PART- B :APPLICATION FOR THE POST OF VICE-CHANCELLOR

ANNAMALAI UNIVERSITY, CHIDAMBARAM

(Applicant is requested to type the information in this format only and can add
more lines if required. Valid proofs should be attached for all claims.
Please sign in all the pages)

Affix latest colour

passport size
photograph

1. General Information of the Applicant

Name of the
Applicant
(In CAPITAL
A LETTERS as it :
appears in Ph.D.
Degree Certificate)

B Father’s Name :

Date of Birth
C : D D M M Y Y Y Y
(DD / MM / YYYY)

Age (As on
31.07.2021) : Y Y M M D D
(YY / MM / DD)

Place of Birth and

D Nativity :
(District and State)

E Gender (√ mark) : Male Female Other

F Nationality :

G Community :

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 H Mother Tongue :

Permanent Address
(Door No, Street,
I Village/Town, :
District, State, PIN
Code)

Address for
Communication
(Door No, Street,
J :
Village/Town,
District, State, PIN
Code)

K e-mail Address :

L Phone Number :

M Mobile Number :

2. Present Position / Position last held:

A Designation :

B Organization :

C Pay Scale :

D Years of experience in the Present

Position / Position last held: : ----------------------------------------------

E Total Experience (in YY / MM) : Y Y M M

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** Valid proof to be attached

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3. Educational Qualifications:

(3 a) Qualifications in chronological order from highest):**

No Degree University/ Major / Class /

Year
Awarded Institute Specialization Distinction

Date of award of Ph.D. D D M M Y Y Y Y

** Valid proof to be attached

(3 b) Additional Educational Qualifications:**

No Qualifications Institution/ Duratio Year Topic/area Output To be filled

acquired from n of in 1-2 by the
place
recognized bullets committee
Award
institutions

1 Dsc/DLitt

2 From Abroad( not less than 1 year)

a)PDF

b)PDF

3 From India ( not less than 1 year)

a)PDF

b)PDF

4 Any other Diploma/degree from abroad ( not less than 1 year)

a) Degree/

diploma

5 Any other Diploma/degree from India ( not less than 1 year)

a ) Degree/

diploma

** Valid proof to be attached

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4. Administrative Experience**

Duration Experience To be filled

by the
University/ (in Years &
Position To committee
Institution From Months)
S. (DD/MM/YY
No (DD/MM/YY)
) Y Y M M

1 Vice-Chancellor

2 Registrar

3 Controller of
Exam

4 Dean

5 HOD

6 Principal
/college

7 Director/ Dy.
Director ,
National
research
institutes

8 Others, if any

** Valid proof to be attached

5. Academic experience /contributions

(5 a) Teaching and research experience as professor in university system (excluding the

10 years shown under eligibility criteria) **

S. Positio Institution/ Courses taught and Duration Year To be filled by the

No n research carried out s committee
Place

** Valid proof to be attached

OR

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 Teaching and research experience in Universities, P.G. colleges,Public funded
institutions (excluding the 20 years shown under eligibility criteria)**

S. Positio Institution/ Courses taught and Duration Year To be filled by the

No n research carried out s committee
Place

** Valid proof to be attached

(5 b) Innovative academic programmes brought from UGC /other recognized agencies

along with Special grants **

S. Role of Institution Title of Duration Specialty No of Funding To be

the /Place the years of the benefic filled
N Agency/
Applicant program program iaries by the
o amount
me me commit
tee

** Valid proof to be attached

(5 c) MOUs signed and the executed academic programmes with foreign recognized
institutions with students/faculty exchanges**

S. Role of Indian and No of To be filled

the foreign Indian & by the
N Title of the Duration Funding
Applicant institutions committee
o /years Foreign agency/
involved programme benefici
Amount
cries

** Valid proof to be attached

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(5 d) MOUs signed and the executed academic programmes with Recognised Indian
institutions with student/faculty exchanges**

S. Role of Host and Title of the Duration No of Funding To be filled

No the the partner /years agency/ by the
programme Beneficries
Applicant Indian committee
from each Amount
institutions
involved (if any)

** Valid proof to be attached

(5 e) Other special contributions, if any , to enrich the academic programmes**

S. Role of the Institution/place Nature of To be filled by the

No Applicant contributions committee

** Valid proof to be attached

6. Research contributions

6 (a) Research Guidance **

S. Item Institution/ Duration Year No of To be filled by the

No awarded awardees committee
place

1 PDF from
abroad

2 PDF from
India

3 PhD

** Valid proof to be attached

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(6 b) Research Papers Published** (Please attach reprints of FIVE of your best research
Papers- other than the five shown under eligibility criteria )

National Journals International journals Total To be

filled
S. Number of Non- Non- by the
Indexed Indexed
No. Publications indexed indexed commi
Journals Journals (A+B) (C+D)
Journals Journals ttee
(A) (B) (C) (D)

Research
Papers as
1
Single
Author

Research
2 Papers as
First Author

Research
3 Papers as
Co-author

Reviews as
(Single
4 author/
First /co-
author)

National (A) International(B) (A+B)

Monographs
5
published

Papers in
6 conference
proceedings

** (Attach details of Title of the article/paper, Authors, Title of the Journal, Year of Publication,
page nos, ISSN, UGC Journal / CARE List Number, Journal Impact Factor, No. of Citations, if
any, in a separate sheet as Annexure)

** Valid proof to be attached

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6(c) Books Authored / Edited**

National International Total To be filled

S.
Publication Publishers publishers Numbers by the
No.
(A) (B) (A+B) committee

Number of Text/
Reference Books
authored as Single
1
author / First
Author
(Pl. specify)

Number of Text/
Reference Books
2
authored as Co-
author

Number of Books
3 edited as First
Editor

Number of Books
edited as one of
4
the Editors (Pl.
specify)

Number of
Conference Books
5 edited as Single /
one of the Editors
(Pl. specify)

**(Attach details of Title of the Book, Authors, Publisher, Year of Publication, ISBN,
in a separate sheet as Annexure along with a copy of the imprint page of the book)

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(6 d) Research Projects**

Funded by International agencies

Sl. Position No of projects No of Funding Grant To be

projects (in filled by
No Completed Agency
lakhs) the
On going
committee

1 As
PI/Coordinator

2 As Co PI/Co
Coordinator

Funded by National agencies

1 As
PI/Coordinator

2 As Co PI/Co
Coordinator

** attach proof for each item and a table showing the list of projects, funding agencies,
year, amount duration, brief outcome etc.

(6 e) Consultancy projects - List key consulting assignments undertaken:**

Value To be filled
Nature of
Role of Client/Organization’s by the
S. Assignment
the Name with Outcome (Rs. committee
No. / Years/
Applicant reference No. in
duration
lakhs)

** Valid proof to be attached

(6 f) Citation Profile: **

S. To be filled by the
Web of Google
No Details Scopus committee
Science Scholar
.

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 Total Number of
1
Citations

2 h-Index

3 i-10 index

** Valid proof to be attached

(6 g) Patents**

Quantum To be
Title of Patent National of filled
S.
the Applica / revenue by the
No Filed Published Awarded
patent/ tion No. Internati generate commit
.
invention & Date onal d (Rs. in tee
lakhs)

** Valid proof to be attached

(6 h) Editor-in-Chief / Co-Editor / Associate Editor of Journals **

Name of the
Publication Editor-in- National International To be filled
S. (Online/Print Chief/ Co- Publishers publishers Total by the
No version or Editor/ with no. with no. of Numbers committee
. both with Associate of year(s) year(s) (A+B)
ISSN Editor (A) (B)
number)

** Valid proof to be attached

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7. National / International Academic Assignments:

(7 a) academic assignments, if any**

Duration To be filled
Post/ Nature of
S. Organization/ by the
duty and
Assignmen In years committee
No. University Outcome,
t From To &
if any
months

National assignments

International assignments

(7 b) Countries visited on academic assignment, part of delegation, etc.,**

S. Organization/ To be filled
Nature of
Outcome Year/Period Country by the
No University
assignment committee
. Visited

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 ** Valid proof to be attached

8. Extension

(8a) Keynote address / Invited Lectures delivered at International /National Level

academic or research events**

S. Title of Title of Organised To be filled by the

Date
No. address/lecture event by committee

International (Notable Five)

National (Notable Five)

** Valid proof to be attached

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(8 b) Papers presented at International/National Level Academic or Research events:

S. Title of the paper Name of the Organization To be filled by

Date
No. presented event and Place the committee

International level Academic or research events (Notable Five)

National level Academic or research events (Notable Five)

** Valid proof to be attached

(8 c) International level Conference, Seminar, Symposium, Workshop, etc. organized **

(Notable Three)

No of To be filled
Funding
Title /period Organization foreign and by the
S. Role of the agency &
and Place of Indian committee
No. applicant /year Quantum
the event delegates
of grant
/out come

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 ** Valid proof to be attached

(8 d) National level Conference, Seminar, Symposium, Workshop, etc. organized **

(Notable Three)

Funding To be filled
Title /period Organization No of
S. Role of the agency & by the
and Place of delegates
No. applicant /year Quantum committee
the event /out come
of grant

** Valid proof to be attached

(8 e) Member in International /National policy making bodies**

Years/ To be filled
S. Role of the Policy documents
Body /place by the
No. applicant duration prepared
committee

International policy making bodies (Notable Three)

National policy making bodies (Notable Three)

** Valid proof to be attached

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(8 f) In Editorial Boards of international/National journals (Please avoid college magazines,
souvenirs, annual reports, etc.,)**

To be
Role of the filled by
S. No. Years/duration Journal Publishers ISSN
applicant the
committee

International Journals

National journals

** Valid proof to be attached

(8 g) In International/National project sanctioning and monitoring committees **

S. Role of Committee Duration/ No of projects To be filled by the

No the /organization sanctioned/ committee
years
monitoring
Applicant

International committees

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 National committees ( like PAMC of DST , DBT , other advisory committee etc)

** Valid proof to be attached

(8 h) Teaching Aids Developed **

S. Role of the Details of To be filled by the

Year Utility Impact
No. applicant Teaching Aids committee

** Valid proof to be attached

(8 i) Faculty Development Programme/ Refresher courses (not less than 3 weeks)

Organized **

Funding To be filled by
Role of Details of
S. Organization agency & the committee
the the Year
No. and Place Quantum of
applicant programme
Grant

** valid proof to be attached

(8 j) Other Outreach Programmes / Social Indulgence Schemes conceived and

implemented**

S. Name of Duration Place Collaboratin No. of To be

the of g agency, beneficiarie filled by
No
programme activit s the
. if any
/ activity y committe
e

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 Y M D

** Valid proof to be attached

9. Institution Building:

(9 a) Institutions established/Major Institutional Projects **

Name of Funding To be filled by the

Role of Institution/ Title of Agency Quantum committee
S.
the the with of grant/ Outcome
No. Centre/
Applicant Project reference Year
Unit No.

** Valid proof to be attached

(9 b) Infrastructure facilities developed/Major Departmental Projects (DST- FIST, UGC-SAP-

DRS, DBT,ICSSR, ICAR etc)**

Funding To be
Role of Years/ filled by
S. Title Agency Quantu
the Infrastructur Outcom the
No of the with m of duratio
Applican e built e committe
. projec referenc grant n
t e
t e No.

** Valid proof to be attached

10. Membership in Councils, Professional Bodies, etc.*

Membership in Councils and Professional Bodies (viz., International/National /state

level academic–research bodies; Academic Council / Standing Committee on
Academic Affairs, Senate, Syndicate, Planning Board, etc.,)

S. Positio Organization/ Duration Experience Quantifiable To be

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 Contributions, filled by
(in years & if any the
committee
No. n University months)

From To
Y Y M M

11. Awards / Fellowships / Prizes / Recognition for outstanding contributions **

S. Name of award/ Type of Conferred Year of the To be filled by the

No recognition recognition / committee
fellowship/prize/ by
Validity
recognition

International

National

** Valid proof to be attached

12. Any other Outstanding Contributions/ Achievements not covered (Please provide as
points only, in quantifiable terms)**

S. No Outstanding contributions/ achievements To be filled by the committee

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 ** Valid proof to be attached

13. Details of Three National / International Referees (Due certification from the
Referees to be enclosed)

Post holding/ held by the Contact details of the Referee

Name of the Referee
Referee (Phone, Mobile & e-Mail)

14. Strength / Area of Specialization / Innovation(s) / Any other Significant Contribution

(up to 100 words)

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15. Your Vision for the Annamalai University (up to 500 words)

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 BONAFIDE AFFIDAVIT

I, Dr. ___________________________, hereby declare that all the statements / particulars

made / furnished in this application are true, complete and correct to the best of my

knowledge and belief.

I also declare and fully understand that in the event of any information given /

furnished in this application being found to be false, misleading or incorrect at any stage,

my application / candidature is liable to be summarily rejected and if I am already

appointed, my services are liable to be terminated without any notice, from the post of

Vice-Chancellor, as per the relevant Act / Statutes, etc., and other applicable rules.

I also declare that I have never been convicted for any offence and that there are

no criminal / departmental proceedings pending / contemplated against me.

PLACE: __________________

DATE : __________________ SIGNATURE

Please Note: ** valid proof wherever required should be attached only in the hard copy
and not in email.

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