Gujarat Power Engineering and Research Institute

Gujarat Power Engineering and Research Institute

Mewad, Mehsana

Date: ______

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Photo

Post Applied for ______Subject: ______

Department: ______

1. Name in Full: _____ ______

(Capital Letters only) (Surname) (First Name) (Last Name)

2. Address:

Correspondence:______

City: ______District: ______Country:______

Permanent:______

Phone: ______Mobile No. ______E-mail:______

3. Date of Birth: ______4. Nationality: ______5. Sex: M/F______

6. Present Status:

Designation: ______

Organization: ______

Total Emoluments: ______

7. Areas of Specialization: ______

8. Current Areas of Research: ______

9. Academic Record (Starting with Bachelor’s Degree)

(Please attach photocopies of degree certificates and also brief synopsis of the Master’s & the Doctoral thesis)

Degree
(Subjects) / Institution / Year / Marks/
Division/ Grade / Remarks

10. Title of Ph.D/M.E/M.Tech. Thesis: ______

11. Category: Open/SC/ST/SEBC

(Attach a certificate from the authority prescribed under government rules for SC/ST/SEBC category)

12. Previous Experience (Starting with the recent)

A1. Teaching Experience:

Sr. No. / Organization / Designation / Pay Scale / Total Pay (PM) / Duration / Total Experience
From / To

A2. Details of Academic Experience (in years and months):

(a) Teaching at Post Graduate Level: From______to______

Subject taught at P.G. Level Name of Subjects: ______

______

(b) Teaching at Graduate Level: From______to______

Subject taught at Graduate Level Name of Subjects:

Teaching at other Level(s), if any ______

Name of Subjects: ______

______

B1. Research Experience: (Excluding Research during M.Tech./Ph.D.)

Sr. No. / Organization / Designation / Pay Scale / Total Pay (PM) / Duration / Total Experience
From / To

(a) Research Supervision: (i) Ph.D. Level______

(ii) P.G. Level______

(b) Other Research Experience, if any ______

______

B2. Sponsored projects:

Duration / Sponsoring Organization / Title of Project / Amount of Grant / Co-Investigators (if any)

B3. Consultancy

Duration / Sponsoring Organization / Title of Project / Amount of Grant / Co-Investigators (if any)

C. Publications:

No. of Research Papers published in journals.

(I) In Refereed Journals:

No. of Publication / *Total Impact Factor
International
National

*Cumulative total of impact factor of all the publications in Refereed journals

(ii) In Proceeding of Refereed (i) International: ______

Conference (ii) National: ______

Note: Please attach the summary on separate sheet for publication in refereed journals and refereed conferences papers including all details (i.e. Title, Year, Vol., Page No. Name of the Publisher (may be mentioned) & Impact factor.)

(iii) Details of published Books/Review article: ______

______

D. Industrial Experience:

Duration / Organization / Nature of Work / Total Pay (pm)

E. Contribution in Institutional/department activities (administrative):

Duration / Organization / Nature of Responsibility / Designation

13. Professional distinctions/Awards/Medals if any:

______

14. Details of any other innovation/activity involved during professional career.

a. Innovation/Contributing in teaching:

(i) Design of Curriculum : ______

(ii) Teaching methods: ______

(iii) Laboratory Development: ______

(iv) Evaluation method: ______

(v) Preparation of Resource Material: ______

(vi) Remedial teaching: ______

b. Extension work (Community service/ ______

Corporate life) ______

15. Membership of Professional Bodies: (i) ______

(ii) ______

(iii) ______

16. Give Names, designation and address of three persons (not related to you), to whom reference may be made about your work, conduct & performance.

(i)______

Email: ______Contact No.:______

(ii)______

Email: ______Contact No.:______

(iii)______

Email:______Contact No.:______

17. State any other information not covered elsewhere (Please attach a sheet, if required)

______

18. Minimum time duration for joining: ______

DECLARATION TO BE SIGNED BY THE CANDIDATE

I hereby declare that the details given above are correct to the best of my knowledge and belief. I understand that if any information provided above is found to be false or inaccurate my candidature shall be treated as cancelled at any point of time.

Date:

(Signature)

Name: ......

Summary Sheet

Post Applies for:
Name of Candidate:
Address:
Date of Birth: / Nationality:
Qualification: / Year / Percentage/grade
Ph.D. / Title:
Master Degree / Title:
Bachelor Degree
Teaching Experience:
Pre Ph.D. experience : Total No. of ______Years______Months
Post Ph.D. experience: Total No. Of______Years______Months
Present Position: ______Designation______
Organization:______Total Emoluments (PM):______
Research Experience:
(Excluding Research done for M.tech/Ph.D. / Total No. of ______Years______Months
No. Publications: / In Referred Journal / Total Impact Factor / Conference/
Seminar / Books
No. of Thesis/Dissertation guided (Independently/Jointly) / M.Tech. / Ph.D. / Consultancy
No. of Consultancy projects completed/Continuing with budget Funds / Title of the Projects / Funding Agency / Budget Fund (Rs. Lakhs)
No. of Consultancy projects completed/continuing with budget Funds (Rs. Lakhs) / Title of the Projects (Rs. Lakhs) / Funding Agency / Budget Fund
(Rs. Lakhs)
Awards &Distinctions:
Any other Information
For Use of GPERI
Remarks if any

Cumulative total of impact factor of all the publications in Referred journals

SIGNATURE OF THE CANDIDATE

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