FACULTY RECRUITMENT - 2017

PERSONAL PROFILE (To be written legibly or typed neatly)

APLICATION ID NO.______

APPLICATION FOR THE POST OF ______in______
______(Department), SPECIALIZATION______

1.Name in Full: Mr. / Ms. ______

(In Block Letters)

2. a) Father’s Name: ______Occupation: ______

b) Mother’s Name: ______Occupation: ______

3. Nationality: ______Place of Birth: ______

Date of Birth: ___/____/______Age:______Marital Status:______

4. i) Address for :

Correspondence / Permanent
Phone No. / Mobile No.
Aadhaar No. / E-mail ID
PAN No.
5. Category: / SC / ST / OBC* / UR / PWD

* Indicate if belonging to Creamy Layer… Yes / No

(Enclose OBC Certificate along with IncomeCertificate issued inFY 2017-18)

6. Particulars of Educational Qualifications:

Sl. No. /
Degree Obtained &
Branch / Specialization
(specify) / Name of the University/Institute / Year of Passing / % of Marks/ CGPA / Class/ Division
1 / SSC / Matriculation
2 / Intermediate / 10+2
3 / Bachelor’s Degree
4 / Master’s Degree
5 / Ph.D. Degree(with Title of the Thesis)
6 / Others (if any)
N.B.: / Photo copies of documents in support of claims made by the candidate in respect of date of birth, academic qualifications, practical training, experience, caste, projects, publications, consultancy etc. to be enclosed along with this Personal Profile)

7. Experience:

Total Experience: Years Post Ph.D. Experience: Years
Name of the Organisation / Position / Basic Pay / AGP / From / To
8. Publications:
No. of Publications / National / International
JournalPapers (SCI/Scopus)
Journal Papers (Others)
Papers in ConferenceProceedings
Books
Chapters in Books
9.PatentsAwarded:______Filed:______
10. Ph.D. thesis Guided: ______(Completed)______(On going)
11. R & D and Consultancy (attach separate list, if necessary)
Projects / R & D / Consultancy
Amount / Year / Amount / Year
12.Awards / Distinctions, if any: ______
13.Administrative Responsibilities held:
Sl. No. / Name of the Organisation / Designation / Duration/Period
1.
2.
3.

14.Details of present employment:

Name of the Organisation / Position / Basic Pay / AGP / From / To

15. Joining time required, if selected: ______

16. References:

S.No / Name & Designation / Mobile No. / Email Id
1.
2.
3.

Declaration:

I hereby solemnly declare that the information furnished above is true,correct and I vouch for the veracity of the same.

Place:

Date: - -2018 Signature of the Applicant

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