K.S.

RANGASAMY COLLEGE OF TECHNOLOGY

K.S.R. KALVI NAGAR, THOKKAVADI - 637215. TAMIL NADU, INDIA.
PHONE: 0488 274748 / 274741 to 274744 (4 LINES)
TELE FAX 04288 - 274860

APPLICATION FORM FOR FACULTY POSITION

Qualification With Specialization

Affix Photo

UG :

PG :

Post: AP / ASP / Prof

Department :

Reference : Advertisement in ______________________

appeared on _____________

PERSONAL DETAILS

1. Name:
2. Father / Husband Name:
3. Date of Birth:
5. Sex:

Male

4. Age:
Female

6. Nationality:
8. Community : FC / BC / MBC / SC / ST

7. Religion:

(For Statistical Purpose only)

10. Marital status :

Married

/ Un-Married

9. Caste:
If married, Spouse : Employed / Unemployed
(For Statistical Purpose only)
No. of Children :
Address for Communication
________________________________________
________________________________________
________________________________________
_______________PIN
Phone No. with STD Code:
Mobile No

Email id.

: _____________________________________________
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ACADEMIC QUALIFICATIONS * (From X Std onwards)

No

Degree

Specialization

Month &
Year of
Passing

Full time /
Agg.
Part time /
%/
Distance
CGPA
Education

Name of the Institution

studied

Name of the Board /

University

1. X Std
2. XII Std
3. Diploma
4. UG
5. PG
6. M.Phil.

7. Ph.D.
8. Others

* Copies of certificate must be submitted at the time of Interview.

PROFESSIONAL EXPERIENCE *
Teaching (in Engineering Colleges only) in chronological order

Duration
Sl.No.

Designation

Institution

From

1.
2.
3.
4.
TOTAL

* Copies of certificate must be submitted at the time of Interview.

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Experience
(in years)
To

Year Month

Others (Industry, Research, Teaching in Arts College / Polytechnic / School) chronological order

Sl.
No.

Designation

Duration
Institution

From

Experience
(in years)
To

Year

1
2
3
4
5
6

TOTAL

SKILL DEVELOPMENT PROGRAMMES [FDP / STTP / WORKSHOPS ATTENDED]

Sl.
No.

Programme

Duration
From

Institution
To

1
2
3
4
5
6
* Copies of certificate must be submitted at the time of Interview.
PUBLICATIONS

Book Publications

1.

(give the title, publisher & year of publication)

2.
3.

Paper : Journal Publication

International :

(give the no. of publications)

National :

Paper : Conference Publication

International :

(give the no. of publications)

National :

* Copies of certificate must be submitted at the time of Interview.

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Month

SEMINARS / CONFERENCES

Seminars / Conference Organised

(give the Conference Theme and the date)

Seminars / Conference attended

International :

(give the number)

National :

* Attach Photo copy of relevant certificates.

ANY OTHER INFORMATION

Sponsored Research Projects Undertaken

Yes

No

If 'yes', provide details

Membership in Professional bodies

1. __________________________________
2. __________________________________
3. __________________________________

Awards & Achievements (if any)

I declare that the above particulars furnished by me are true to the best of my knowledge

Place :
SIGNATURE OF THE CANDIDATE
[With Name]

Date :

* Attach Photo copy of relevant certificates / documents wherever necessary.

Office Use
Date of Interview

: _________________

Selected for the post : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Salary details: _ _ _ _ _ _ _ _ _ _ _ _ _ _

PRINCIPAL
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CHAIRMAN

INSTRUCTIONS TO CANDIDATES

1. The filled in applications should be sent to the Principal with in 15 days from the
date of advertisement.
2. All applications will be scrutinised and eligible candidates will be called for
interview.
3. Salary will be fixed as per the AICTE norms based on qualifications and experience.
4. Written test will be conducted before personal interview if needed.

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