Indian Institute of Information Technology Sonepat

भारतीय सूचना प्रौद्योगिकी संस्थान सोनीपत

(An Autonomous Institute of National Importance under Act of Parliament)
Official Address: MBA Department Building, NIT Kurukshetra- 136119.
Phone: +91 1744 233189, Email: sonepatiiit@gmail.com, website: www.iiitsonepat.ac.in

APPLICATION FORM FOR FACULTY POSITION

ADVT. NO. ______________________________ DATE: -____________

____________________________________________________________________________
Details of Application Fee:

DD No. /NEFT Id Date Amount Name of Issuing Bank

Affix Recent Passport

size photograph

Demand Draft should be drawn in favor of “Indian Institute of Information Technology

Sonepat” or “IIIT Sonepat” payable at Kurukshetra.

Post Applied:

Department:

Specialization:

1. Personal Details:

Full Name :
Email ID :
Mobile No :
Date of Birth : Gender:
Father’s/Husband’s Mother’s
Name : Name :
Marital Status : Nationality:
Reservation Cat. (SC / ST / OBC/EWS):
PWD : VH : HH : OH :
Address for
Correspondence : Pin Code: ________________

Permanent Address : Pin Code: _________________

 2. Educational Qualification Details (Attach Photocopies of Relevant Certificates & Marksheets):

# Examination Specialization School/College/ Board/ Year of Marking % of Class/

Institute University Passing Mode Marks/ Grade/
CGPA Division

1. 10th

2. 10+2

Graduation:
3.
B. Tech / B.Sc. etc.

Post-Graduation:
4. (MTech / M.Sc. /
MA etc.)

3. Details of Doctoral Degree (Attach Photocopies of Relevant Certificate):

# Thesis Title College/ Board/ Name of Enrollment Status (In Defense/ Degree
Institute University Supervisor(s) Month/ progress/ Submission Awarded
Year Submitted/ Date Date
Degree
Awarded)

4. Details of Teaching Experience: (Attach extra sheet, if needed)

# Name of Address of Post held Pay Scale AGP/GP From To Organization

Organization Organization Date Date Type
1

2
3
4
5

5. Details of Industry Experience:

# Name of Address of Designation Pay Scale Gross From To Organization

Organization Organization Annual Type
Pay
1

3
 6. Details of Research Experience in R & D (Excluding PhD period):

# Name of Address of Designation Pay Scale Gross Pay From To Organization

Organization Organization Type
1

7. Summary of Experience as filled in by the applicant:

# Experience Details Year
1 Total Teaching and Research Experience in reputed academic Institute / R&D Labs /
relevant industry
2 Total Experience after Ph.D.

3 Total Experience since last promotion

8. Details of Post-Doctoral Work:

# Nature of Work Name of Institution/ Organization/ Name of Mentor(s)/ Supervisor(s) From To
Location / Country

9. Details of establishment of new lab(s):

# Name of Lab established List of Equipment/Software Sponsoring Agency Responsibility of

including Institute Individual
1

2
3
4
5

10. Details of theory courses taught in semesters where total credit (or credit hours) exceeds six in current
position:

# Academic Year Semester Details of Theory Courses Separated by Total Credit (or Credit Hours)
Autumn/ Semicolon (Course Title-L-T-P-C ;)
Winter
1

2
3
4

5
11. Last Promotion date in your current organization (if any):

12. Year of service over and above the relevant minimum

teaching experience required for the given cadre:

13. Details of Experiments/ Computational projects added to teaching laboratories/

Courses offered through application of ICT/E-learning packages prepared:

14. Use of e-learning in class room and lab courses teaching for last 10 years:

15. Papers Published in National/ International Journals: Web of Science (SCI/SCIE/SSCI/ Master Journal List),
IEEE/ACM/Scopus only.
# Authors; Title; Journal; Vol; No; Pages; Year of Publication Indexed By Points
Claimed

Total Credit Points: ______________

16. Papers Presented in National/ International Conferences:
# Authors; Title; Vol; No; Pages Role DOI Conference Indexed Points
type By Claimed

Total Credit Points: ___________

17. Details of Ph.D. Students guided (Thesis Submitted and Awarded):

 # Name of the Thesis Title University/ Status Degree Role Total No. of Points
Student Institute Awarded/ (Main Supervisor(s) Claimed
Thesis Supervisor/
Submission Co-
Date Supervisor)

Total Credit Points: _________

18.Details of M. Tech (research)/ MS (Equivalent Research based Master Program – Submitted and/ or
Awarded):
# Name of Thesis University/ Status Degree Role Total No. of Points
Student Title Institute Awarded/ (Main Supervisor(s Claimed
Thesis Supervisor/ )
Submissio Co-
n Date Supervisor)

Total Credit Points: __________

19.Patents and Copyrights:
Title of Patent/ Owner(s)/ Points
# Category Applicant Status Date
Copyright Investor(s) Claimed

Total Credit Points: ____________

20. Books/ Monographs/ Book Chapters Published:
Title of Books/Monograph/Book Year of Publication Points
# Type Publisher
chapter; Authors Publication Type Claimed

Total Credit Points: ______________

21. PG Thesis Guided:

# Title of the Name of University/ Date of Award/ Status Points

Project Supervisor(s) Institute Submission Claimed

Total Credit Points: ____________

22. UG Supervision (Thesis Guided):

# Title of the Project Name of Supervisor(s) University/ Date of Award Points Claimed
Institute

Total Credit Points: _____________

23. Fellow of professional Bodies:
# Fellows Year of Award Membership Points Claimed
Number

Total Credit Points: _____________

24. Seminars/ Conferences/ Short-Term Courses/ Workshop Organized:
# Type Title of the Program Sponsoring From To Date Your Role Points
Agency/ Self- Date Claimed
financed

Total Credit Points: ___________

25. Professional Training Received/ Short-Term Courses attended:
# Training Nature of Training Duration Organization where Points Claimed
Year training was
provided

Total Credit Points: ___________

26. Seminar/ Conference/ Workshop attended to present paper:
# Title of the Program Organized by From Date To Date Points
Claimed

Total Credit Points: _____________

27. Sponsored Project Details:

# Project Title Sponsoring Starting Ending Amount Status Your Total Number Points
Agency Month – Month (INR) Role of Claimed
Name Year – Year Investigator(s)

Total Credit Points: _____________

28. Consultancy Project Details
# Project Title Sponsoring Starting Ending Amount Status Your Total Number Points
Agency Month – Month (INR) Role of Claimed
Name Year – Year Investigator(s)

Total Credit Points: ___________

29. Membership of Professional Bodies:
# Name of Professional Bodies Year of Grade of Membership Points
Membership Membership Number Claimed

Total Credit Points: ___________

30.Administrative/ Institute Support Work (Attach Photocopies of Relevant Certificates):

# Section/ Office/ Institute From To Position Responsibility Responsibilities Points

level Committee Held Type Claimed

Total Credit Points: __________

31. Details of Academic Outreach Activities:
# Academic Outreach Activities Year Points Claimed

Total Credit Points: ____________

32. Placement Percentage (only for the placement cell officers/ faculty in-charge of placement):

# Year Percentage of Placement (% to be based on Points Claimed

total number of students passing out and
single job offer)
 Total Credit Points: ____________

33. Awards/ Honors/ Distinction:

34. Teaching and Research Plan for Next Five Years (One Page):
(Attach extra sheet, if needed)

35. Other activities/responsibilities (academic/administrative):

(Attach extra sheet, if needed)

36. Any Other Relevant Information:

 37. Name and Address of two References:
First Referee:
Name : Position :
Address : ,Email ID :
Phone No. : Mobile No. :

Second Referee:
Name : Position :
Address : Email ID :
Phone No. : Mobile No. :

38. Have you ever been discharged/ suspended from any position? (Yes/ No)
If yes, provide particulars:

39. Have you ever been convicted by any court of Law? (Yes/ No)

40. Have you any relation among the employee of IIIT Sonepat? (Yes/ No)
If yes, provide details:

Declaration
I hereby declare that; I have carefully gone through the advertisement and recruitment rules and have understood it.
Further, I certify that all particulars provided by me in this application form are correct and true to the best of my
knowledge and belief. There has been no suppression of any material facts. Detection of any false information at any
point of time will lead to rejection of my candidature/ selection summarily.

Date: Signature of Applicant