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Proforma - A: S. No. Degree University Month & Year of Passing % of Marks Class

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PROFORMA - A

(To be filled up by faculty members with M.E./M.Tech./M.Phil/Ph.D. Qualification) 1. Name 2. Date of Birth : : Age :

3. Educational Qualification : S. No. Degree University Month & Year of Passing % of Marks Class

4. a. Academic : S. No.

Experience in Degree Level Institution : Designation Years of Experience Period of Experience

Name of Institution

4. b. Experience in Industry / Any other institution: S. No. Name of Institution Designation Years of Experience Period of Experience

Please attach Xerox copies of Service Certificates

/2/ 5. Date of Joining in our institution :

6. Designation at the time of Joining

7. Are you an author or co-author of Monographs / Books? Give details and Proof

8. Have you published any papers? Give details and proof

9. Details of academic activities / Subjects handled as Sr.Lect./Lect. in Engg. College:

10. Have you attended any Seminars / Workshops / Summer Institutes etc. Give details and proof and the No. of days

11. Have you presented any paper in any Seminar? Give details and proof

/3/ 12. Your contribution to i. Your Department in addition to your regular teaching :

ii.

The College in addition to your regular teaching

13. Are you a member of any Academic body / (Institutional body) Give details :

14. Other details which, you would like to furnish

Date : Remarks of the H.O.D.:

Signature of the applicant.

Signature of H.O.D.

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