KLE SOCIETYS

KLE COLLEGE OF ENGINEERING & TECHNOLOGY, CHIKODI

In pursuance of excellence
(Approved by AICTE, New Delhi and Affiliated to VTU, Belagavi)

RECRUITMENT FOR FILLING UP FACULTY POSITIONS

(Please type or write using BLOCK LETTERS)

Advertisement No.
Recent
Post Applied Name of the Post Passport size
photo

Department

1. Name in Full

a) Father Name

Spouse Name

b) Gender Male Female

c) Marital Status Married Single

d) Caste : e) Category SC ST OBC GEN

f)Attested caste certificate enclosed (Yes / No)

(only in case of SC/ST/OBC)

2. Address:
(a) Permanent:
Address Line 1
Address Line 2
Address Line 3
City
Pin Code State

(b) Address for Correspondence

Address Line 1
Address Line 2
Address Line 3
City
Pin Code State
KLECET, Chikodi - Application Form for Faculty Position___________________________________________________________

Mobile
Telephone Office
(with STD Code) Res. No.
Email

3. Date of Birth: 4. Nationality

Day Month Year

4. Present Employment:
Designation
Organization
Date of Joining to the present post
Scale of Pay Rs. AGP / GP:
(if applicable)
Current Basic Pay Rs.
Total Emoluments (per month) Rs.

(* Enclose Copy of Salary Certificate)

5. Areas of specialization:

6. Academic Career Record starting with SSLC: (Attach photocopies)

Certificate/ Year School/ College Board/ University Class/ Percentage/ Remarks/

Degree [UG & Division CGPA Status
PG]
th
10 Level
10+2 Level

7. Academic - Doctoral Degree [Ph.D.] Details: (Attach photocopies)

Thesis Title From To Institute / Guide / Mentor Mode ( Full/ Final Viva Award Date
Date Date University Part Time) Voce Date

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KLECET, Chikodi - Application Form for Faculty Position___________________________________________________________
8. Post Doctoral Work: (Attach photocopies)

Career From To Date Institute / Organization Guide / Mentor Field of Research

Date Work

9. National/State/Others -Test Scores/ Ranks (Attach photocopies)

Sl. No. Examination Year Branch / Area of Specialization Score Rank Percentile

10. Employment Details (Particulars of your past employment in Chronological order starting with current employment -Attach
photocopies)
No. of Scale of Pay & Gross Pay
Date of Date of
Employer Position Held Months/ GP/AGP (If
Joining Leaving
Years Applicable)

11. Total Experience (Number of Years and/or months)

Teaching Experience
Research Experience (Post-Ph.D.)
Industrial Experience
Total Experience

12. Teaching Experience (Number of Years and/or months)

Academic experience as
applicable (month / year) in the
posts indicated or equivalent
Lecturer/Assistant Professor or equivalent
Associate Professor or equivalent
Professor

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KLECET, Chikodi - Application Form for Faculty Position___________________________________________________________

13. Subjects Taught (Last 4 years)

Approximate
Title of the Course taught Year U.G. / P.G. No. of Institution/University
students

14. Research guidance

Completed Ongoing
Ph.D. P.G. Ph.D. P.G.

15. a. Publication details - No. of Papers:

International National
Journal Papers
Conference Publications

b. Provide best papers details (maximum 3)

Author Title Journal Volume Pages Year

16.
Books / Chapters Published & E-learning
materials Developed

17.
Patents

18. Sponsored Projects (Project handled as Principal Investigator)

Current
Funding Agency Title of the Project Project Cost Duration Remarks
Status

19. Consultancy Project (in last 4 Years)

Project Project
Funding Agency Title of the Consultancy Work
Duration Cost

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KLECET, Chikodi - Application Form for Faculty Position___________________________________________________________
20. Professional Training Received / Summer / Winter Schools attended

Year Nature of Training Duration Organization where

training was provided

21. Conferences / Seminars / Workshops attended

Year Conferences / Seminars /Workshops Title of paper presented
attended

22. Industrial Experience / Interaction:

Organization Nature of work Period

23. Continuing Education Programmes /Short Term Courses/Workshops/Seminars etc. organized

Title of Programme Period Funding Agency

24. Experience in Administrative Positions, Curriculum and Lab Development, Student Welfare,
Professional and Outreach Activities:

25. Awards and Recognitions (Attach photocopies):

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KLECET, Chikodi - Application Form for Faculty Position___________________________________________________________

26. Any other relevant information you may like to furnish:

27. Names and addresses of two Professional References:

Name 1. 2.
Position/
Designation
Address

Phone &
Fax
Mobile
E-mail

28. Please indicate how in your opinion you can contribute to KLECETs growth. (Use a separate
sheet, if required)

29. I hereby declare that the entries in this form are true to the best of my knowledge and belief. I understand that my
Candidature will be cancelled if any of the information is found to be false or incorrect. Further, if selected, I will abide
by the rules and regulations of the Institute and also the directions given to me from time to time.

Date :
Place :
Signature of Applicant

List of Self Attested enclosures / certificates / testimonials (tick the appropriate ones)
1. Proof of Date of Birth 7. Conferences/Workshops attended and presented
2. Category certificate (SC/ST/OBC/PWD) papers
3. Salary certificate / pay slip 8. Sponsored and consultancy projects
4. Academic records (SSLC marks card onwards up 9. Workshops / Conferences / Short Term Courses
to Ph.D.) organized
5. Experience certificates 10. Publication and Patents details (list and reprints)
6. Training / Summer / Winter Schools attended 11. Awards and recognitions
12. Testimonial

___________________________________________________________________________________________

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