Beruflich Dokumente
Kultur Dokumente
1. Name in Full
(In Block Letters)
2. Fathers/Husband/
Wife Name
3. Date of Birth: Gender: Age: Marital Status: Nationality: Religion:
(dd/mm/year)
Male/Female Married/Unmarried
4. Category
(GEN/OBC/SC/ST/PWD)
(Enclose proof)
5. Present Employment with Salary Details
Institute/Organization Designation Nature of Pay Band Grade Total Salary
Work Pay (Per month) in
Rs.
6. Address for
Correspondence
Pin Code:
Tel.Nos./Fax Nos
Email
1
7. Permanent Address
Pin Code:
8. Educational Qualifications (Please add more rows if needed)
Sl. Degree Obtained Specialization Name of the Year of % of Class/
No. University/Institute Passing Marks/ Division
CGPA
(i) Ph.D.
(ii) M. Tech/MS/MCA/
M.Sc./MBA/MA
(v) X Class
2
11. Post Doctoral Fellowship Details
(i) No. of years of Post Doctoral
Fellowship
(ii) Area of Specialization
12. Industrial Experience Details (Post-Ph.D.) Post-Ph.D. Industrial Experience (in years):
Industry/Organization Start Date End Date Duration Designation Nature Pay Scale
of
work
13. Industrial Experience Details (Pre-Ph.D.) Pre-Ph.D. Industrial Experience (in years):
Industry/Organization Start Date End Date Duration Designatio Nature Pay Scale
n of
work
14. Teaching Experience Details (Post-Ph.D.) Post-Ph.D. Teaching Experience (in years):
Institute/Organization Start Date End Date Duration Designation Nature Pay Scale
of
work
15. Teaching Experience Details (Pre-Ph.D.) Pre-Ph.D. Teaching Experience (in years):
Institute/Organization Start Date End Date Duration Designation Nature Pay Scale
of
work
3
16. R & D Experience Details (Post-Ph.D.) Post-Ph.D. R&D Experience (in years):
Institute/Organization Start Date End Date Duration Designation Nature Pay Scale
of
work
17. R & D Experience Details (Pre-Ph.D.) Pre-Ph.D. R&D Experience (in years):
Institute/Organization Start Date End Date Duration Designatio Nature Pay Scale
n of
work
19. Courses Taught during last 3 years (Add more rows if needed)
(i) Course Title Level (UG/PG) Branch No. of
Times
4
21. Number of Academic Programmes Developed:
Programme Title Level (UG/PG)
22. Conducting Laboratory Classes During Last 3 years (Add more rows if needed)
Course Title Level (UG/PG) Branch
24. Number of Publications (Please attach a separate sheet with all details and also list the best SCI
Journal papers along with ISBN No.):
Nature Published (SCI) In-Press (SCI)
(i) Refereed Journals National (SCI)
International
(SCI)
(ii) Conference National (SCI)
Proceedings International
(SCI)
25. Number of Books Published:
Title of the Book Name of Name of the ISBN Year of Reprint
Author(s) Publisher No. Publicati No./
on Edition No.
5
29. Ph.D. Thesis Supervised Completed: On-going:
Title of the Thesis Research area Year Supervisor/ Complete
Co-Supervisor d/ On-
going
6
37. Your immediate short-term plans for the development of research at NIT Jamshedpur. Also
include research and Laboratory facilities (equipment, space, funds, manpower) that you will need
for the same
(i) Research
(ii) Laboratory Development
38. List the courses you would like to develop at NIT JSR
Course Title(s) Level (UG/PG)
39. List the courses you would like to teach at NIT JSR
Course Title(s) Level (UG/PG)
(ii)
Place:
8
NATIONAL INSTITUTE OF TECHNOLOGY JAMSHEDPUR
Jamshedpur-831014, Jharkhand, India
(An Institution of National Importance under MHRD, Government of India)
Post Applied with AGP Deapartment Specialization Reg. No. (for office)
for
1. Name in Full
(In Block Letters)
2. Fathess/Husband/
Wife name
3. Date of Birth: Gender: Age: Marital Status: Nationality: Religion:
(dd/mm/year)
Male/Female Married /
Unmarried
4. Category
(GEN/OBC/SC/ST/PWD)
(Enclose proof)
5. Phone/ Mobile No.
7. Educational Qualifications
Sl. Degree Obtained Specialization Name of the Year of % of Class/
No. University Passing Marks/ Division
/ Institute CGPA
(i) Ph.D.
(ii) M.
Tech/MS/MCA/
M.Sc./MBA/MA
(iii) BA/B.Sc./B.
Tech.
(iv) XII Class
(v) X Class
9
8. Ph.D. Degree Details
(i) Ph.D. Thesis Title
(ii)Area of
M.Tech/MS/MCA/M.Sc./MBA/MA
Dissertation work
10. Post Doctoral Fellowship Details
(i) No. of years of Post Doctoral
Fellowship
(ii) Areas of Specialization
(ii) Research
(iii)Industry
(iv) Administrative
Place:
Date:
Signature of the Applicant
11
jk"Vh; izkS|ksfxdh laLFkku Tkeksniqj
National Institute of Technology Jamshedpur-831014
Jharkhand (India)
(An Institution of National Importance under MHRD, Govt. of India)
To claim credit points in different categories, enclose relevant documents with self-
attestation.
Declaration
I hereby declare that the information furnished above is true to the best of my knowledge and
belief. If at any time it is found that I have concealed any information or have given any
incorrect data, my candidature/ appointment may be cancelled/terminated, without any notice
or compensation
15
jk"Vh; izkS|ksfxdh laLFkku Tkeksniqj
National Institute of Technology Jamshedpur-831014
Jharkhand (India)
(An Institution of National Importance under MHRD, Govt. of India)
16
3. Details of Ph.D. Thesis supervised (awarded) / thesis submitted) as Sole Supervisor / 1 st
Supervisor / Co-supervisor
Sl Title of Ph.D. Role Institute Name of Co- Year Status
No. Thesis student[s] Supervisor[s] [Awarded/
, Submitted
if any
17
6. HOD, Dean, Chief Warden, Prof In-Charge (T&P), Advisor (Estate), CVO, PI (Exam),
TEQIP Coordinator
[Max 16 Credit Points since last promotion]
Sl Position held No. of Period
No. Semesters From To
8. Chairman and Convener of different standing committees and special committees (ex
officio status will not be considered). Faculty in charges (each for one yr duration) of
different units or equivalent
[Max 3 Credit Points since last promotion]
Sl Position held No. of Period
No. Semesters From To
18
10. Workshop/FDP/Short term courses of min 05 working days duration offered as
coordinator or convener
[Max 8 Credit Points since last promotion]
Sl In the Title Period Organise Sponsor Amount
No. Capacity of From To d at ed by [in
lakhs]
11. For conducting National Programs like GIAN etc. as course coordinator [Max 4 Credit
Points (of 2 weeks duration / Max 2 Credit Points (for 1 week duration) since last
promotion]
[a] Programs of 2 weeks duration
Sl In the Name of Period Organised at Sponsored by
No. Capacity of Program From To
13. Length of service over and above the relevant minimum teaching experience required for
a given cadre [Max 10 Credit Points since last promotion]
Sl Current cadre Experience in Current Cadre Over and above teaching
No. experience
19
14. Establishment of new Lab(s) [4 Credit Points since last promotion]
Sl Name of Lab Year of Establishment Department/Institute
No.
15. Theory Teaching of over and above 6 credit hrs course [Max 6 Credit Points since last
promotion]
Sl Name of the Total teaching hours per week Year and Semester
No. Course
19. Text/Reference Books Published on relevant subjects from reputed national publishers or
book chapters in the book published by reputed International publishers [Max 6 Credit
Points since last promotion]
Sl Author(s) Year of Book Title of Page No. ISBN/I National Publish
No. publicati Title Chapte (if reqd) SSN / er
on r, if Fro To No. Internat
any m ional
20
20. Significant Outreach Institute Activities [Max 4 Credit Points since last promotion]
To claim credit points in different categories, enclose relevant documents with self-
attestation.
24. There are .number of enclosures with pages attached along with this form.
Declaration
I hereby declare that the information furnished above is true to the best of my knowledge and
belief. If at any time it is found that I have concealed any information or have given any
incorrect data, my candidature/ appointment, may be cancelled/terminated, without any
notice or compensation
21