FACULTY PROFORMA FOR ENGINEERING

PONDICHERRY UNIVERSITY (A CENTRAL UNIVERSITY) PUDUCHERRY 605 014 INDIVIDUAL FACULTY DATA SHEET
1. 2. 3. 4. 5. 6. 7. Name of the College Name of the faculty member With present Designation Present Scale / Pay band Department Classes handled Residential Address Contact Numbers

Affix recent Passport size Photograph

: Regency Institute of Technology, Yanam : : : : : : Land Line: Email: : Male / Female : :

Mobile:

8. Gender 9. Age & date of birth 10. Religion a) Community b) State whether SC/ST/MBC /OBC /Others 11. PAN Card No I.

a) Educational Qualification * : ( 10 th Standard onwards) Month & Year of passing Marks obtained Overall Percentage Class /Division

Examination SSLCE / Matric or equivalent PUC /+2(HSC) or equivalent Diploma

Board

b) Educational Qualifications * : ( UG Degree Onwards) Sl.No UG PG Ph.D c) Other Qualifications: i. Gate Score ( In case of B.E / B.Tech) ii. NET / SLET ( In case of M.C.A / M.Sc /M.A) Details: a) Name of the Exam & Examining body b) Subject c) Reg.No d) Year of passing Degree Subject of specialization University /Institute Percentage / Class / Grade Year of passing

: : : : : :

II.

Academic Experience as on date*

: Year of Experience Any other designation please specify

Sl.No

Name of the College/ Institution

As Lecturer From To

As Asst. Professor From To

Assoc.Professor From To

III.

Industrial Experience *

: Period From To Total No.of Years

Sl. No

Name of the Organization

Designation

Nature of work

IV.

Research Publications (if any) a)

Journals: i) National: ------ ii) International: ----( Enclose Reprints and list of publications & citation index for each)

b) Books: ( Enclose first three pages of the book) V. Seminars/ Workshops/ Conferences Attended: a) As resource person i) National -------ii) International-----b) As participant i) National -------ii) International-----( Enclose list giving details of the Seminars/ Workshops / Conferences) Patents / Awards (if any) ( Enclose copy of the Certificates): Other Relevant Information:

VI.

VII.

Declaration: I declare that all the information given above are true to the best of my knowledge and I am not working in any other college / Institution. Enclose copies of certificates and testimonials as proof. Signature of the Faculty

( Endorsement by the Principal of college/ institution or authorized signatory of the Management with seal)

For office use only Remarks of Certificate Verifying Expert / Chairman of Inspection Committee: Eligible to hold the post of ----------------------------------Verifying Expert CHAIRMAN Inspection Committee Place: Date: