ANNEXURE - II

(To be submitted to the Inspection Committee)

ANNA UNIVERSITY
CHENNAI – 600 025
INDIVIDUAL FACULTY DATA SHEET [Details to be typed]

Name of the College :

Name of the Department :

Name of the faculty member :

Present Designation :

Residential Address :
:
Contact Nos.

Gender :

Community :

PAN Number : DPZPS3371M

Date of Birth and Age :

Date of joining the present post :

Scale of pay :

Present basic pay :

Total salary :

I. Particulars of Educational Qualification: (only completed)

% of
Name of
Year of Name of the Name of the Marks / Class
Category the Specialization
Passing College University Grades obtained
Degree
obtained

UG

PG

* Enclose copies of certificates and testimonials duly attested by the faculty member and the principal as proof.

I.a. Additional Qualification : Nil

i. GATE Score (In case of B.E. / B.Tech.)
ii. NET / SLET (In case of M.C.A. / M.Sc. / M.A.)

II. Title of Ph.D. Thesis * : Nil

III. Faculty in which Ph.D. was awarded : Nil

IV. Academic Experience as on December 2017:

Page 1 of 2
 Experience
Joining Relieving
Name of the College Designation
Date Date
Years Months Days

Total 0 04 17

V. Industrial Experience:
Experience
Name of the Nature of Joining Relieving
Designation
Organisation Work Date Date
Years Months Days
Total 1

VI. Other Relevant Information :

It is certified that all the information provided are true to the best of my knowledge.

Signature of the Faculty

(Endorsement by the Principal)

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