MAHATMA GANDHI INSTITUTE OF TECHNOLOGY Chaitanya Bharathi P.O., Gandipet, Hyderabad-500 075. TELANGANA (Permanent Affiliation to Jawaharlal Nehru Technological University Hyderabad) Twice Accredited in 2009 & 2014 by NBA, New Delhi Ph.No.040-24193057, 24193069 Fax: 040-24193067 Website: www.mgit.ac.in, email: principal@mgit.ac.in ----------------------------------------------------------------------------------------------------------------------- APPLICATION FORM FOR RECRUITMENT Submitted to: BY SELECTION TO THE POST OF PROFESSOR/ASSOCIATE PROFESSOR/ ASSISTANT PROFESSOR The Principal, Mahatma Gandhi Institute of Technology, Kokapet (V ), Chaitanya Bharathi (P.O.), Gandipet, Hyderabad 500 075 Note: Please read enclosed instructions before filling up this form. Post to which applied Department/ Subject DD No. & Date Amount (Rs) Bank & Branch 1000.00 Professor/Associate Professor/Assistant Professor (Strike off, whichever not applicable). Advt. Number MGIT/1/2016, dated 13.02.2016 Name of the Candidate Father s Name Father s Occupation Reservation Date of Birth Nationality Address for Communication: Mobile Number MGIT Present Designation Physically Handicapped Place of Birth Office number if any? Surname Gender E-mail Aadhaar No: PAN No: Present Designation Date of Last Promotion UG-Course PG-Course Pay band & AGP Membership in professional bodies UG-Specialization PG-Specialization Ph.D. (Whether awarded or not) Yes/No Year Awarded Affix latest Colour Passport size Photograph (Self Attested) 1
EDUCATIONAL QUALIFICATIONS DETAILS (Beginning with 10 th / SSC): S.No. Degree School/College Board /University Year of Passing Class or percentage Subjects 1 SSC (10 th ) 2 INTER (10+2) 3 UG 4 PG 5 Ph.D. 6 Any Other EMPLOYMENT DETAILS (Beginning with the latest employment): S.No Name & Address of Institute Post Held Scale of Pay (Please Specify the Range) From Date To Date Total Period Basic Pay Gross Pay Job Type (Regular, Ratified, Adhoc/Part time) DETAILS OF RESEARCH (enclose a separate sheet if required): a) Title of Thesis: b) Total number of Research Publications (Conference and Journals): National ---- International ---- Journals Conferences c) Text Book Publications: 2
TOTAL TEACHING EXPERIENCE (enclose a separate sheet if required): a) U.G. Teaching in College/University : b) Teaching to Post-Graduates : c) Guiding Research : d) Any other : Any other academic achievement in support of your application (enclose a separate sheet if required): Mention any two references: 1) Name : Occupation : Address : 2) Name : Occupation : Address : Joining time required, if selected : DECLARATION BY THE APPLICANT I, hereby, declare that the above particulars furnished are true to the best of my knowledge and belief. Place: Hyderabad Date: Signature of the Applicant Note: Please attach Xerox copies of the certificates of qualifications, employment, publications and all other achievements. 3
PART-B (i) FOR THE POST OF PROFESSOR/ASSOCIATE PROFESSOR ONLY (THE PROFORMA TO BE FILLED BY THE CANDIDATE AND HAS TO BE ENCLOSED WITH THE APPLICATION FORM) ACADEMIC PERFORMANCE INDICATORS (Please see detailed instructions of this PBAS proforma before filling out this section) CATEGORY : I. TEACHING, LEARNING AND EVALUATION RELATED ACTIVITIES Lectures, Seminars, Tutorials, Practicals, Contact Hours (give semester-wise details, where necessary) S.No. Course/Paper Level Mode of teaching * Hours per week allotted % of classes taken as per documented record (a) Classes Taken (max 50 for 100% performance & proportionate Score up to 80% performance, below which no score may be given) (b) Teaching Load in excess of AICTE/UGC norms (max score: 10) (ii) Reading / Instructional material consulted and additional knowledge resources provided to students S.No. Course/Paper Consulted Prescribed Additional Resource provided API score based on Preparation and imparting of knowledge / instruction as per curriculum & syllabus enrichment by providing additional resources to students (max. score : 20) 4
(iii) Use of Participatory and Innovative Teaching-Learning Methodologies, Updating of Subject Content, Course Improvement etc. S.No. Short Description Total Score (Max Score : 20) (iv) Examination Duties Assigned and Performed S. No. Type of Examination Duties Duties Assigned Extent to which carried out (%) Total Score (Max Score : 25) CATEGORY: II. CO-CURRICULAR, EXTENSION, PROFESSIONAL DEVELOPMENT RELATED ACTIVITIES Please mention your contribution to any of the following: S.No. Type of Activity Average Hrs/week API Score (i) Extension, Co-curricular & field based Activities Total (Max: 20) (ii) Contribution to Corporate Life and Management of the Institution Yearly/Semester wise responsibilities Total (Max:15) (iii) Professional Development activities Yearly/Semester wise responsibilities Total (Max:15) Total Score (i+ii+iii) (Max:25) 5
CATEGORY: III. RESEARCH, PUBLICATIONS AND ACADEMIC CONTRIBUTIONS A) Published Papers in Journals S. Title Journal ISSN/ISBN Whether No of Whether API No. with No. peer Co- you are the Score page reviewed authors main nos. Impact author Factor, if any B(i)) Articles / Chapters published in Books S. Title Book ISSN/ISBN Whether No. of Whether API No. with Title, No. peer Co- you are the Score page editor & reviewed authors main nos. publisher author ii) S. No. Full Papers in Conference Proceedings Title with page nos. Details of Conference Publication ISSN/ISBN No. No. of Coauthors Whether you are the main author API Score iii) Books Published as single author or as editor S. Title Type of Publisher & Whether peer No. of Whether API No. with Book & ISSN/ ISBN Reviewed Co- you are the Score page Authorship No. Impact Factor, authors main nos. If any author 6
iii C). Ongoing and Completed Research Projects and Consultancies (c)(i & ii) Ongoing Projects / Consultancies S. No. Title Agency Period Grant/Amount Mobilized (Rs lakh) API Score (c)(iii & iv) Completed Projects / Consultancies S. No. Title Agency Period Grant/Amount Mobilized (Rs lakh) Whether policy document/patent as outcome API Score (D) Research Guidance S. No. Number Enrolled Thesis Submitted Degree awarded M.Phil or equivalent Ph.D or equivalent (E) (i) Training Courses, Teaching-Learning-Evaluation Technology Programmes Sl. No. Programme Duration Organised by (ii) S. No. Papers presented in Conferences, Seminars, Workshops, Symposia Title of Organised Conference by / Seminar Title of the Paper presented Whether International/ National/State/ Regional/College or University Level S. No. (iii) Invited Lectures and Chairmanship at National or International Conference/seminar etc Title of the Paper Organised presented by Title of Conference / Seminar Whether International/ National 7
I II III IV. SUMMARY OF API SCORES Criteria Teaching, Learning and Evaluation related activities Co-curricular, Extension, Professional development etc. Total I + II Research and Academic Contribution Last Academic Year Total API Score for Assessment Period Annual average API score for Assessment Period OTHER RELEVENT INFORMATION Please give details of any other credential, significant contributions, awards received etc. not mentioned earlier. S. No. Details (Mention Year, value etc. where relevant) LIST OF ENCLOSURES: (Please attach all copies of certificates, sanction orders, Research Publications / Articles / Conference Proceedings / Books) 1 6 2 7 3 8 4 9 5 10 I certify that the information provided is correct as per records available and documents enclosed along with the duly filled PBAS proforma. Signature of the applicant with Designation, Place & Date Signature of the Head of the Department/Principal N:B: The individual PBAS proforma duly filled along with all enclosures 8