P.S.R.

Group of Institutions
Sivakasi - 626 140, Virudhunagar Dist. Tamilnadu

APPLICATION FOR FACULTY POSITION 2015-16

Post Applied For: _________________

Department______________

Date____________

1) Name (in Block Letters)

2) Father / Husband Name

Gender : Male / Female

3) Date of Birth & Age

Religion :

4) Community
OC / BC / MBC / SC / ST / Others
Present Address

Permanent Address

5) Present / Permanent
Address with Pin code

Phone / Mobile :

E-Mail ID :

6) Educational Qualifications

No.Sl.

Course / Branch
(From First Degree Onwards)
Degree

Specialization

Full Time/
Part Time/
Distance
Mode

Name of the Institution

University

%
of
Marks

Class

Month
&
Year of
Passing

7) Experience:

Sl. No.

A. Teaching
Period
Designation

Name of the Institution

From

Total Service
To

Year

Month

Last
Pay
Drawn

Sl. No

B. Industry
Period
Designation

Name of the Industry

From

Total Service
To

Year

Month

Last
Pay
Drawn

8) Publications (if any):

Journals

: National ____________ International ______________

Conferences

: National ____________ International ______________

9) Patents / Awards (if any)

10) Books authored (if any)

11) Sponsored Research Projects

(If any)

12) Scholars Guided

: (Enclose Separately)

13) Visits Abroad

: (Enclose Separately)

14) Membership in Academic Bodies

: (Enclose Separately)

15) Any other Achievements

: (Enclose Separately)

Declaration
I declare that the information given above are true to the best of my knowledge.

Signature of the Applicant