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(e) Subject:
(f) Specialization:
2. Details of Educational Qualifications (from Graduation onwards to final degree) (Please attach self-
attested mark sheets and certificates/Degrees)
Degree/ Exam University/College/ Specialization Year of Percentage Division Duration of
passed (with Board /Subjects Passing Marks/ /Grade Course
discipline) Grade
Obtained
Graduation*
Post Graduation*
M. Phil
Ph. D
10. Details of Conferences/Seminars, etc., attended and paper(s) presented (please attach self-
attested proof of presentations)*
Name of Conference When and Where
(a) International
(b) National
4
15. Membership/ Fellowship of the Professional Societies, if any (Please attach self-attested proof and details in a
separate sheet)
16. Extra –curricular Activities/ Administrative Responsibilities handled: (Please attach self-attested proof and details
in a separate sheet)
17. Any other information in favour of the candidature of the applicant: (Please attach self-attested proof and details
in a separate sheet)
(j) Email ID
(k) Phone No with STD Code
(l) Mobile No.
(m) Adhar card No. (Pleaseattach self-attested valid proof)
23. General
i. Are you willing to accept the initial pay of the grade? Yes/No
(If no, state the minimum pay acceptable or expected
with justification for the same)
ii. Period needed for joining the duties, if the post is
offered
24. References: Give Name, Designation and Address, Email, Mobile,& Phone No. of three Referees who are
acquainted with your Teaching /Research/Professional work
I.
II.
III.
Declaration
I, hereby, declare that I have carefully read and understood the instructions and particulars advertised, and
that all the information provided by me in this application are true to the best of my knowledge and belief. If at any
time I am found to have concealed/suppressed any material/information or given any false detail, my appointment
shall be liable to be summarily terminated without notice or compensation.
Date:-
Primary Information
(c) Achievements
Mention significant achievements
(if any)
(d) Experience (No. of years)
Total In India Abroad Teaching Research Industry Industrial Administrative
Research
8
(e) Publications
Number of Publications
Refereed Conference Books Chapters in Reviews Articles
Journals Presentations Books
(f) Patents
Name Application No. Granted/Applied
S. No Category Yes No
1. Industrial experience
2. Sponsored/Institutional Research Project experience
3. Consultancy experience
4. Experience concurrently with Ph. D
5. Post-Doctoral Research Work
6. List of courses taught to Undergraduate, Post Graduate, M.Phil and
Doctoral research level
7. Details of setting up of Laboratories
8. Any other relevant information
(Pleaseattach self-attestedproof)
Date:
Place: Signature of the Applicant
10
Annexure - I
Criteria for calculating Academic/Research Score
(Based on duly attested evidence produced, such as, copy of publications, project sanction letter,
utilization and completion certificates issued by the University, and acknowledgements for patent filing
and approval letters, students’ Ph.D. award letter, etc,.)
(b) More than two authors: 70% of total value of publication for the
First/Principal/Corresponding author and 30% of total value of publication for each of
the joint authors.
Joint Projects: Principal Investigator and Co-investigator would get 50% each.
Note:
Paper presented If part of edited book or proceeding can be claimed only once.
For joint supervision of research students, the formula shall be 70% of the total score for
Supervisor and Co-supervisor. Supervisor and Co-supervisor, both shall get 7 marks each.
*For the purpose of calculating research score of the teacher, the combined research score
from the categories of 5(b). Policy Document and 6. Invited lectures/Resource Person/Paper
presentation shall have an upper capping of thirty percent of the total research score of the
teacher concerned.
The research score shall be from the minimum of three categories out of six categories.
XXX
I hereby certify that the above given information is true to the best of my knowledge.