Registration No.

____________________
(To be filled by NITH Office)

National Institute of Technology, Hamirpur

Hamirpur –177 005(HP)
Signed Photo
Application Form For Faculty Position

Advertisement No.______________________________ Deptt./Centre _______________________________

Post Applied for ______________________________ Field of Specialisation ___________________________

Reservation Category: General /SC /ST /OBC /PH /Other

To be returned to: Registrar, National Institute of Technology, Hamirpur- H.P. 177 005

NIT Hamirpur is an Equal opportunity Employer

Appointments are made on the recommendations of Statutory Selection Committee
1. Full Name (including Surname) ________________________________________________
(in block letters)
2. Date and Place of Birth ________________________________________________

3. Sex Male / Female (Strike off whatever is not relevant)

4. Marital Status Married / Unmarried (Strike off whatever is not relevant)

5. Nationality _______________________________________________

6. Postal Address for correspondence _______________________________________________

(any change of address should be
communicated at once to the Institute)
_______________________________________________
_______________________________________________
Pin Code _______________________________________
Telephone No ___________________________________
Mob.No. ______________________________________
e-mail ID______________________________________

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7. Permanent Address _______________________________________________
(Mention Tehsil, District and State _______________________________________________
you belong to) _______________________________________________

8. a. Were you at any time declared medically unfit;

asked to submit your resignation; discharged or
dismissed from Govt./Semi-Govt./Autonomous
Body or Private Service ? If yes, give details
In a separate sheet. ________________________________________

b. Is any disciplinary proceeding pending against you

and what is its status (Give Details) _______________________________________

9. Academic Qualifications: (1) Please attach Xerox copies of certificates including Date of Birth.
(2) Give particulars in a chronological order starting with High School Certificate.
Sl. University Year Degree/ Subject/ Division/Grade/ Rank in
No. /Board Certificate Specialisation % of Marks Class

10. Title of your M.Tech./Ph.D. Thesis awarded, with name and address of Ph.D. Guide.(Enclose abstract of
thesis on separate sheet)
Degree University Year Guide(s) Title of Thesis
M.Tech./
M.Phil.

Ph. D.

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11. Professional/Teaching/Research Employment (Give particulars in descending chronological order starting
with the present post and ending in Ph. D. Period. If space is insufficient, attach separate sheet)

Sl. Period of Employment Employer Post held Basic Pay on

No. From To last
Day in the
Scale

12. Thesis supervised: Ph. D. /M.Tech.(by research) or M.S./M.Tech./M.Phil.

Sole/
Sl. Principal
No. Degree Name of Student Brief Title or Co supervisor

13. (a) Publications (Attach comprehensive list of publications during last five years, arranged in
chronologically, giving details of Author, Title, Name of Journal, Volume, Page Numbers, Year, Name
of Conference Place etc. including books, edited books, e-learning packages, journal and conference
publications and all other Scholars work) (Annexure-iv)

Under Role as Author.

Preparation (Student/supervisor/
(Preprint Editor/Coordinator/
Types of Scholars Publications Published In Press available) Sole Author )
Books/monographs with ISBN No.
or equivalent
Publications in International
referred journals
Publications in National
referred journals
Publications in proceedings of
Conference held outside India
Publications in proceedings of
Conference held within India
Edited Books

E-Learning packages Published

(b)List of 5 Publications (# 1 is most important) that contains your most outstanding contributions:

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Sl. No. Authors, Title, Other details Role as Author

14. (a)Teaching Experience in Institutions of Higher Learning (Attach list of Courses taught , new course
introduced, e-learning courseware, laboratory courses etc. in Annexure-ii)

(b) Five most Important subject (including laboratory Courses) taught or introduced during the past 10
years
Sl. Title of Introduced Volumes of
No. Course Level First Time Class notes
Yes/No Distributed (Pages)

(c) Syllabus of one new subject (Theory & Laboratory) that you would like to introduce in NIT.
(Syllabus, text books if any, equipment needed etc.)

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15. Short term Course/Continuing Education Programmes / Distance Education Programmes
(List 3 most important courses offered or coordinated by you during the past 5 years)

Sl. Title of Target Audience No. of No. of

No. Course (College/Institutions) Participants Budget Lectures

16. (a)Sponsored research/Consultancy Projects – Completed/In progress/Proposal under review (Attach

separate sheet giving details of all Projects (Annexure-vi):
As Principal Investigator As Co-investigator
Type of
Project Total Value Total Value Total Value Total Value
Completed Ongoing Completed Ongoing

Sponsored
R&D Projects

Consultancy
Projects

(b) Details of 3 most important projects of your career taken up as P.I. or Co-P.I.:
Sl. No. Period Sponsor Value P.I./Co-P.I.

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 From To

17. Membership/Fellowship and Positions of Responsibility in Professional Societies ;

Prizes/Medals/Awards/Divisions, Scholarship Received and Any other academic award/activities.

18. Attainment in sports, fine arts, performing arts, NCC, NSS and extra-curricular activities:

19. Any other information relevant to the post applied for :

20. Reference ( Name and address of five referees with their complete postal and electronic addresses.
Referees should be persons with or under whom, the candidate has worked, or who are familiar with the
work of the candidate as sponsors, collaborators or clients:

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Sl. No. Name and Address E-mail ID and Phone No. How he knows the Candidate

21. Copies of documents enclosed:

22. Bank Draft No.:___________________ Date;_______________ Amount :_____________________

Name of the Bank: ____________________________________

Place:
Date: Signature of the Candidate

Enclose the following: (Please use clear computer print on A4 size paper only, except where it is not
feasible)

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1. Outline of research proposal that you would like to submit to a funding agency on joining NIT
Hamirpur (Annexure – I) (Also applicable to internal candidates).

2. Syllabus of a specialized course in the area that you would like to introduce on joining NIT
Hamirpur (Annexure – II) (Also Applicable to internal candidates).

3. One page write-up on significant contributions/innovations through teaching, research, design, or

any other innovative/creative activity during past five years - Annexure III

4. Details of Research Publications during past five years - Annexure- IV

(a) Journals
Author(s), Title of the Paper, Conference, Year, No. of Pages.

(b) In Conferences/ Symposia:

Author(s), Title of the Paper, Conference, Year, No. of Pages.

(c) Communicated (Separately for Journals and Conferences/ Symposia)

5. Details of theses supervised: (a) M.Tech.; (b) Ph.D. - Annexure - V

Name of student: Thesis title ; Year; Co-Supervisor, if any .

6. Details of Sponsored/Consultancy Projects handled during past five years -Annexure -VI
Title, Funding Agency, Amounts, Duration and Co-workers, if any.

7. Details of technology development, transfer patents - Annexure -VII

Note: Candidates for the posts of Assistant Professor/Associate Professor should attach copies of grade
marks in courses taken during M.Tech./Ph.D. programmes and abstract of Ph.D. thesis.

All candidates should enclose two copies of the reprints / preprints of three most significant
recent research publications.

Please mail ‘SUMMARY SHEET’ Soft Copy of MS-EXCEL file to registrar@nitham.ac.in

Use Subject Line (Faculty Recruitment)

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 NATIONAL INSTITUTE OF TECHNOLOGY, HAMIRPUR(HP)

ACKNOWLEDGEMENT

Advt. No.____________________Registration No. _________________________________________

Sub: Recruitment to the post of _____________________Deptt. /Center__________________________

Received an application from Dr./Mr./Mrs._________________________________________________

(Candidate to write his/her name above in capital letters)
for the above mentioned post. For any correspondence in future, candidate must quote the registration number
given above.

Office Superintendent
Date __________________ (Establishment / Recruitment)

To

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

(To be filled by the candidate his/her present address)

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 FORM NO. FAC/ 2A
NATIONAL INSTITUTE OF TECHNOLOGY HAMIRPUR
SUMMARY SHEET
(To be filled by the Candidate)
1. Name ______________________________________ 2. Date of Birth _________________________________
3. Post _______________________________ 4. Department / Centre ___________________________
5. Specialization & Present Research Area _________________________________________________________
6. Education:
Degree Displine University / Year Division / Remarks if any
Grade/
Board (Rank, Hons etc.)
Percentage
of Marks
High
School
(Class- X)
Higher
Secondary
( +2 )
Bachelors
(B.A./B.Sc.)

(B.E./B.Tech)
Masters
(M.A./M.Sc.)

(M.E./M.Tech.)
Doctorate
(Ph.D./D.Sc.)
Others (JEE
Rank, GATE
Score, GRE Score
etc.)

7. Employment (in descending chronological order starting with the present employer):
Employer Post Pay Scale Period of Employment
From To
Previous Review,
if any, at NIT,
Hamirpur

FORM NO. FAC/ 2A-1

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8. Summary of Performance:
U.G. P.G.

Courses Developed (No.)

Research Publications In Journals In Conferences/Symposia

Past five years Total Past five years Total

Published (Nos.)

Communicated (Nos.)
Thesis Supervised M. Tech./ M. Phil Ph.D.

- Completed

- In Progress
Sponsored Projects Consultancy Projects
Sponsored/Consultancy
Projects
- Completed
- In Progress
- Proposals under
review
Authored Edited

Books

9. Special Training / Assignment / Any other relevant Particulars

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