ANNEXURE - II
(To be submitted to the Inspection Committee)
ANNA UNIVERSITY
CHENNAI 600 025
INDIVIDUAL FACULTY DATA SHEET [Details to be typed]
Name of the College
Name of the Department
Name of the faculty member
Present Designation
Residential Address
:
:
Landline :
Email :
Gender
Male / Female / TG
Community
OC / BC / MBC / SC / ST
Contact Nos.
PAN Number
Mobile
Passport Number
Date of Birth
Affix and
Attest
passport
size
photograph
I. Particulars of Educational Qualification: (only completed)
Category
Name of
the Degree
Specialization
Year of
Passing
Name of the
College
Name of the
University
% of Marks
/ Grades
obtained
Class
obtained
UG
PG
Ph.D.
* Enclose copies of certificates duly attested by the faculty member and the Principal as proof.
I.a. Additional Qualification
i. GATE Score (In case of B.E. / B.Tech.)
ii. NET / SLET (In case of M.C.A. / M.Sc. / M.A.)
II. Title of Ph.D. Thesis *
III. Faculty in which Ph.D. was awarded
IV. Academic Experience as on 31st December 2014:
Name of the College
Designation
Joining
Date
Relieving
Date
Years
Experience
Months Days
Total
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V. Industrial Experience:
Name of the
Organisation
Nature
of Work
Designation
Joining
Date
Experience
Relieving
Date
Years
Months
Days
Total
VI. Other Relevant Information
Signature of the Faculty
(Endorsement by the Principal)
(Inspectors use only)
VII. Remarks of Certificate Verifying Officer / Chairman of Inspection Committee:
Eligible to hold the post of ___________________
Verifying Officers
CHAIRMAN
Inspection Committee
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