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Application Format Osme 19082011

This document is an application form for a regular faculty position at Biju Patnaik University of Technology in Odisha, India. The application requests information such as the applicant's name, date of birth, nationality, gender, address, academic qualifications, research and work experience, publications, awards, and references. The applicant must declare that the information provided is accurate and acknowledges that concealing or distorting information could result in termination.

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42 views3 pages

Application Format Osme 19082011

This document is an application form for a regular faculty position at Biju Patnaik University of Technology in Odisha, India. The application requests information such as the applicant's name, date of birth, nationality, gender, address, academic qualifications, research and work experience, publications, awards, and references. The applicant must declare that the information provided is accurate and acknowledges that concealing or distorting information could result in termination.

Uploaded by

akbisoi1
Copyright
© Attribution Non-Commercial (BY-NC)
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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BIJU PATNAIK UNIVERSITY OF TECHNOLOGY, ORISSA

ROURKELA
APPLICATION FORM FOR REGULAR FACULTY POSITION

Post applied for Discipline .... Category (UR/ SC/ ST/ SEBC) .. Draft No. ________ Date ________ Amount______
(enclose the caste certificate for claim of reservation)

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Name in Full Date of Birth (DD/MM/YY) Nationality Category (General/ SC/ST) Sex (Male/ Female) Marital Status (Married / Unmarried) Fathers Name/ Husbands Name Address for Correspondence
(with email, fax & phone)

: : : : : : : : : :

(in block letters) (as indicated in secondary school certificate)

Permanent Address Academic Qualifications


(from HSC onwards)

Sl No

Exam passed

University/ Board/ Institution

Month/ Year of passing

Subjects

Specialization

% of Marks/ CGPA*

Division

Rank/ Position

In which degree awarded

If any

1 2 3 * Please specify the percentage of marks upto two decimal place * In case of CGPA / CPI, please give marks in percentage along with the conversion formula

11.

Research Experience (i) (ii) (iii)

Scientific / Engineering Discipline : Field of Specialization : Length of Experience : : Period From To Training Area

12.

Professional Training Organization

2 13. Employment Records


Period of service From To

:
Designation Scale Pay of Work Description Reason of leaving Total period of employment

Name & address of employer/ inst.

14.

Research Papers in Journals International Journals No. of Papers

: National Journals No of Papers

* The details to be attached in a separate sheet

15. No 1 2 16. No 1 2 17. Sl

Research Papers presented in Conference/ Seminar Conference/ Seminar

: Year

* The details to be attached in a separate sheet

Patents filed (separately for India & Overseas) Details

: Year

Research Projects Undertaken Name of the Project

: Sponsoring Agency Name of Coinvestigator, if any Amount sanctioned

18. Sl

Research Guidance Name of the Book/ Title

: M.Tech/ Ph.D Year

19.

Awards / Honours received No. of Awards/ Honours Year Detail

International National State Professional bodies Any other 20. Publications : No. Books Book Chapter (s) Monograph Reports Title & Year

3 21. Affiliation to Professional Society :

Academic Fellowship (i)_________________________ (ii)_________________________ Professional Body Membership (i)_________________________ (ii)_________________________ 22. Sl. No. 1 2 Other Academic Activities (Curricular/ co-curricula/ Examination/ Hostel/ Sports/ NSS/ NCC/ Scouts etc) : Name of the activities Date of activities held Remarks

23. 24. Sl. No. 1 2 3 25.

Minimum joining time require (if selected) : Have you been interviewed by any University during past year ? give detail Name of the post & discipline Date of interview Result/ remarks

Any other information in support of your candidature :

26.

Name of the two referees : Address/ Tel/ Email

27.

Declaration : I declare that the foregoing information is correct to the best of my knowledge and belief and

nothing has been concealed / distorted. If any time, I am found to have concealed / distorted any material information, my appointment shall be liable to summary termination without notice. I will, if and when required, take up duty in the discharge of Government assignment anywhere in India.

Place : Date :

Signature of Candidate

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