For submission to
FORMAT – II Indian Universities and Teachers Recruitment Board, Chennai – 600 006
Deemed Universities etc.,
TEACHING EXPERIENCE CERTIFICATE
(Separate Form should be used for each Institution) Recent Passport size –
Photograph of the
Sl.No : candidate duly attested
by the Certificate
issuing authority
1. Name of the Candidate :
(Sign and Seal should
be partly in photograph
2. Post Held : and application)
3. Name of the University :
with Full Address and Email ID
4. Type of Institution :
(University, Deemed University, Others, etc.,)
5. Details of Teaching Experience : Academic Year wise
No. of Period of Service
Academic
Whether
Sl. Year Subject Periods
(UG/PG Date Period
No Taught per
Level)
From To Week From To Month Days
1.
2.
3.
4.
5.
Certified that the above particulars are verified against records maintained in the University/
Institution / College and are found correct. Also certify that a copy of the certificate issued along with
records is maintained by this office for future reference.
Place : Head of the Department / Dean
Date : Name :
(Office Seal)
Countersignature
Thoroughly verified the above particulars with the appointment order / Institution/College-
Staff approval order/ Attendance / Acquittance / ECS Statements and other relevant records and
found to be correct. I also certify that before countersigning this experience certificate I am satisfied
with the genuineness of the records relating to the candidate. A copy of the same is maintained in
this office for future reference.
Ref. No :
Place : Registrar
Date : Name :
(Office Seal)
For Instructions P.T.O