Application No.

Affix your
recent

Date of Receipt Passport size

Photo here

Initial of Clerk THIAGARAJAR COLLEGE OF ENGINEERING

(A Govt. Aided ISO 9001-2000 Certified, Autonomous Institution Affiliated to Anna University)

MADURAI-625 015

Post Discipline
Application for (Aided / Self-finance)

1. a) Name in full (in Capital Letters) :

b) Sex :

2. Address :

a) Permanent Address: b) Communication Address with Phone No./

Mobile No. /E.mail ID :

c) Father’s / Husband’s Name :

Address :

3. Age & Date of Birth :

4. a) Nationality : b) Religion :

c) Community : SC/ST SCA MBC / DNC BC GT

d) Sub Caste :

5. Educational Qualification (Starting from basic degree) :

Degree Area of Institute / University Month & Year Class % of Marks /

Specialisation of passing Equivalent
 -2-

6. Details of Thesis:

Course Title of the Project / Thesis Brief Details

M.Tech/M.E./M.Sc.,

Ph.D.,

7. Experience (Starting from current Position):

a) Academic * :

Period No. of Years Designation / Last Pay Drawn Institute /Organisation

From To Nature of job

b) Research * :

Period No. of Years Designation / Last Pay Drawn Institute /Organisation

From To Nature of job

a) Industrial * :

Period No. of Years Designation / Last Pay Drawn Institute /Organisation

From To Nature of job

8. Publications

Total No. of Publications:

8.1 Books Published *:

Sl. No. Title Area Publishers Year

 -3-

8.2 Publications in Journals *:

Sl. No. Title Area Name of the National / Year / Vol.

Journal International

8.3 Publications in conference *:

Sl. No. Title Area Name of the National / Year / Vol.

Journal International

9. a) Seminars /Schools/Conferences/Workshops Organised:

Sl.No. Title Period Place Remarks

b) Seminars /Schools/Conferences/Workshops Attended *:

Sl.No. Title Period Place Remarks

10) Special /Invited Lectures Delivered *:

Topic Area Delevered at Year / Date Remarks

 -4-

11) Sponsored Projects Done *:

Title Sponsoring Year Details of Responsibility Amount

Agency Project Sanctioned

12) Consultancy & Testing Work done:

Nature of Interacted Year Details Facilities Revenue
work Industry /Institute utilised / co- Earned
workers

13. Academic Research Guidance / Supervisorship:

Name of Research Course / M.Phil / Ph.D Area of Research / Work Status

Scholars

14. Membership in professional societies:

Name of the Society Details of Membership Nature of Tech. activities Remarks

done through the society

15. Prizes, Medals and honours received, if any:

Details Awarded for the work Status Remarks

 -5-

16. Contribution to the College (Internal candidates only)*:

Date of joining Year of Experience Responsibilities held Nature of activities for the
betterment of the college.

17. Computer knowledge (Specify in particular) :

18. References :1.

2.

19. Testimonials :

20. Any other relevant information :

21. List of enclosures :

1.
2.
3.
4.
5.

DECLARATION

I hereby declare that the information provided in this form are true to the best of my
knowledge and belief

Signature of the Candidate

*Additional Sheets may be used if necessary