KLE SOCIETY’S

KLE COLLEGE OF ENGINEERING & TECHNOLOGY, CHIKODI

In pursuance of excellence…
(Approved by AICTE, New Delhi and Affiliated to VTU, Belagavi)

RECRUITMENT FOR FILLING UP FACULTY POSITIONS

(Please type or write using BLOCK LETTERS)

Advertisement No.
Recent
Name of the GIRISHKUMAR RATHOD
Post
Department CIVIL ENGINEERING

1. Name in Full G I R I S H K U M A R R A T H O D

a) Father Name S H A N K A R R A T H O D

Spouse Name

b) Gender Male Female

c) Marital Status Married Single

d) Caste : e) Category SC ST OBC GEN

f) Attested caste certificate enclosed (Yes / No)

(only in case of SC/ST/OBC) YES

2. Address:

a) Permanent

Address Line 1 H O S E N O. 1 2 9/ 8 W A R D N O. 1 0
Address Line 1 M A H A V E E R R O A D
Address Line 3 N E A R R A I L W A Y S T A T I O N
City B A G A L K O T
Pin Code 5 8 7 1 0 1 State K A R N A T A K A

(b) Address for Correspondence

Address Line 1 H O S E N O. 1 2 9/ 8 W A R D N O. 1 0
Address Line 1 M A H A V E E R R O A D
Address Line 3 N E A R R A I L W A Y S T A T I O N
City B A G A L K O T
Pin Code 5 8 7 1 0 1 State K A R N A T A K A
 Mobile 9 7 3 8 3 4 8 0 7 7
Telephone Office
(with STD Code) Res. No.
Email g i r i s h k u m a r . r a t h o d @ g m a i l . c om

3. Date of Birth: 1 7 1 11 1 7 8 6 4. Nationality I N D I A N

Day Month Year

4. Present Employment:
Designation H E A D O F D E P A R T M E N T
Organization
V. P. M POLYTECHNIC,
BAGALKOT
Date of Joining to the present post 01 / 01 / 2013
Scale of Pay Rs. AGP / GP:
(if applicable)
Current Basic Pay Rs.
Total Emoluments (per month) Rs. 1 5 0 0 0
(Consolidated Salary)

5. Areas of specialization: Structural Engieering

6. Academic Career Record starting with SSLC: (Attach photocopies)

Certificate/ Year School/ College Board/ University Class/ Percentage/ Remarks/

Degree [UG & PG] Division CGPA Status
10th Level 2002 S.S.H.S Bagalkot KSSE Board Ist 64.64
10+2 Level
BVVS Polytechnic
DIPLOMA 2005 Bagalkot DTE Bangalore IInd 57.00
BE (CIVIL) 2009 BEC Bagalkot VTU Belagaum IInd 58.00
M-TECH
(Structural Engg) 2012 BEC Bagalkot VTU Belagaum FCD 78.30

7. Academic - Doctoral Degree [Ph.D.] Details: (Attach photocopies)

Thesis Title From To Institute / Guide / Mentor Mode ( Full/ Final Viva Award Date
Date Date University Part Time) Voce Date
8. Post Doctoral Work: (Attach photocopies)

Career From To Date Institute / Organization Guide / Mentor Field of Research

Date Work

9. National/State/Others -Test Scores/ Ranks (Attach photocopies)

Sl. No. Examination Year Branch / Area of Specialization Score Rank Percentile

10. Employment Details (Particulars of your past employment in Chronological order starting with current employment -Attach
photocopies)
No. of Scale of Pay & Gross Pay
Date of Date of
Employer Position Held Months/ GP/AGP (If
Joining Leaving
Years Applicable)
01/01/20 Till
VPM Polytechnic, Bagalkot HOD 13 Working 04 Years 15000 15000
KHB Bangalore Site Engineer 2009 2010 01 Years 20000 20000

11. Total Experience (Number of Years and/or months)

Teaching Experience 04
Research Experience (Post-Ph.D.)
Industrial Experience 01
Total Experience 05

12. Teaching Experience (Number of Years and/or months)

Academic experience as
applicable (month / year) in the
posts indicated or equivalent
Lecturer/Assistant Professor or
equivalent Associate Professor or
equivalent Professor
13. Subjects Taught (Last 4 years)
Title of the Course taught Year U.G. / P.G. Approximate
No. of students
Institution/University

14. Research guidance

Completed Ongoing
Ph.D. P.G. Ph.D. P.G.

15. a. Publication details - No. of Papers:

International National
Journal Papers
Conference Publications

b. Provide best papers details (maximum 3)

Author Title Journal Volume Pages Year

16.
Books / Chapters Published & E-learning
materials Developed

17.
Patents

18. Sponsored Projects (Project handled as Principal Investigator)

Funding Title of the Project Project Cost Duration Current Status Remarks
Agency
19. Consultancy Project (in last 4 Years)

Project Project
Funding Agency Title of the Consultancy Work
Duration Cost

20. Professional Training Received / Summer / Winter Schools attended

Year Nature of Training Duration Organization where

training was provided

21. Conferences / Seminars / Workshops attended

Year Conferences / Seminars /Workshops Title of paper presented
attended

22. Industrial Experience / Interaction:

Organization Nature of work Period

23. Continuing Education Programmes /Short Term Courses/Workshops/Seminars etc.

organized
Title of Programme Period Funding Agency
24. Experience in Administrative Positions, Curriculum and Lab Development, Student
Welfare, Professional and Outreach Activities:

25. Awards and Recognitions (Attach photocopies):

26. Any other relevant information you may like to furnish:

27. Names and addresses of two Professional References:

Name 1. 2.
Position/
Designation
Address

Phone &
Fax
Mobile
E-mail

28. Please indicate how in your opinion you can contribute to KLECET’s growth. (Use
a separate sheet, if required)
29. I hereby declare that the entries in this form are true to the best of my knowledge and belief. I
understand that my Candidature will be cancelled if any of the information is found to be false or incorrect.
Further, if selected, I will abide by the rules and regulations of the Institute and also the directions given to
me from time to time.

Date :
Place :
Signature of Applicant

List of Self Attested enclosures / certificates / testimonials (tick the appropriate ones)
1. Proof of Date of Birth 7. Conferences/Workshops attended and presented
2. Category certificate (SC/ST/OBC/PWD) papers
3. Salary certificate / pay slip 8. Sponsored and consultancy projects
4. Academic records (SSLC marks card onwards up 9. Workshops / Conferences / Short Term Courses
to Ph.D.) organized
5. Experience certificates 10. Publication and Patents details (list and reprints)
6. Training / Summer / Winter Schools attended 11. Awards and recognitions
12. Testimonial

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