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Application Form - Associate Professor & Professor

This document is an application form for the position of Professor or Associate Professor at PSG Institute of Technology and Applied Research. It requests information such as the applicant's name, qualifications, experience, academic background, publications, expected salary, and references. The form has sections for educational details, work experience, research and teaching experience, awards received, and membership in professional organizations. Supporting documents such as degree copies and salary proof must be attached with the application.

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Meenakshi Sundaram
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371 views6 pages

Application Form - Associate Professor & Professor

This document is an application form for the position of Professor or Associate Professor at PSG Institute of Technology and Applied Research. It requests information such as the applicant's name, qualifications, experience, academic background, publications, expected salary, and references. The form has sections for educational details, work experience, research and teaching experience, awards received, and membership in professional organizations. Supporting documents such as degree copies and salary proof must be attached with the application.

Uploaded by

Meenakshi Sundaram
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PSG INSTITUTE OF TECHNOLOGY AND APPLIED RESEARCH

Neelambur, Coimbatore - 641062


Affiliated to Anna University, Approved by AICTE

Application for the post of Professor/Associate Professor

1. Name (in block letters)

2. Qualifications

3. Date of Birth

Recent
Photograph

Age :

4. Address for Communication :

(a) Mobile Number

(b) E-mail ID

5. Marital Status

Name and Occupation of Spouse

6. Mother Tongue

Caste :

7. Religion

Community :
Nationality :

8. Teaching / Industrial / Research Experience (Starting from Present Experience)

Name of the
post held

From
Date

To
Date

Months

Sl.
No

Monthly
Gross Pay
(Rs)

Years

Period of Employment
Name of the
Employer /
Institution

Teaching/
Industrial/
Research

_____years____months:Teaching

Total Experience

_____years____months:Industry

_____years____months:Research

Reason
for
Leaving

a)Academic Qualifications: (Starting from Highest Qualification)

Degree/
Diploma

Branch/
Specialization

Class

% of Marks/
CGPA

Cleared all
the papers
in single
attempt
(Say Yes/
No)*

Name of the
Institution

F / P / D **

9.

University

Month &
Year of
Passing

Ph.D
PG
UG
HSC/
Diploma
SSLC

* If No, please provide the details in the following format


** Note : - F / P / D State Whether Full-Time (F), Part-Time (P), D Distance Education

9
Sl.
No.

b) Details of Arrears (If any):

Degree

Name of the subject cleared as


an arrear subject

10. Present Salary Details


Basic

Semester in
which arrear
occurred

No. of attempts
to clear the
subject

: Rs

Scale of Pay:

Total Gross Monthly Emoluments: Rs./ =pm.


11. Expected Salary
12. Joining Time Required :

Semester in which it was


cleared

: Rs./ =pm.
months

13. Name and addresses of persons to whom reference can be made about the applicant:
1.

2.

14. Subjects taught/ Interested subject to teach:


Sl.No

No. of times
taught

Subjects Taught

Sl.No

Subjects interested to teach

15. Any Laboratory Models/ Teaching Aids developed/ New Laboratory Experiments devised during last
three years (Give Details):

16. Department/ Laboratory Development during the last three years (State Your Contribution):
Equipment

Cost

When Purchased

Your Involvement

17. State any innovations in teaching/ evaluation you have experimented during the last three years:

18. Participation in the organization of continuing educational programmes during the last three years:
Programme

Duration

Period

Nature of

No. of Participants

Involvement

19. Sponsored Research carried out during the last three years:
Project

Sponsoring

Period

Organization

Principal

Grant

Investigator

20. Student Projects supervised during the last three years:


Under Graduate

Post Graduate

21. Tutorship during the last three years (Please state your experience and contribution as a tutor):
Class

Year

Specific Contribution

22. Accompanying students for Educational tours/ Industrial Visits during the last three years:
Class

Visit To

Duration

Year/ Month

23. Distinctions and Awards received and Patents obtained:

24. Papers published in International Journals during the last five years:

25. Papers published in National Journals during the last five years:

26. Conferences/ Workshops/ Summer/ Winter School Organized:

27. Membership of Professional Bodies:


Professional Body

Type of Membership

Position Held

28. Any other information the applicant wishes to state:

Place :
Date :

Signature of the Applicant

Note : ATTESTED PHOTOCOPIES of degrees, service certificates, testimonials, community, salary proof
etc. are to be annexed to the application

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