Thangal Kunju Musaliar Institute of Technology

Musaliar Hills, Karuvelil P.O, Ezhukone, Kollam 691 505 Ph: 0474 2482833, 2482083
Fax: 0474 2483715 E-mail : tkminst@gmail.com Website: www.tkmit.ac.in
Application No & Date:

FACULTY APPLICATION FORM

For the post of
In the Dept. of

Professor
EEE
English

Asst. Prof
ECE

CSE

Maths

Senior Lecturer
Mech

Physics

Reference : Advertisement in

FT

Chemistry

Lecturer
Biomedical
Civil

appeared on

1. PERSONAL DETAILS

Please affix recent

Passport size
photograph

Name
Father / Husband Name
Marital status :
Sex :

Male

Female

Married

If married, Spouse :

Employed

Un-Married
Unemployed

No. of Children :
Age :

Date of Birth :

Religion :

Community :

Nationality :

Caste :
Address for Communication

Phone / Mobile :

Email :
1

FC

BC

MBC

SC/ST

2. ACADEMIC QUALIFICATIONS *

Degree

Specialization

Year of
Passing

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

Institution

University

No. of
subjects
passed in
more than
1 attempt

1.
2.
3.
4.
5.
6.

* Attach Photo copies of relevant certificates

3. EXPERIENCE DETAILS *

i. Teaching (in Engg. Colleges only) chronological order

Sl.No.

Designation

Institution

Experience (Duration)

1.
2.
3.
4.

TOTAL

Last Salary drawn (Gross) Rs. / month

Experience (in
years)

ii. Others (Industry, Research, Teaching in Arts College / Polytechnic / School) chronological order
Sl.No.

Designation

Institution

Experience (Duration)

1.
2.
3.
4.
5.

TOTAL

4. PUBLICATIONS

Book publications (give the title, publisher & year

of publication)

Paper : Journal Publication (give the no. of

International :
publications) (attach the Xerox copy of the first page National :
of the publications)
Paper : Conference Publication (give the no. of
publications)

International :
National :

5. SEMINARS / CONFERENCES / JOURNALS

Seminars / Conference organised (give the

Conference Theme and the date)

Seminars / Conference attended (give the number) International :

National :

Experience (in
years)

6. ANY OTHER INFORMATION

Undertaken any Sponsored Research Projects

Yes

No

If 'yes', provide details

Membership in Professional bodies

Awards & Achievements (if any)

I declare that the above particulars furnished by me are true.

Place :
Date :

Name :

SIGNATURE

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