ATALBIHARIVAJPAYEE

INDIANINSTITUTEOFINFORMATIONTECHNOLOGY
&MANAGEMENT,
GWALIOR
(AnAutonomousInstituteofGovt.of
India)

ROLLINGADVERTISEMENT
APPLICATIONFORFACULTYPOSITION(ASSISTANTPROFEESOR)
Advt.NoDate..

PARTA:DETAILSOFAPPLICANT
1PostAppliedfor

2.Name

3.Fathers/Mothers/HusbandsName:
4.DateofBirth(DD/MM/YYYY):
5.Category:SCSTPHOBCGEN
5.1TypeofPwDCategory:.(OH/HH/VH)
(EnclosePhotocopyofselfattestedcertificate)

5.2)%ofDisability

6.1.ContactDetails:
(a)Address

(b)Email

c)Phone

d)Mobile

PIN:

(d)Fax:___________________

7.EducationalQualifications(inchronologicalorder:startingfromthecurrenttothefirst)
Degree/Certificate NameofInstitution

PassingYear

Grade/Division&
Marks

Remarks

TechnicalQualifications(inchronologicalorder:startingfromthecurrenttothefirst)
Degree/Certificate NameofInstitution

PassingYear

Grade/Division&
Marks

Remarks

8.Areasofspecialization:
Economics:GrowthandDevelopment

9.Teaching/Research/WorkExperience:
Sn

Designation

Scaleandpay(specify
revisedorold)

Nameand
Addressofthe
Organization

From

To

Years Natureofworkand
responsibilities

10.InstitutionalAdministrativeExperience:

11.Teaching/ResearchExperience:(inchronologicalorder)

S.No.

Designation

Organization

From

To

Years

NIL
2

12.AshortwriteuponwhyIconsidermyselfsuitableforthepostappliedforwithin200words.

___________________________________________________________________________________
13.(A)Publications
TotalNumber
InternationalJournal
NationalJournal
InternationalConference
NationalConference
Details
A.1)InternationalJournals
S.No. Author(s)

TitleofPaper

JournalName

Vol,Issue

Year

ImpactfactorofJournal

TitleofPaper

JournalName

Vol,Issue

Year

ImpactfactorofJournal

1.
2.
3.
4.
A.2)NationalJournals
S.No. Author(s)
1.
2.
A.3)InternationalConference
Intheformat:
Authorname1,AuthorName.,Year,NameofConference,Publisher,Place,PageNos.
A.4)NationalConference
Intheformat:Authorname1,AuthorName.,Year,NameofConference,Publisher,Place,PageNos.
13.(B)ProjectsCompleted/developed
S.
No.

Titleofthe
Project

Funding
agency

Amount

Duration

StatusCompleted/ RolePrincipalInvestigator/
ongoing
Coinvestigator

1
3

2
3

13.C)Thesissupervised
C.1)PhDThesis
S.No. TitleoftheThesis

Nameofstudent

Year

Status
NamesofOthersupervisor(if
Completed/ongoin any)
g

1
2

C.2)MastersThesis
S.No. TitleoftheThesis

Nameofstudent

Year

Status
Completed/
ongoing

NamesofOther
supervisor(ifany)

1
2
3

13.D)Consultancyassignments
S.No. Titleofthe Client
Project

Amount

Duration

Status
Completed/ongoing

Role
Principal
Consultant//Co
consultant

(E)Achievementsoflast3years
(F)Awards/Honors/fellowships
14.
Name&Addressesof3Refereeswhoknowsyourwork
Referee1
Referee2
Name
Designation
Address

Referee3

Phone
Office
Residence
Mobile
Email

PARTB:PRESENTEMPLOYMENT
Additionaldetailsaboutpresentemployment(Ifany)
PresentPayscale

:
(CentralGovt/StateGovt/PSU/PrivateEnterprise/Others(Specify)

Ifpayscalehasbeenrevisedrecentlystatethedateofrevisionandalsotheprerevisedscale
Prerevised
Revised
Basicpay
Dearnessallowance
OtherallowancePlspecify)

Remarks

AnyOtherinformationyouwishtofurnish

PARTC:DECLARATION

DeclarationbytheApplicant
Iherebydeclarethatalltheparticularsstatedintheapplication&enclosures,aretruetothebestofmyKnowledge
and belief. At any time I am found to have concealed/distorted any material information, my
candidature/appointmentshallbesummarilyterminatedwithoutanynotice/compensation.
IalsocertifythatIfulfilltheeligibilityrequirementof4tierflexiblecadrestructure.

Place:
Date:

_______________________
SignatureofApplicant

PARTD:FORWARDINGAUTHORITY/EMPLOYERSENDORSEMENT
This is to certify that Mr/Ms/Dr. is working as
from on regular/ contract/tenure appointment in our department/organization. The above
details given by him /her are verified and found correct as per our records. We have no objection for his/her
applyingtoABVIIITMGwalior.
5

Itisfurthercertifiedthatnovigilancecaseenquiryispendingagainsthim/her.Incaseofhis/herselection,he/shewill
berelivedondeputation/directrecruitment.
Date
Place

SignatureoftheEmployerwithyOfficeSeal