P.S.R.

Group of Institutions
Sivakasi - 626 140, Virudhunagar Dist. Tamilnadu

APPLICATION FOR FACULTY POSITION – 2017-18

Post Applied For: _________________ Department______________ Date____________

1) Name (in Block Letters)

2) Father / Husband Name Gender : Male / Female

3) Date of Birth & Age Religion :

4) Community
OC / BC / MBC / SC / ST / Others

Present Address Permanent Address

5) Present / Permanent
Address with Pin code

Phone / Mobile : E-Mail ID :

6) Educational Qualifications

Course / Branch
(From First Degree Onwards) % Month
Name of the Institution University of Class &
Degree Specialization Full Time/
No.Sl.

Marks Year of
Part Time/
Distance Passing
Mode
7) Experience:
A. Teaching
Sl. No.
Period Total Service Last
Designation Name of the Institution Pay
From To Year Month Drawn

B. Industry
Sl. No

Period Total Service Last

Designation Name of the Industry Pay
From To Year Month Drawn

8) Publications (if any):

Journals : National ____________ International ______________

Conferences : National ____________ International ______________

9) Patents / Awards (if any) :

10) Books authored (if any) :

11) Sponsored Research Projects

(If any) :

12) Scholars Guided : (Enclose Separately)

13) Visits Abroad : (Enclose Separately)

14) Membership in Academic Bodies: (Enclose Separately)

15) Any other Achievements : (Enclose Separately)

Declaration

I declare that the information given above are true to the best of my knowledge.

Signature of the Applicant