BANNARI AMMAN INSTITUTE OF TECHNOLOGY

SATHYAMANGALAM - 638 401 ERODE DISTRICT TAMIL NADU INDIA

APPLICATION FORM
Application for the Post of ___________________________________
in the department of ___________________________________________
1. General Information
Name
Date of Birth & Age
Gender

Male / Female

Marital Status

Single / Married

Photo

Father / Spouse Name

Mother Tongue & Language Known
Nationality, Religion & Community

Correspondence Address

Email Address

Permanent Address

Mobile Number

Landline Number

2. Academic Details
Degree

Specialization

School / College &

University

Year of Part Time / Full Time /

Passing
Distance

PhD / Mphil
Post graduate
Under graduate
Diploma
HSC
SSLC

3. Experience (Attach the details as separate annexure if necessary)

Sl. No.

From

No. of
Years

To

Position / Title

Institution / Industry
Name

4. Publication Details (Provide only the count. Attach the details as separate annexure)
Category
Conferences
Journals

National
International
5. Programmes Organized/Attended (Provide only the count. Attach the details as separate
annexure)
Category
Conferences
Workshops
FDP / SDP / STTP

Organized
Attended
6. Funds received from the external agencies
Name of the Agency
Amount Received
Scheme Name

7. Membership in Professional Bodies

(ISTE, IE, CSI, etc.,)

Status

: 1.
2.
3.
4.
5.

8. (a) Name of the present working Institution / :

Industry
(b) Present Status
Designation

(c) Pay Expected (Rs.)

9. References

:
Basic pay / Month
(Rs.)

Total Emoluments
(Rs.)

Name
Designation
Organization
Contact Number
Email

Name
Designation
Organization
Contact Number
Email
10. Joining time required, if selected

Place :
Date

Attach Photo Copies of the following :

1.
2.
3.

Educational Qualifications
Proof for Experience Certificate (If any)
Salary Proof (If applicable)

Signature of the Applicant