Application Form for Admission Short-Term Courses Academic Writing, Research and Publication Ethics (Offline) From 2025-01-08 To 2025-01-14 Application No: STC00150 1. Personal Information Please upload a recent Passport size Photo (max 300kb)
Name of the teacher APARNA RADHAKRISHNAN
(in block letters initials after name) Date of Birth & Age 13/10/1987 Sex female Educational Qualifications (Copy of M.Phil / Ph.D certificates should be attached) Community General Residential Address TC 23/167.1, SARADA, Valaisala, TVM-36 Phone No 8468990086 (with STD Code) Mobile No 8468990086 Email aparna.r@kau.in Mailing Address TC 23/167.1, SARADA, Valaisala, TVM-36 2. Details of Employment Designation Assistant Professor Subject Agricultural Extension Basic pay & Scale of Pay 66800 Address of the College / University / CoA Vellayani, TVM Dept of Name of the Affiliating University Kerala Agricultural University 3. Details of Teaching Experience Date of regular Appointment 0019-03-20 Copy of appointment order should be attached Teaching Experience (5) Year's (9 Months) (College / University) Classes handling PG Research Guidance phd 3a. Details of Courses Attended Earlier Orientation Programme Course Institution From (0000-00-00) To (0000-00-00) Refresher Courses Institution From (0000-00-00) To (0000-00-00) Short-Term Courses Institution From (0000-00-00) To (0000-00-00) I hereby undertake to participate in the Course and to do the project work as per rules. I shall abide by the rules and regulations of the UGC-HRDC from time to time. The particulars given above are true to the best of my knowledge and belief. Upload Signature of the Applicant with date
CERTIFICATE OF RECOMMENDATION FROM THE PRINCIPAL /HOD/HOI
I recommend Dr. / Mr. / Ms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Assistant Professor / Associate Professor / Professor/Librarian / Any others (Specify) (Strike off which ever is not applicable) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . for the (Course Details) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . in . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . He /She will be relieved in time to participate in the above course at HRDC, if selected. Certified that this College is affiliated to . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . University for the last two years. Also certified that the service and other details given in the application are verified and found correct Place : Signature of the Principal /HOD/HOI Date : with Office seal
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