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
Photo
Father / Spouse Name
Mother Tongue & Languages
Known
Nationality & Religion

Correspondence Address Permanent Address

Email Address Mobile Number Landline Number

2. Academic Details
%
Part Time / Full
Name of the School / Marks Year of
Degree Specialization Time / Distance
College or Passing
Mode
CGPA
Post Doc

Ph D NA

M Phil

Post
-graduate

Under
Graduate

Diploma

HSC

SSLC

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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. Project 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.,)

8. Academic Performance Indicator Score

(In case of Candidates with Teaching Experience):
Period (From – To)
Category I Category II Category III

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9. Any Other Information

10. References

Name

Designation

Organization

Contact
Number

Email

Name

Designation

Organization

Contact
Number

Email

Place :
Date :

Signature of the Applicant

Attach Photocopies of the following

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