Individual Faculty Data Sheet

(To be submitted to the Inspection Committee)ANNA UNIVERSITY

CHENNAI 600 025

INDIVIDUAL FACULTY DATA SHEET [Details to be typed]Name of the College:

Name of the Department:

Name of the faculty member :

Present Designation:

Residential Address:

Contact Nos.:Landline :

Mobile

Email :

Gender:Male / Female / TG

Community :OC / BC / MBC / SC / ST

: O

PAN Number :OC / B

Passport Number :

Date of Birth:

I. Particulars of Educational Qualification: (only completed)CategoryName of the DegreeSpecializationYear of PassingName of the CollegeName of the University% of Marks / Grades obtainedClass obtained

UG

PG

Ph.D.

* Enclose copies of certificates duly attested by the faculty member and the Principal as proof. I.a. Additional Qualification

:

i. GATE Score (In case of B.E. / B.Tech.)

ii. NET / SLET (In case of M.C.A. / M.Sc. / M.A.)

II. Title of Ph.D. Thesis * :

III. Faculty in which Ph.D. was awarded :

IV. Academic Experience as on 31st December 2014:Name of the CollegeDesignationJoining DateRelieving DateExperience

YearsMonthsDays

Total

V. Industrial Experience:Name of the OrganisationDesignationNature of WorkJoining DateRelieving DateExperience

YearsMonthsDays

Total

VI. Other Relevant Information:Signature of the Faculty(Endorsement by the Principal)

(Inspectors use only)VII. Remarks of Certificate Verifying Officer / Chairman of Inspection Committee:

Eligible to hold the post of ___________________

Verifying Officers

CHAIRMAN

Inspection Committee

Affix and Attest

passport

size photograph

ANNEXURE - II

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