Institute of Public Enterprise Affix your

Survey No.1266, Shameerpet Campus, Passport

R R District, Hyderabad – 500 101 Size
Tel: 040 – 23490900, Fax: 040-23490999 Photograph
Website: www.ipeindia.org here

Application Form

Application for the post of Assistant Professor/Associate Professor/Professor

Area of Specialization: ________________________________________

1. Name in Full : _________________________________________

2. Date of birth: _________ Age as on 15/04/2018,_____ yrs ____ months

3. Mailing Address: __________________________________________________

_________________________________________________________________

_________________________________________________________________

Tel. No. __________________________ Mobile No. ____________________

Fax No. ___________________________ E-mail ________________________

4. (a) Gender (M/F): ____ (b) Marital Status: ________

5. Nationality : ___________

6. Teaching Interests: _______________________________________

_________________________________________________________________

7. Areas of Research Interests: _________________________________________

____________________________________________________________________
 8. Topic of Ph.D./Equivalent: _________________________________________

____________________________________________________________________

9. Educational Qualifications recognized by AIU/UGC/any other statutory

body or parity (in reverse chronological order):

Sl. Examination University/ Subjects Year of %age Class/ Part- Full

No. Passed Institution passing of Division time time
marks

10. Courses (Subjects) Taught:

S.No. Course (Subject) Title Organization/ Institution Level Participants’

(UG/PG) Feedback (if
available)
 11. Full time Work Experience (in reverse chronological order):

Sl. Name of the Pre- Post Period of Position/ Scale of Pay & Reason for
No Employe Ph.D Ph.D Service Designation Basic Pay leaving
. r . . From To

(a) Total work experience: __________ years

(b) Total Post-Ph.D. Teaching Experience

(i) at P.G. level: ______ years

(ii) at U.G. level: ______ years

(iii) any other (please specify): _______ years

(c) Total Work Experience as Assistant Professor/Associate Professor/

Professor: ________ years

12. Details of Publications, Research and Consultancy Works (Please attach

separate sheet, if necessary). Please provide separately the details of
publications in refereed journals with citation index/ impact factor.
13. MDPs/Workshops/Seminars/Consultancy conducted (Please attach separate
sheet, if necessary)

14. Experience of Administrative Responsibilities in Academic Institutions:

15. Any other information you may wish to add (use separate sheet, if
necessary):

16. Names of two Professional References ( Please attach the copy of the
two professional references)

17. Declaration:

I declare that the foregoing information is correct and complete to the best
of my knowledge and belief and nothing has been concealed/distorted. If I
am found to have concealed/distorted any material information, my
appointment shall be liable to summarily termination without any notice. If
offered appointment, I will join on specified date and subsequently take up
IPE’s assignment anywhere as and when required.

Date: ______________

Place: ______________ Signature of the Candidate