¥ÀeÁ/¥À¥ÀA zÀªÀjUÉ gÀÆ.250/-)(ºÀtPÁ¸ÀÄ
¤AiÀÄAvÀæuÁ¢üPÁjUÀ¼ÀÄ, PÀÈ««, gÁAiÀÄZÀÆgÀ EªÀgÀ ºÉ¸Àj£À°è) ®UÀwÛ¹ ¸À°è¸ÀvÀPÀÌzÀÄÝ. rr CxÀªÁ
L¦N ®UÀwÛ¸ÀzÉà EgÀĪÀ CfðUÀ¼À£ÀÄß wgÀ¸ÀÌj¸À¯ÁUÀĪÀÅzÀÄ.

1
 Cfð £ÀªÀÄÆ£É
APPLICATION FORM
1. AiÀiÁªÀ ºÀÄzÉÝUÉ ¤ÃªÀÅ C¨sÀåyð
1. Name of the post applied for

2. ¥ÀÆtð ºÉ¸ÀgÀÄ
2. Name in full (BLOCK LETTERS)
(as entered in SSLC or equivalent )

3. CAZÉ «¼Á¸À (¥ÀvÀæ ªÀåªÀºÁgÀ

ªÀiÁqÀ¨ÉÃPÁzÀ «¼Á¸ÀªÀ£ÀÄß
£ÀªÀÄÆ¢¸ÀvÀPÀÌzÀÄÝ.)
3. Address (indicate only address to
which all communications are to be
sent)

Phone No:

Mobile No :
4. d£Àä ¢£ÁAPÀ ªÀÄvÀÄÛ eÁ»ÃgÁw£À°è
UÉÆvÀÄÛ¥Àr¹zÀ ¢£ÁAPÀzÀAzÀÄ ªÀAiÀĸÀÄì
(gÀÄdĪÁvÀÄ¥Àr¸ÀĪÀ ¥ÀvÀæzÀ ¥ÀæwAiÀÄ£ÀÄß
®UÀwÛ¸ÀPÀÌzÀÄÝ)
4. Date of birth in words and age on the
date of advertisement (Enclose the
attested copy)
5. d£Àä¸ÀܼÀ (UÁæªÀÄ, vÁ®ÆèPÀÄ, f¯Éè d£Àä¸ÀܼÀ:
ªÀÄvÀÄÛ gÁdåzÀ ºÉ¸ÀgÀ£ÀÄß §gÉAiÀÄvÀPÀÌzÀÄÝ) UÁæªÀÄ :
5. Place of birth (Name of Village or
Town, Taluka, District and State to vÁ®ÆèPÀÄ :
which the candidate belongs should be f¯Éè:
stated)
gÁdå:
6. C) zsÀªÀÄð
6. a) Religion
D) eÁw / G¥À eÁw
b) Caste / Sub-caste

PÀ) ¤ÃªÀÅ ¥Àj²µÀÖ eÁw, ¥Àj²µÀÖ

¥ÀAUÀqÀPÉÌ ¸ÉÃjzÀªÀgÉÃ? ºÁVzÀÝgÉ
PÉÆëģÀ CxÀªÁ eÁwAiÀÄ ºÉ¸ÀgÀ£ÀÄß SC / ST (please tick)
w½¹ (¸ÀA§AzsÀ¥ÀlÖ C¢üPÁjUÀ½AzÀ
¥ÀqÉzÀ ¥ÀæªÀiÁt¥ÀvÀæ ®UÀwÛ¹)

2
 c) Are you a member of the
Scheduled Castes or the
Scheduled Tribes? If so, mention
the caste or the tribe and enclose a
certificate from competent authority
PÀ) PÀ£ÁðlPÀ ¸ÀPÁðgÀzÀªÀgÀÄ ªÀiÁrgÀĪÀ
ªÀVðÃPÀgÀtPÀÌ£ÀĸÁgÀªÁw ¤ÃªÀÅ
»AzÀĽzÀ ªÀUÀðPÉÌ ¸ÉÃjzÀªÀgÉ?
ºÁUÁzÀgÉ ¸ÀÆPÀÛ C¢üPÁjUÀ½AzÀ Cat. I 2A 2B 3A 3B
¸ÀA§AzsÀ¥ÀlÖ ¥ÀæªÀiÁt ¥ÀvÀæªÀ£ÀÄß (please tick)
®UÀwÛ¹. (ºËzÀÄ JAzÀÄ
GvÀÛj¹zÀ°è «ªÀgÀUÀ¼À£ÀÄß PÉÆr)
c) Are you a member of Backward
Class according to the classification
made by the Govt. of Karnataka.
Enclose the certificate from
appropriate authority (if the answer
is ‘YES’ give particulars)
d)
E) PÀ£ÁðlPÀ ¸ÀPÁðgÀzÀªÀgÀÄ ªÀiÁrgÀĪÀ
ªÀVðÃPÀgÀtPÀÌ£ÀĸÁgÀªÁV ¤ÃªÀÅ UÁæ«ÄÃt / ªÀÄ»¼Á / ªÀiÁf ¸ÉʤPÀgÀÄ
AiÀiÁªÀÅzÁzÀgÀÆ ¸ÉàõÀ¯ï PÁålUÀjUÉ
PÀ£ÀßqÀ ªÀiÁzsÀåªÀÄ / CAUÀ«PÀ®gÀÄ
¸ÉÃjgÀÄwÛÃgÁ? ºÁUÁzÀgÉ ¸ÀÆPÀÛ
C¢üPÁjUÀ½AzÀ ¸ÀA§AzsÀ¥ÀlÖ AiÉÆÃd£Á ¤gÁ²ðvÀÄ (UÀÄgÀÄvÀÄ ªÀiÁr)
¥ÀæªÀiÁt ¥ÀvÀæªÀ£ÀÄß ®UÀwÛ¹.
e) Do you belong to any Special
Category? If, yes enclose the Rural / Woman / Ex-serviceman /
certificate from appropriate
authority (please tick the category) Kannada Medium / Physically Handicapped /

Project Displaced Person

F) ¤ÃªÀÅ gÀPÀëuÁzÀ¼ÀzÀ ¸ÉêɬÄAzÀ
¤ªÀÈvÀÛgÁzÀªÀgÉ? CxÀªÁ
CAUÀ«PÀ®gÉÃ? ºÁVzÀÝgÉ CzÀ£ÀÄß
gÀÄdĪÁvÀÄ¥Àr¸ÀĪÀ ¥ÀæªÀiÁt ¥ÀvÀæzÀ
¥ÀæwUÀ¼À£ÀÄß ®UÀwÛ¹.
f) Are you a person discharged from
military service or a physically
handicapped? If so, attach a copy
of the certificate in proof of it

7. vÀAzÉAiÀÄ CxÀªÁ ¥ÉÆõÀPÀgÀ ºÉ¸ÀgÀÄ,

«¼Á¸À, gÁ¶ÖçÃAiÀÄvÉ ªÀÄvÀÄÛ ªÀÈwÛ
7. Name of the Father or Guardian,
address, nationality and present
occupation

3
 8. ¤ÃªÀÅ ²PÀët ¥ÀqÉzÀ «ªÀgÀUÀ¼ÀÄ
8. Particulars of Education
7£ÉÃ,
J¸ï.J¸ï.J¯ï.¹.
¦AiÀÄĹ /
r¥ÉÆèêÀiÁ/ ¥ÀjÃPÁë ªÀÄAqÀ½/
¥ÀzÀ« MlÄÖ UÀ½¹zÀ ±ÉÃPÀqÀ vÉUÉzÀÄPÉÆAqÀ vÉÃUÀðqÉAiÀiÁzÀ «±Àé«zÁå®AiÀÄUÀ¼À
¥ÀjÃPÉëUÀ¼À°è UÀÄtUÀ¼ÀÄ UÀÄtUÀ¼ÀÄ «µÀAiÀÄUÀ¼ÀÄ ªÀµÀð ºÉ¸ÀgÀÄ
Percentage
vÉÃUÀðqÉ of Marks
Total Marks Subjects Year of Name of Board of
7th, Marks Obtained Obtained taken Passing Examination/
SSLC/PUC/ University
Diploma /
Degree / Post-
Graduate
passed

¸ÀÆZÀ£É: ¥ÀæªÀiÁt ¥ÀvÀæzÀ ¥ÀæwUÀ¼À£ÀÄß ®UÀwÛ¸À¨ÉÃPÀÄ

Note: The copies of Certificates should be enclosed without fail.

4
 9. ¤ÃªÀÅ w½¸À§AiÀĸÀĪÀ EvÀgÉ ¥ÀjÃPÉëUÀ¼ÀÄ/CºÀðvÉUÀ¼ÀÄ (¸ÁßvÀPÉÆÃvÀÛgÀ r¥ÉÆèêÀiÁ / ¸ÁßvÀPÉÆÃvÀÛgÀ
ºÉaÑ£À vÀgÀ¨ÉÃw / E¯ÁSÉAiÀÄ ¥ÀjÃPÉëUÀ¼ÀÄ, ªÁtÂdå ¥ÀjÃPÉëUÀ¼ÀÄ, PÀȶ vÀgÀ¨ÉÃw / UÀtPÀAiÀÄAvÀæ
vÀgÀ¨ÉÃw EvÁå¢)
9. Additional qualifications (viz., PG / PG. Dip / Higher Training / Departmental Examinations /
Commercial Examinations / Agricultural Training / Computer Training etc.)

MlÄÖ UÀ½¹zÀ CºÀðvÁ ¥ÀvÀæUÀ¼À£ÀÄß PÉÆlÖ

vÉÃUÀðqÉAiÀiÁzÀ ±ÉÃPÀqÀ vÉÃUÀðqÉAiÀiÁzÀ
¸ÀA¸ÉÜAiÀÄ ºÉ¸ÀgÀÄ
¥ÀjÃPÉëUÀ¼À «ªÀgÀUÀ¼ÀÄ UÀÄtUÀ¼ÀÄ UÀÄtUÀ¼ÀÄ Percentage ªÀµÀð
of Marks Name of Institution
Examination Total Marks Year of
Obtained awarding the
passed Marks Obtained Passing
Certificate

¸ÀÆZÀ£É: ¥ÀæªÀiÁt ¥ÀvÀæzÀ ¥ÀæwUÀ¼À£ÀÄß ®UÀwÛ¸À¨ÉÃPÀÄ

Note: The copies of Certificates should be enclosed without fail.

10. £ËPÀjAiÀÄ «ªÀgÀUÀ¼ÀÄ (C£ÀĨsÀªÀ)

10. Particulars of employment (Experience)
GzÉÆåÃUÀzÁvÀgÀ ºÀÄzÉÝAiÀÄ ºÉ¸ÀgÀÄ EAzÀ __ UÉ __ ªÉÃvÀ£À ¥ÀqÉAiÀÄÄwÛgÀĪÀÅzÀgÀ §UÉÎ
ºÉ¸ÀgÀÄ ªÀÄvÀÄÛ Designation of From __ To __ «ªÀgÀUÀ¼À£ÀÄß PÉÆr
«¼Á¸À Post held Salary drawn details
Name of the
Employer

¸ÀÆZÀ£É: ¥ÀæªÀiÁt ¥ÀvÀæzÀ ¥ÀæwUÀ¼À£ÀÄß ®UÀwÛ¸À¨ÉÃPÀÄ

Note: The copies of Certificates should be enclosed without fail.

5
11. ®UÀwÛ¹zÀ zÁR¯ÉUÀ¼À ¥ÀæwUÀ¼À ¥ÀnÖ:
List of documents attached:

12. ¤ÃªÀÅ w½¸À §AiÀĸÀĪÀ EvÀgÀ «µÀAiÀÄUÀ¼ÀÄ:

Any other information

ªÉÄÃ¯É PÉÆnÖgÀĪÀ ªÀiÁ»w £Á£ÀÄ w½¢gÀĪÀµÀÄÖ ªÀÄvÀÄÛ £ÀA§ÄªÀµÀÖgÀ ªÀÄnÖUÉ ¸ÀvÀåªÉAzÀÆ,

¸ÀªÀÄUÀæªÉAzÀÆ ¥ÀæªÀiÁt ªÀiÁqÀÄvÉÛãÉ.
I hereby declare and certify that the entries furnished above are true to the best of my
knowledge and belief.

¸ÀܼÀ:
Place:

¢£ÁAPÀ:
Date: CfðzÁgÀ£À ¸À»
SIGNATURE OF THE APPLICANT

6
 GzÉÆåÃUÀzÁvÀgÀ CxÀªÁ ¤AiÉÆÃdPÀgÀ gÀªÁ£É CºÀðvÁ ¥ÀvÀæ
Forwardal Certificate by the Employer

F CºÀðvÁ ¥ÀvÀæªÉãÉAzÀgÉ ²æÃ/²æêÀÄw/PÀÄ _________________________EªÀgÀÄ F ¸ÀA¸ÉÜ/

E¯ÁSÉAiÀÄ ____________________________ ºÀÄzÉÝAiÀÄ°è ____________________
¢£ÁAPÀ¢AzÀ _____________________ªÀgÉUÉ gÀÆ. ________________ªÉÃvÀ£À
±ÉæÃtÂAiÀÄ°è PÉ®¸À ªÀiÁqÀÄwÛzÁÝgÉ. EªÀ£À/EªÀ¼À FV£À ªÀÄÆ® ªÉÃvÀ£À gÀÆ.
______________________G½zÀ ¨sÀvÉåUÀ¼ÀÄ gÀÆ.___________________ EgÀÄvÀÛªÉ.
EªÀ£À/EªÀ¼À CfðAiÀÄ£ÀÄß PÀȶ «±Àé«zÁå®AiÀÄ, gÁAiÀÄZÀÆgÀ ºÀÄzÉÝAiÀÄ £ÉêÀÄPÁwAiÀÄ ¸À®ÄªÁV
PÀ½¸À®Ä £ÀªÀÄäzÉãÀÆ C¨sÀåAvÀgÀ«®è.
Certified that Mr./Ms. ______________________________is working in the Department / Institute
/ Organization as ___________________________ w.e.f. ___________ in the scale of Rs.
_________. He / She is at present drawing a basic pay of Rs. _________. The DA and other
allowances amount to Rs.________________________________.
We have no objection in forwarding his / her application for employment in the University of
Agricultural Sciences, Raichur.
¸ÀܼÀ:
Place:

¢£ÁAPÀ: ¸À» ªÀÄvÀÄÛ PÀbÉÃjAiÀÄ ªÀÄÄzÉæ

Date: Signature and Designation

Forwardal Certificate (Applicable to UAS, Raichur Employees

(Regular/Temp/MRE/DRE/DW/Contract etc.,)
F CºÀðvÁ ¥ÀvÀæªÉãÉAzÀgÉ ²æÃ/²æêÀÄw/PÀÄ __________________________EªÀgÀÄ F
PÀbÉÃj/ªÀĺÁ«zÁå®AiÀÄ/ ¸ÀA±ÉÆÃzsÀ£Á PÉÃAzÀæzÀ __________________________ºÀÄzÉÝAiÀÄ°è
________________________¢£ÁAPÀ¢AzÀ ________________________ªÀgÉUÉ PÉ®¸À
ªÀiÁqÀÄwÛzÁÝgÉ. EªÀ£À/EªÀ¼À FV£À ªÉÃvÀ£À ±ÉæÃt gÀÆ. _________________EzÀÄÝ, ªÀÄÆ®
ªÉÃvÀ£À gÀÆ. ______________________ EgÀÄvÀÛzÉ.
Certified that Mr. / Ms. ________________________________ is working this Office / College /
Research Station as _______________________ w.e.f. ___________ in the scale of Rs._______.
His / Her present basic pay is Rs.__________.

¸ÀܼÀ:
Place:
¢£ÁAPÀ: ¸À» ªÀÄvÀÄÛ PÀbÉÃjAiÀÄ ªÀÄÄzÉæ
Date: Signature and Designation

7
 GUIDELINES FOR THE CANDIDATES APPLYING FOR THE POSTS OF
SERVICE PERSONNEL IN UAS, RAICHUR

1. The entire notification and application pro-forma along with the detailed qualifications
prescribed for each of the posts notified are accessible from the official web site
(http://www.uasraichur.edu.in) of UAS, Raichur.
2. Separate applications with separate prescribed fees are required for each of the posts applied
for. Application for two different posts should not be tagged together.
3. Number of vacancies notified are provisional and is subject to variation.
4. The University reserves the right to fill-in any or all the vacancies.
5. Candidates already in service (Government/Quasi-Government or private) should submit their
applications through proper channel. Candidates anticipating delay in sending their
applications through proper channel may submit an advance copy of the application along with
the processing fee. The original application duly forwarded by the parent office must reach this
office within a fortnight after the last date prescribed for submission of filled in applications.
Such of the candidates who do not forward their applications through the parent office have to
produce a No Objection Certificate at the time of interview, failing which they will not be
allowed to appear for the interview.
6. As per the stipulations in the Government Order No.SiAaSuI:08:SaHiMa:95, Bangalore, dt.
20.6.1995, in case of non-availability of eligible candidates belonging to Other Backward
Classes viz., Cat. I, 2A, 2B, 3A and 3B, the posts earmarked for the said categories shall be
filled-up by candidates belonging to General Merit and the unfilled roster shall be carried
forward in the future advertisements.
7. Candidates claiming reservation under Rural Category quota should enclose the certificate of
study in rural areas (for 10 full academic years from 1st to 10th standards) issued by the
competent authorities.
8. Candidates claiming reservation under Kannada Medium Quota should enclose the certificate
of study in Kannada medium (for 10 full academic years from 1st to 10th standards) issued by
the competent authorities.
9. Further, in case of non-availability of candidates belonging to special categories under
horizontal reservation such as Rural, Women, Kannada Medium & Ex-servicemen categories,
the posts earmarked for the said categories shall be filled-up by other candidates belonging to
the respective reservations as per the provisions of the Government Order
No.SiAaSuI:08:SaHiMa:95, Bangalore, dt. 20.6.1995.
10. The applicants belonging to General category & Cat.2A/2B/3A/3B, who claim reservation
under Rural candidate quota, have to produce a certificate issued by the competent authority
confirming that they do not come under the purview of creamy layer in the prescribed form,
while submitting the application form, as per the Government Circular
No.SaKaI:26:BiCiA:2002, dt. 6.3.2002.
11. Ex-servicemen or children of defence personnel killed or disabled in action are exempted from
payment of application fee provided they furnish appropriate certificate along with the filled-in
applications.
12. The University reserves the right of posting the selected candidates to any of the institutions
under its control. The candidates are also liable to be transferred against equivalent posts in
any of the Institutions of the University.
13. Applicants, if called for interview should be prepared to appear before the selection committee,
at their own cost at the place indicated.
14. Applications received after the last date and incomplete applications will be rejected.
15. Only the candidates belonging to SC/ST would be considered against the respective reserved
posts. As such, other candidates NEED NOT APPLY against the reserved post/s.

8
16. Roaster for SC/ST and other backward classes are followed as per Rules in force in the
Government of Karnataka.
17. The minimum and maximum age prescribed is 18 and 40 years, respectively, for service
personnel. However, there is no age limit for inservice candidates including MREs & DREs.
18. The age of retirement in the University is 60 years.
19. The selected candidates shall be on probation for a period of one year from the date of joining.
20. The rate of Dearness Allowance and other allowances, if any, shall be as determined by the
University / Government from time to time.
21. Conditions of service in the University shall be as prescribed under the Act, Statutes and C
& R Regulations and Guidelines of the University.
22. Persons with working knowledge of Kannada will be given preference.
23. Any pressure brought on the Selection Committee or the members of the Board of
Management by a candidate will disqualify the candidature for the post.
24. The prescribed Essential Qualifications are minimum and possessing of same does not entitle
the candidates to be called for interview. Where the number of applicants is large, the
University may restrict the number of candidates for interview to a reasonable limit
(10 candidates for one post) based upon the merit of the qualifications prescribed for the
respective post. However, the candidates (Regular / Temporary / MRE / DRE / Daily wages /
Contract etc.) working in UAS, Raichur are exempted from this condition.
25. For all recruitments to the posts in the University, other things being equal, the University
employees (Regular/Temporary/MRE/DRE/DW/Contract etc.) shall be given preference.
26. Filled-in applications together with attested copies of testimonials and prescribed fees in the
form of requisite Indian Postal Order / Demand Draft (Rs. 250/- for SC/ST candidates and
Rs. 500/- for other candidates) drawn in favour of “THE COMPTROLLER, UAS, RAICHUR”
within the period from 29-11-2010 to 31-12-2010 should be sent in an envelope,
superscribing on it, “APPLICATION FOR THE POST OF __________________
_____________ ” to “THE REGISTRAR, UNIVERSITY OF AGRICULTURAL SCIENCES,
P.B.No. 329, RAICHUR-584 102” on or before 31-12-2010 at 4 PM.
27. Practical tests shall be conducted for the posts of Service Personnel wherever required for
recruitment, before interview.
28. Working hours of the University: 9.00 AM to 5.00 PM., Saturday: 9.00 AM to 1.00 PM.

(P. BALAKRISHNAN)
REGISTRAR
UAS, RAICHUR