Anil Neerukonda Institute of Technology & Sciences (Autonomous)
(Affiliated to AU, Approved by AICTE & Accredited by NBA & NAAC)
Sangivalasa-531 162, Bheemunipatnam Mandal, Visakhapatnam District
Phone: 08933-225083/84/87 Fax: 226395
Website: www.anits.edu.in email: principal@anits.edu.in
APPLICATION FORM FOR THE POST OF …………………………………...…….
(For Office Use only)
(Photo)
To be filled by the Candidate
1) Post Applied for :
Name of the Candidate in Capitals
2) :
(As per Academic Records)
3) Gender : Male / Female
4) Category (OC, BC, SC & ST) :
5) Date of Birth (As per Academic Records) :
6) Name of the Father / Husband :
Address for Correspondence (in Capital letter with
7) :
PIN Code
8) Mobile Number(s): :
9) Email Address :
10) Marital Status : Married / Single
11) Nationality :
Academic Qualification (Give particulars commencing from 10th Class)
Board / Aggrega
S. Year of School/College specialization, if Division
Examination University to te % of
No. Passing attended any obtained
which affiliated Marks
12)
Particulars of higher academic qualification for which
working, if any, (Give the title of Program, Institution
13) :
where registered, duration and probable date of
completion)
14) Title of Dissertation / Thesis at Post-Graduate level :
15) Title of Ph.D. Thesis :
Particulars of Academic achievements/Prizes/Awards,
16) :
if any
Particulars of Academic Publications, if any, (if necessary use separate sheet)
The journal is listed in
Title, Name of Journal or Proceeding of Conference together with Month & Scopus/SCI/UGC care
S. No.
Year of Publication of Publications list/others (if others
mention)
17)
Details of Grants / Projects received from AICTE/UGC/Others, if any
Role (PI/Co- Sanctioned Year & month of
S.No. Title Project / Grant Sanctioned authority
PI) amount grant
1.
18)
2.
3.
4.
19) Details of Patents, if any:
i.
ii.
iii.
Details of work experience (attach the service certificate of present working organization)
Period of
S. No. Designation Employer Nature of Duties
Employment
1.
2.
3.
4.
20)
5.
6.
7.
8.
9.
10.
If you have teaching experience during the last 3 years, indicate:
a) Courses taught
i)
ii)
21)
III)
iv)
v)
vi)
b) Projects guided: Under-Graduate / Post Graduate (use separate sheet if necessary)
i)
ii)
III)
iv)
v)
vi)
d) Particulars of Experience in Institutional Administration, if any:
i)
ii)
III)
iv)
v)
vi)
If employed, Details of last pay drawn (attach last drawn salary slip):
a) Scale of Pay:
22)
b) Basic Pay:
c) Gross salary:
23) Expected Salary:
24) If selected, joining time required:
Any other relevant information:
25)
Date: Signature of the applicant
