EBET Group of Institutions

Nathakadaiyur, Kangayam 638 108

Approved by AICTE & Affiliated to Anna University - Coimbatore

Application for the post of Professor/Assistant Professor

Institution applied for : BRIT Civil/Mech/CSE/ECE, BRIM, BRIC

1. Name (in block letters)

2. Date of Birth 3. Religion 4. Caste : : :

: Age : Nationality : Community : Recent Photograph

5. Address for Communication :

Present Permanent

Phone :..

Mobile Number :..

E-mail ID .

6. Marital Status 7. Place of Birth 8. Mother Tongue

: : : : Scale of Pay : District : State:

9. Present Salary Details

Basic : Rs 10. Expected Salary :

Total Gross Monthly Emoluments: Rs..

11. Joining Time Required: 12. Name and address of the persons to whom reference can be made about the applicant

1.

2.

13. Academic Qualifications: (Starting from Highest Qualification) *

Degree/ Diploma Specialization Class
% of Marks

Name of the Institution

F/P/D

Month & University Year of Passing

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

14. Professional / Teaching / Research Experience (Starting from Present Experience)

the post held Scale of Pay
Months

Sl. No

Name of

Name of the Employer / Institution

Pay and

Period of Employment
Years From Date To Date

Teaching/ Industrial/ Research

15. COURSE MATERIALS PREPARED TITLE YEAR 16. MONOGRAPHS PREPARED TITLE YEAR BOOKS PUBLISHED NAME OF THE BOOK PUBLISHER YEAR

17. PAPERS PUBLISHED IN INTERNATIONAL JOURNALS DURING THE LAST FIVE YEARS: (Give Annexure if required)

18. PAPERS PUBLISHED IN NATIONAL JOURNALS DURING THE LAST FIVE YEARS: (Give Annexure if required)

19. PARTICIPATION IN CONSULTANCY ACTIVITIES THROUGH THE INSTITUTION DURING THE LAST THREE YEARS CONSULTANCY JOB REMUNERATION / PROJECT ORGANISATION PROJECT LEADER EARNED

20. PARTICIPATION IN SUMMER/CONTINUING EDUCATION PROGRAMMES DURING THE LAST THREE YEARS PROGRAMME HELD AT DURATION

MEMBERSHIP OF PROFESSIONAL BODIES PROFESSIONAL BODIES TYPE OF MEMBERSHIP POSITION HELD

21. PAPERS PRESENTED IN CONFERENCES DURING THE LAST THREE YEARS: (Give Annexure if required)

22. STATE ANY INNOVATION IN TEACHING/EVALUATION YOU HAVE EXPERIEMENTED DURING THE LAST THREE YEARS

23. PARTICIPATION IN ORGANISING CONTINUING EDUCATIONAL PROGRAMMES DURING THE LAST THREE YEARS PROGRAMME DURATION PERIOD NO. OF PARTICIPANTS NATURE OF INVOLVEMENT

24. SPONSORED RESEARCH CARRIED OUT DURING THE LAST THREE YEARS PROJECT SPONSORING ORGANISATION PERIOD GRANT PRINCIPAL INVESTIGATOR

25. DISTINCTION AND AWARDS RECEIVED

Place: Date :
Attach Xerox Copies of the following: 1. 2. 3. Educational Qualifications Community certificate Salary Proof

Signature of the Applicant