Kanjirappally, Koovappally P.O, Kottayam Dist.

, Kerala - 686518
Afliated to Mahatma Gandhi University, Kottayam & Approved by AICTE, New Delhi
JOB APPLICATION FORM - 01

OFFICE USE ONLY

Afx
recent
passport
size
photograph

Application No.
Interview Date:
Selected:

Yes

No

Reference: Advertisement in .................................................................... dated .................................

1. Name of the Applicant:
2. For the post of:

Professor

3. In the dept. of:

AU

Chemical

MCA

Associate Professor
CE
Maths

CS

EC

Assistant Professor
EE

Physics

IT

Chemistry

ME

MT

Humanities

4. Qualication

Degree

Specialization

Full Time/
Agg. %
Year of Part time/ Class/
or
Passing Distance Position
CGPA
Education

Institution

University

5. EXPERIENCE
a). Teaching Experience ( in Engineering colleges / Institutes of Higher Educations only)
Sl.
No.

Designation

Institution

Period

Experience (in
years and months)

b). Other Experience (Industry, Research, Teaching in Arts & Science colleges / Polytechnic / School)
Sl.
No.

Designation

Organization / Institution

Period

Experience (in
years and months)

6. Last drawn monthly salary:

7. PUBLICATIONS
a). Books published
Sl.
No.

Tittle of the book

Publisher

Year of
publication

b). Papers: Journal Publications (give number of publications)

International
National
c). Papers: Conference Publications (give number of publications)
International
National
8. SEMINARS / CONFERENCES
a). Seminars / Conferences organized
Sl. No.

Date

Theme

Venue

b). Seminars / Conferences attended (give number of Seminars / Conferences attended)

International
National
9. Sponsored Research Projects undertaken, if any: Yes
If 'YES' provide details:

10. Membership in Professional bodies:

11. Awards and Achievements (if any)

Technical
General

12. Any other Information:

No

13. PERSONAL DETAILS

a) Age:

b) Date of birth: DD

MM

c) Gender (M/F):

YYYY

d) Marital Status:
e) Nationality:
f) Religion:
g) Caste/Community:
h) If Catholic, name of the parish & diocese:
i) Address for Communication

j) Permanent Address

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.....................................................................

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.....................................................................

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.............................. Pin

.............................. Pin

k) Phone (Res):

Mobile:

l) E-mail:
14. REFERENCES (One from the organization last worked with or institution last attended)
1.

2.

15. DECLARATION
I declare that the above particulars are true to the best of my knowledge and belief.

Place:
Date:

Signature of the Candidate