KHULNA UNIVERSITY OF ENGINEERING & TECHNOLOGY Photograph

Khulna-9203
(Application Form for the Post of Lecturer/Assistant Professor)

1. Name (English) :
(Capital Letter)
(Bengali) :

2. a) Father’s Name (English) :

(Capital Letter)
(Bengali) :

b) Mother’s Name (English) :

(Capital Letter)
(Bengali) :

3. Date of Birth :

4. Nationality :

5. NID Number :

6. Present/Mailing Address :
(With Mobile No. & Email Address)

7. Permanent Address :

8. Present Position :

9. Post Applied for :

10. Educational Qualifications (Include ongoing education if any):

Year Board/University Certificate/Degree Division/Class % of marks/CGPA

11. Service Records Non-Teaching, if any (Starting from first appointment):

Organization Designation From To Y M D

Total:
12. Higher Studies (for internal candidates):

Position Held During From To Duration Nature of

Higher Studies (Date) (Date) Years Months Days Leave *

Total
*1. Deputation, 2. Study Leave, 3. Leave without Pay, 4. Others.

13. Teaching Experience (if any) :

Designation/Institution From To Duration

(Date) (Date) Years Months Days

Total

14. Publications in Journals/Proceedings (if any):

Name of the Journal

Sl. Publisher and Name of
Title of the Paper with Vol. No. Issue
No. Publishing Year Author(s)
No, pp.

15. Other Experiences (if any):

16. Name of 2 (Two) Referees (non-relative of the applicant):

(1) (2)

17. Money Receipt No: Amount: Date:

Date: Signature of the Applicant

Mobile Number: