APPLICATION FORM FOR TEACHING STAFF

(To be filled by the Candidate)

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Department Applied for: Choose an item.

Position Applied for: Choose an item.

Specialization Code: Choose an item.

SECTION A: GENERAL
1. Name in full

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2. Date of Birth

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3. Fathers /
Mothers Name
4. Mailing Address

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Pin Code

5. Tel. No.
(with STD code)

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6. E-mail ID

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Mobile No. Click here to enter text.

7. Permanent Address Click here to enter text.

Pin Code
8. Nationality

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9. Marital Status

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10. Name of the

Spouse

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11. Occupation

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12. Languages known

English

13. State of Domicile

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14. Present Employer

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Kannada

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Designation Click here to enter text.

Hindi

Tamil

Telugu

Any Other

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Page 1 of 10

SECTION B: CATEGORY I: TEACHING, LEARNING AND EVALUATION RELATION ACTIVITIES

EDUCATIONAL QUALIFICATIONS (Starting with highest degree obtained )

Sl.
No.

Name of Board/
Examination/Degree
College/University

Percentage of
Marks/Final
Grade

Specialization/
subjects

Class/Division
/Grade

Year of
Passing/
Awarding
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Whether Ph.D. awarded: Choose an item.

Ph.D / M.Tech Degree

If Yes, please indicate below

University

Title & Area of Work Done

Date of
Awarding
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DETAILS OF EMPLOYMENT EXPERIENCE (In chronological order starting with the most recent)

Sl.
No.

Name of
Employer/Status of
Institute/University

Period of employment

Post held /
Designation

From
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Copyright to MVJ College of Engineering, Bangalore

To

Basic/ Gross
last drawn

Nature of
duties

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Page 2 of 10

TOTAL : Click here to enter text.

TEACHING EXPERIENCE

Years

Months

i. Under Graduate
ii. Post Graduate
iii Total Teaching Experience
iv. Short term/Continuing Education / Specialist courses / any other
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RESEARCH EXPERIENCE

Years

Months

v. 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

2. Contribution to corporate life

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Description

3. Professional development activities (such as participation in seminars, conferences, short term, training
courses, talks, lectures, membership of associations, dissemination and general articles, etc.)
Sl No.

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Description

Page 3 of 10

SECTION B: CATEGORY III: RESEARCH AND ACADEMIC CONTNRIBUTION

RESEARCH PUBLICATIONS
1. Books- Self authored/co-authored/edited
Sl.
No.

Whether
Sole Author/
Co-author

Title of the Book (s)

Name of Publisher
(with City / Country)

Month & Year of

Publication

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date.
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date.
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date.
2. Research Articles/Papers published in Journals /Periodicals /Conference proceedings/Newspapers
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Sl.
No.

Title of research article /

paper(s)

Name of
journal
(with city/
country)

Month & year of

Publication,
Volume no.
& page no.

Whether
Sole Author/
Co-author
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Level

Impact
Factor

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item.
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item.

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)

Total
Grants /
Funding
received
(Rs.)

Whether
final report
published as
monograph
book

Whether
major or
minor
project

Date of
Commencement

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Date of
Completion

RESEARCH GUIDANCE:
Number of scholars who have been awarded Ph.D. degree
under your supervision both as Guide and/or Co-Guide:
Name of Degree

Submitted

Name of
Sponsoring/
Funding
Agency

Whether
Outcome /
Outputs
sent to
Sponsoring
Govt.
Agency

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Awarded

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Page 4 of 10

PROJECTS/THESIS SUPERVISED / FACULTY GUIDANCE

Title

Year

Level of Students/No of
students

Institute/Organization

III SECTION B: CATEGORY IV: TRAINING COURSES AND CONFERENCE/SEMINAR/WORKSHOP/PAPERS

Refresher Course, Methodology, Workshops, Training, Faculty Development Programs, etc. attended.

Sl. No.

Name of Course attended

Duration

Sponsoring Institution

From
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To
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Papers presented at National and International Seminars/Conferences / Workshop/ Symposium.

Indicate whether the Conference Proceedings are published.

Sl.
No.

Title/Subject
of paper presented

Subject of Conference
/ Seminar /
Symposium /
Workshop

Organizing
Institution/ and
Name of City/
Country

Whether the
proceedings
published

Duration
From

To

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date.
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date.
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date.

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date.
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date.
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date.

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item.
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item.
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item.

Lecture/Special Lecture in Institutions of repute.

Sl.
No.

Title/Subject of Lecture delivered

Name and Place of

Institution

Date of Lecture

Duration

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Page 5 of 10

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:
Has there been any break in your academic career? If so, give details.
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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.
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Do you have any case pending against you in any court of law? If yes, give details
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Do you suffer from any major ailment /medical problem? Yes/No, If yes, give details:
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Are you willing to accept the minimum initial pay in the grade? If not, state reasons for claiming higher Starting pay
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If selected for appointment, what notice would you require for joining the post?
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Do you intend to work for minimum 3 years in MVJCE?
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Have you ever applied to / worked for MVJCE before? If yes, give details
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Is any member of your family employed in the past or the present in any MVJ group of institutions? If yes, Give details
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Expected salary
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Copyright to MVJ College of Engineering, Bangalore

Page 6 of 10

Names and Addresses of Two Referees*:

1)

Name:

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2)

Name: Click here to enter text.

Designation: Click here to enter text.

Mobile No.:

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Email-Id:

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Designation: Click here to enter text.

Mobile No.: 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
applicants 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
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Latest Pay Slip or Bank Statement
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Bachelors Degree Certificate
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Bachelors Degree Marks Cards
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Masters Degree Certificate
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Masters Degree Marks Cards
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Ph.D Degree Certificate
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Research Experience Certificate
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Teaching Experience Certificate
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Industrial Experience Certificate
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Research Publications / Papers
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Professional Membership Certificates
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Reference Letters
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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 1 is Authentic, Accurate and Complete. Any deviation will be sufficient cause for disqualification or dismissal.

Signature of Candidate_____________________

Copyright to MVJ College of Engineering, Bangalore

Date: Click here to enter a date.

Place: Click here to enter text.

Page 7 of 10

Candidates are required to upload the Scanned Copies of Documents as mentioned in ANNEXURE I in the below table:
SSLC Marks
Card or Age
Proof
Document
Latest Pay Slip
or Bank
Statement

Bachelors
Degree
Certificate

Bachelors
Degree Marks
Cards

Masters
Degree
Certificate

Copyright to MVJ College of Engineering, Bangalore

Page 8 of 10

Masters
Degree Marks
Cards

Ph.D Degree
Certificate

Research
Experience
Certificate

Teaching
Experience
Certificate

Industrial
Experience
Certificate

Research
Publications /
Papers

Copyright to MVJ College of Engineering, Bangalore

Page 9 of 10

Professional
Membership
Certificates

Reference
Letters

Any other
Documents

Copyright to MVJ College of Engineering, Bangalore

Page 10 of 10