NATIONAL INSTITUTE OF TECHNOLOGY SIKKIM
FORM OF APPLICATION FOR FACULTY APPOINTMENT
To
Registrar-in-Charge
Photograph
National Institute of Technology Sikkim
Ravangla Campus
South Sikkim 737 139, India
1.
Name in full (in capital
letters) (Underline Surname)
2.
Fathers / Husbands Name
3.
a. Marital Status
b. Male / Female :
4.
a. Permanent address
b. Address for correspondence
Phone No.
E-mail ID
(including STD code)
6.
a) Post applied for
b) Advt. No.
c) Department
d) Field of specialisation
If you wish to apply for more than one Department, please send separate applications for each Department.
11.
Date of birth (please attach true copy
of certificate )
12. Are you a citizen of India by birth or by
domicile?
13. Please state your category (SC/ST/OBC/PD/General)
(Please attach true copy of certificate in case of SC/ST/OBC/PD)
9.
If the appointment is offered, how
much time would you need before
joining the post?
10. If you are employed, please state your
employment details with salary (basic
pay & scale of pay)
11. Details of educational qualifications: Please give particulars of all examinations passed and degrees obtained commencing with the High School Leaving Examination (10 th standard /
Matriculation). For Ph.D., please give details, even if it is not complete. Please attach true copies of certificates and mark sheets duly attested.
Sl.
No.
School / College / Institute
Date of
entry
Date of
leaving
Name of the Board
/ University / Institution
Examination
Distinction Subjects (Please mention field Percentage
/ Degree /
/ Class / of specialization, honours, etc, of marks or
where applicable)
Diploma passed Division
C.P.I.
Year of
passing
12. Details of employments: Please give particulars of your present and past employments in chronological order, starting with the present one :
Sl.
No.
Organisation / Institute
Position
held
Nature of duties / work
Date of
joining
Date of
leaving
Last Pay & Scale
of pay
Additional remarks about
experience, if any.*
13.
Research & Development, Training, Project, Publication etc.:
(a) Please attach a list of your Research & Development / Industrial/Training experience
(b) Please state the following in the format below:
No. of PG
projects guided
No. of Ph.D. thesis guided
Completed
No. of Projects involved in
On-going
Sponsored
No. of Patents
Consultancy
(c) Please state no. of publications (Published/Accepted) in the format below:
In Journals (refereed)
In Conferences
Refereed
National
Technical
Reports
Un-refereed
International
Nation International
al
National
International
(d) Citation of your published papers:
(e) Please list most recent / important research publications in the format below :
Name of the journal
Month & year of
publication
Title of the research paper
Single or with Co-author(s)
(f) Books published:
(g) Book chapters written:
(For each of the above items, please give full details in separate sheets)
30.
(a) Teaching experience
No. of years:
No. of different courses taught:
Please give a list of courses taught on a separate sheet with course titles, level (UG/PG) and number of times taught
(b) Areas of specialization
(c) Title of your Ph. D. Thesis
(d) Name of your Ph.D. Supervisor
35. (a) Awards and honours:
(b) Fellow of professional body:
(c) Member of professional body:
(d) Editorial board memberships:
(e) Seminars/conferences organized:
40.
Additional Remarks:
(Applicants may mention here any
special qualifications or experience,
e.g. in organisations which have not
been included under the heads given
above)
41.
Details of enclosures sent with the
application
I hereby declare that I have carefully read and understood the instructions and particulars supplied to me and that all
the entries in this form are true to the best of my knowledge and belief.
________________________
Signature of the Candidate
Date: ................................
NATIONAL INSTITUTE OF TECHNOLOGY SIKKIM
App.
No.
(For
Office
Use)
Name & Address
DEPARTMENT OF : ...................................................................
DD/MM/YYYY Date of Birth
NAME: ...........................................................
SC/ST/PD)(GEN/OBC/Category
DATA SHEET FOR THE APPLICANT FOR FACULTY POSITION
Academic Qualifications
Post
Applied For
Degree
% of
marks
obtained
Year of
Passing
Research & Teaching experience
including current status
Name:
X
1.
In JournalsNational
International
In Conferences-
Mailing Address:
XII
PIN Code:
Publications in
Journals/Conferences/
books Award/
Citation/Patents(Give
Number(s) only)
2.
B.E./B.
Tech/B.
Sc./B.A.
M.E./M.
Tech./
M.Sc./
M.A.
National
International
Book chapters:
3.
Book(s) Written:
4.
Patent(s):
Phone and Mobile Number:
Ph.D.
Univ/Instt.:
Email ID:
Specialization:
Citation(s):
5.
Award(s):
Remarks
(For
Official
Use)
________________________
Signature of the Candidate
Date: ................................
