PSG INSTITUTE OF TECHNOLOGY AND

APPLIED RESEARCH
Neelambur, Coimbatore-641062
Affiliated to Anna University,
Approved by AICTE

Application for the post of Assistant Professor

1. Name (in block letters) :

2. Address for Communication : Recent

Photograph

(a) Mobile Number :

(b) E-mail ID :

3. Date of Birth : Age :

4. Marital Status : Name and Occupation of Spouse:

5. Mother Tongue : Caste : Community :

6. Religion : Nationality :

7. Teaching / Industrial / Research Experience (Starting from Present Experience)

Period of Employment
Name of the Monthly Teaching/
Sl. Name of the
Months
Employer / Gross Pay Industrial/
Years

No post held From To

Institution (Rs) Date Date Research

_____years____months:Teaching

Total Experience _____years____months:Industry

_____years____months:Research
 8. a)Academic Qualifications: (Starting from Highest Qualification)

Cleared all

F / P / D **
the papers in Name of the Month &
Degree/ Branch/ % of Marks/
Class CGPA
single Institution University Year of
Diploma Specialization attempt (Say Passing
Yes/ No)*

* If No, please provide the details in the following format

** Note : - F / P / D State Whether Full-Time (F), Part-Time (P), D Distance Education

8. b) Details of Arrears (If any):

Semester in No. of attempts

Sl. Name of the subject cleared as Semester in which
Degree which arrear to clear the
No. an arrear subject it was cleared
occurred subject

9. Membership in Professional Bodies:

10. Present Salary Details :

Basic : Rs Scale of Pay:

Total Gross Monthly Emoluments: Rs./ =pm.

11. Expected Salary : Rs./ =pm.

12. Joining Time Required : months

13. Name and addresses of persons to whom reference can be made about the applicant:

1. 2.
 14. Publications (Attach separate sheets, if necessary):

15. Subjects taught/ Interested subject to teach:

No. of
times
Sl.No Subjects Taught Sl.No Subjects interested to teach
taught

16. Any other information the applicant wishes to state:

Place :
Date : Signature of the Applicant

Note : ATTESTED PHOTOCOPIES of degrees, service certificates, testimonials, community, salary proof
etc. are to be annexed to the application