APPLICATION FORM FOR TEACHING STAFF

(To be filled by the Candidate)

Advertisement Dated: / Click here to enter a date. / Department Applied for: / Choose an item. /
Position Applied for: / Choose an item. / Specialization Code:
SECTION – A: GENERAL /
1. Name in full / MR. / Click here to enter text. /
2. Date of Birth / Click here to enter a date. /
3. Father’s /
Mother’s Name / MR. / Click here to enter text. /
4. Mailing Address / Pin Code
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5. Tel. No.
(with STD code) / Click here to enter text. / Mobile No. / Click here to enter text.
6. E-mail ID / Click here to enter text.
7. Permanent Address / Click here to enter text.
Pin Code
8.Nationality / Click here to enter text.
9. Marital Status / Choose an item. /
10. Name of the Spouse / Choose an item. / Click here to enter text. /
11. Occupation / Click here to enter text. / Designation / Click here to enter text.
12.Languages known / English☐ / Kannada☐ / Hindi☐ / Tamil☐ / Telugu☐ / Any Other
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13.State of Domicile / Click here to enter text.
14.Present Employer / Click here to enter text.
SECTION B: CATEGORY I: TEACHING, LEARNING AND EVALUATION RELATION ACTIVITIES
EDUCATIONAL QUALIFICATIONS (Starting with highest degree obtained )
Sl.
No. / Examination/Degree / Name of Board/
College/University / Percentage of
Marks/Final Grade / Specialization/subjects / Class/Division
/Grade / Year of
Passing/
Awarding
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2 / Click here to enter a date. /
3 / Click here to enter a date. /
4 / Click here to enter a date. /
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Whether Ph.D. awarded:Choose an item. / If Yes, please indicate below
Ph.D/ M.Tech Degree / University / Title & Area of Work Done / Date of Awarding
NO / Click here to enter a date. /
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Additional Credentials, (NET/SLET/GATE etc..)
DETAILS OF EMPLOYMENT EXPERIENCE (In chronological order starting with the most recent)
Sl.
No. / Name of
Employer/Status of
Institute/University / Post held/
Designation / Period of employment / Basic/ Gross last drawn / Nature of
duties
From / To
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2 / Click here to enter a date. / Click here to enter a date. /
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TEACHING EXPERIENCE / TOTAL :Click here to enter text.
Years / Months
i. Under Graduate
ii. Post Graduate
iii Total Teaching Experience
iv.Short term/Continuing Education / Specialist courses /any other courses conductedClick here to enter text.
SUBJECTS TAUGHT
Subject / UG/PG / Number of times this subject has been taught / Course materials prepared if any, for the subjects taught
SUBJECTS you can teach other than the above listed Subjects
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RESEARCH EXPERIENCE / TOTAL : Click here to enter text.
Years / Months
Research Experience other than the period spent for obtaining Ph.D Research Degree
SECTION B: CATEGORY II: CO-CURRICULAR, AND PROFESSIONAL DEVELOPMENT RELATED ACTIVITIES
  1. Student related co-curricular, and field based activities(such as e NSS/NCC and other channels, cultural activities, subject related events).

Sl No. / Description
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  1. Departmental\Academic\Administrative Responsibilities

Institute / Year / Responsibility / Important Contribution
SECTION B: CATEGORY III: RESEARCH AND ACADEMIC CONTNRIBUTION
RESEARCH PUBLICATIONS
  1. Books- Self authored/co-authored/edited

Sl.
No. / Title of the Book (s) / Whether
Sole Author/
Co-author / Name of Publisher
(with City/ Country) / Month&Year of
Publication
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  1. Research Articles/Papers published in Journals /Periodicals /Conference proceedings/Newspapers

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No. / Title of research article / paper(s) / Name of journal
(with city/ country) / Whether
Sole Author/ Co-author / Month & year of
Publication,
Volume no.
pageno. / Level / Impact
Factor
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Note: Ignore, if other than National or International
RESEARCH PROJECTS UNDERTAKEN (other than that for a research degree)
Sl. No. / Title/Subject of Research Project(s) / Whether major or minor project / Date of Commencement / Date of Completion / Total Grants / Funding received
(Rs.) / Name of Sponsoring/ Funding Agency / Whether Outcome / Outputs sent to Sponsoring Govt. Agency / Whether final report published as monograph book
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RESEARCH GUIDANCE:
Number of scholars who have been awardedPh.D. degree
under yoursupervision both as Guide and/or Co-Guide: / Click here to enter text.
Name of Degree / Submitted / Awarded
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PROJECTS/THESIS SUPERVISED / FACULTY GUIDANCE
Title / Year / Level of Students/No of students / Institute/Organization
Instructional Materials prepared, if any (give details)
Sl No. / Type of Instructional Material / Title / Subject
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IIISECTION B: CATEGORY IV: TRAINING COURSES AND CONFERENCE/SEMINAR/WORKSHOP
Refresher Course, Methodology, Workshops, Training, Faculty Development Programs,etc. attended.
Sl. No. / Name of Course attended / Sponsoring Institution / Duration
From / To
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Lecture/Special Lecture in Institutions of repute other colleges
Sl. No. / Title/Subject of Lecture delivered / Name and Place of Institution / Date of Lecture / Duration
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Invited Lectures & Chairmanships at International /Seminars/ Workshops/ Conferences Organized
Sl. No. / Particulars
Seminars/ Workshops/ Conferences Organized / Date
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SECTION C: OTHER MISCELLANEOUS INFORMATION
Membership/Fellowship of other institutions/professional societies
Name of the Society/Body / Designation / National/International
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Other activities/Responsibilities:
Details of Scholarships/Awards/Honours/ Patent awarded
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Any other relevant information, if not given above: NA
Has there been any break in your academic career? If so, give details.
Were you at any time declared medically unfit or asked to submit your resignation or discharged or dismissed? If yes, give details in a separate sheet.
Do you have any case pending against you in any court of law? If yes, give details
Do you suffer from any major ailment /medical problem? Yes/No, If yes, give details:
Are you willing to accept the minimum initial pay in the grade? If not, state reasons for claiming higherStarting pay
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If selected for appointment, what notice would you require for joining the post?
Do you intend to work for minimum 3 years in MVJCE?
Have you ever applied to / worked for MVJCE before? If yes, give details
Is any member of your family employed in the past or the present in any MVJ group of institutions?If yes, Give details
Expected salary
Names and Addresses of Two Referees*:
1) / Name: / NA / 2) / Name: / NA /
Designation: / Click here to enter text. / Designation: / Click here to enter text. /
Mobile No.: / Click here to enter text. / Mobile No.: / Click here to enter text. /
Email-Id: / Click here to enter text. / ` Email-Id: / Click here to enter text. /
*Recommendations from two Referees, not related to the applicants, who are scholars closely acquainted with the applicant’s academic training, accomplishment and capabilities.
(NOTE: The College reserves the right to contact the persons referred for ascertaining the credentials of the candidate)
To the applicant:
Any additional information which you have not been able to include elsewhere in the application
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ANNEXURE 1: List of Scanned Copies of Documents to be enclosed with the Application Form :
Option provided in the last page of this document for attaching of enclosures
Nos. / Enclosed / Not Applicable
SSLC Marks Card or Age Proof Document / Enclosed /
Latest Pay Slip or Bank Statement / Choose an item. /
Bachelor’s Degree Certificate / Not Applicable /
Bachelor’s Degree Marks Cards / Enclosed /
Master’s Degree Certificate / Choose an item. /
Master’s Degree Marks Cards / Enclosed /
Ph.D Degree Certificate / Choose an item. /
Research Experience Certificate / Choose an item. /
Teaching Experience Certificate / Choose an item. /
Industrial Experience Certificate / Choose an item. /
Research Publications / Papers / Choose an item. /
Professional Membership Certificates / Choose an item. /
Reference Letters / Choose an item. /
Note: Kindly ensure you carry the original copy of the above listed documents for the Interview Process. Availability of complete documentation will assist in speedy closure of offers.
DECLARATION BY THE APPLICANT
I hereby certify that the information presented in this form and the documents enclosed as mentioned in ANNEXURE 1isAuthentic, Accurate and Complete. Any deviation will be sufficient cause for disqualification or dismissal.
Signature of Candidate______ / Date:Click here to enter a date. / Place:Click here to enter text.

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