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BANNARI AMMAN INSTITUTE OF TECHNOLOGY

SATHYAMANGALAM - 638 401 ERODE DISTRICT TAMIL NADU

APPLICATION FORM

Application for the Post of ________ in the Department of ________________

1. General Information
Name
Date of Birth & Age
Gender Male / Female
Marital Status Single / Married
Father / Spouse Name Photo

Mother Tongue & Languages


Known
Nationality, Religion &
Community

Correspondence Address Permanent Address

Email Address Mobile Number Landline Number

2. Academic Details
% Year
Part Time / Full
Specializati Name of the School / Marks of
Degree Time / Distance
on College or Passin
Mode
CGPA g
Ph D

M Phil

Post
-graduate

Under
Graduate

Diploma

HSC

SSLC

1
3. Experience (Attach the details as separate an Annexure if necessary)
No. of
Position /
Sl. No. Institution / Industry Name From To Years &
Title
Month

Pay Expected (Rs.) :

4. Publication Details (Provide only the count. Attach the details as an Annexure)
Category Conferences Journals
National

International
(In case of patents filed / granted, specify separately)

5. Programmes Organized / Attended (Provide only the count. Attach the details as an annexure)
Category Conferences Workshops FDP / SDP / STTP
Organized

Attended

6. Funds received from the External Agencies


Name of the Amount Title of the Project Duration
Scheme Name
Agency (Rs in Lakhs) and Period

7. Membership in Professional Bodies :


(ISTE, IE, CSI, ISCA, etc.,)

1.

2.

2
8. Any Other Information

9. References

Name

Designation

Organization

Contact
Number

Email

Name

Designation

Organization

Contact
Number

Email

10. Joining time required, if selected :

Place :
Date :

Signature of the Applicant

Attach Photocopies of the following


1. Educational Qualifications
2. Proof for Experience (If any)