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Faculty / Research Staff Application Form: Mepco Schlenk Engineering College, Sivakasi

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Form A11

MEPCO SCHLENK ENGINEERING COLLEGE, SIVAKASI

FACULTY / Research Staff APPLICATION FORM


SFor the post of In the Dept. of Professor Civil Asst. Prof EEE Senior Lecturer ECE CSE Lecturer Mech IT SRF JRF

Biotech

MBA

MCA

English

Maths

Physics

Chemistry

Reference : Advertisement in ______________________ appeared on _____________


1. PERSONAL DETAILS

Name Father / Husband Name Marital status : Sex : Male Female If married, Spouse : No. of Children : Age : Religion : Nationality : Date of Birth : Community : Caste : Address for Communication FC BC MBC SC/ST Married Employed Un-Married Unemployed

Phone / Mobile :

Email :

2. ACADEMIC QUALIFICATIONS *
Full time / Part time / Class / Distance Position Education Agg. %/ CGPA
No. of subjects passed in more than 1 attempt

Degree

Specialization

Year of Passing

Institution

University

1. 2. 3. 4. 5. 6.

* Attach Photo copies of relevant certificates

3. EXPERIENCE DETAILS *

i. Teaching (in Engg. Colleges only) chronological order


Sl.No.
1.

Designation

Institution

Experience (Duration)

Experience (in years)

2. 3. 4. TOTAL

Last Salary drawn (Gross) Rs. / month

ii. Others (Industry, Research, Teaching in Arts College / Polytechnic / School) chronological order
Sl.No.
1.

Designation

Institution

Experience (Duration)

Experience (in years)

2. 3. 4. 5. TOTAL

4. PUBLICATIONS

Book publications (give the title, publisher & year of publication)

Paper : Journal Publication (give the no. of International : publications) (attach the Xerox copy of the first page National : of the publications) Paper : Conference Publication (give the no. of publications) International : National :

5. SEMINARS / CONFERENCES

Seminars / Conference organised (give the Conference Theme and the date)

Seminars / Conference attended (give the number) International : National :

6. ANY OTHER INFORMATION

Undertaken any Sponsored Research Projects If 'yes', provide details

Yes

No

Membership in Professional bodies Awards & Achievements (if any)

I declare that the above particulars furnished by me are true to the best of my knowledge

Place : Date :

SIGNATURE Name :

* Attach Photo copies of relevant certificates / documents wherever necessary.

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