Registration No.

____________________ (To be filled by NITH Office)

National Institute of Technology, Hamirpur Hamirpur 177 005(HP)

Application Form For Faculty Position
Signed Photo

Advertisement No.______________________________ Deptt./Centre _______________________________ Post Applied for ______________________________ Field of Specialisation ___________________________ Reservation Category: General /SC /ST /OBC /PH /Other

To be returned to: Registrar,

National Institute of Technology, Hamirpur- H.P. 177 005

NIT Hamirpur is an Equal opportunity Employer Appointments are made on the recommendations of Statutory Selection Committee 1. 2. 3. 4. 5. 6. Full Name (including Surname) (in block letters) Date and Place of Birth Sex Marital Status Nationality Postal Address for correspondence (any change of address should be communicated at once to the Institute) ________________________________________________ ________________________________________________ Male / Female (Strike off whatever is not relevant) Married / Unmarried (Strike off whatever is not relevant) _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ Pin Code _______________________________________ Telephone No ___________________________________ Mob.No. ______________________________________ e-mail ID______________________________________

7.

Permanent Address (Mention Tehsil, District and State you belong to)

_______________________________________________ _______________________________________________ _______________________________________________

8.

a.

Were you at any time declared medically unfit; asked to submit your resignation; discharged or dismissed from Govt./Semi-Govt./Autonomous Body or Private Service ? If yes, give details In a separate sheet. ________________________________________ Is any disciplinary proceeding pending against you and what is its status (Give Details) _______________________________________

b. 9. Sl. No.

Academic Qualifications: (1) Please attach Xerox copies of certificates including Date of Birth. (2) Give particulars in a chronological order starting with High School Certificate. University /Board Year Degree/ Certificate Subject/ Specialisation Division/Grade/ % of Marks Rank in Class

10.

Title of your M.Tech./Ph.D. Thesis awarded, with name and address of Ph.D. Guide.(Enclose abstract of University Year Guide(s) Title of Thesis

thesis on separate sheet) Degree M.Tech./ M.Phil.

Ph. D.

11. Sl. No.

Professional/Teaching/Research Employment (Give particulars in descending chronological order starting with the present post and ending in Ph. D. Period. If space is insufficient, attach separate sheet) Period of Employment From To Employer Post held Basic Pay on last Day in the Scale

12. Sl. No.

Thesis supervised: Ph. D. /M.Tech.(by research) or M.S./M.Tech./M.Phil. Sole/ Principal or Co supervisor

Degree

Name of Student

Brief Title

13.

(a) Publications (Attach comprehensive list of publications during last five years, arranged in chronologically, giving details of Author, Title, Name of Journal, Volume, Page Numbers, Year, Name of Conference Place etc. including books, edited books, e-learning packages, journal and conference publications and all other Scholars work) (Annexure-iv) Under Preparation (Preprint available) Role as Author. (Student/supervisor/ Editor/Coordinator/ Sole Author )

Types of Scholars Publications Books/monographs with ISBN No. or equivalent Publications in International referred journals Publications in National referred journals Publications in proceedings of Conference held outside India Publications in proceedings of Conference held within India Edited Books E-Learning packages Published

Published

In Press

(b)List of 5 Publications (# 1 is most important) that contains your most outstanding contributions:

Sl. No.

Authors, Title, Other details

Role as Author

14.

(a)Teaching Experience in Institutions of Higher Learning (Attach list of Courses taught , new course introduced, e-learning courseware, laboratory courses etc. in Annexure-ii)

(b) Five most Important subject (including laboratory Courses) taught or introduced during the past 10 years
Sl. No. Title of Course Level Introduced First Time Yes/No Volumes of Class notes Distributed (Pages)

(c) Syllabus of one new subject (Theory & Laboratory) that you would like to introduce in NIT. (Syllabus, text books if any, equipment needed etc.)

15.

Short term Course/Continuing Education Programmes / Distance Education Programmes (List 3 most important courses offered or coordinated by you during the past 5 years)

Sl. No.

Title of Course

Target Audience No. of (College/Institutions) Participants

Budget

No. of Lectures

16.

(a)Sponsored research/Consultancy Projects Completed/In progress/Proposal under review (Attach separate sheet giving details of all Projects (Annexure-vi):
As Principal Investigator As Co-investigator Total Value Completed Total Value Ongoing

Type of Project

Total Value Completed

Total Value Ongoing

Sponsored R&D Projects

Consultancy Projects

(b) Details of 3 most important projects of your career taken up as P.I. or Co-P.I.:
Sl. No. Period Sponsor Value P.I./Co-P.I.

From

To

17.

Membership/Fellowship and Positions of Responsibility in Professional Societies ; Prizes/Medals/Awards/Divisions, Scholarship Received and Any other academic award/activities.

18.

Attainment in sports, fine arts, performing arts, NCC, NSS and extra-curricular activities:

19.

Any other information relevant to the post applied for :

20.

Reference ( Name and address of five referees with their complete postal and electronic addresses. Referees should be persons with or under whom, the candidate has worked, or who are familiar with the work of the candidate as sponsors, collaborators or clients:

Sl. No.

Name and Address

E-mail ID and Phone No.

How he knows the Candidate

21.

Copies of documents enclosed:

22.

Bank Draft No.:___________________ Date;_______________ Amount :_____________________ Name of the Bank: ____________________________________

Place: Date: Signature of the Candidate

Enclose the following: (Please use clear computer print on A4 size paper only, except where it is not feasible)
7

Outline of research proposal that you would like to submit to a funding agency on joining NIT Hamirpur (Annexure I) (Also applicable to internal candidates).
1.

Syllabus of a specialized course in the area that you would like to introduce on joining NIT Hamirpur (Annexure II) (Also Applicable to internal candidates).
2.

One page write-up on significant contributions/innovations through teaching, research, design, or any other innovative/creative activity during past five years - Annexure III
3. 4.

Details of Research Publications during past five years - Annexure- IV Journals Author(s), Title of the Paper, Conference, Year, No. of Pages. In Conferences/ Symposia: Author(s), Title of the Paper, Conference, Year, No. of Pages. Communicated (Separately for Journals and Conferences/ Symposia) Details of theses supervised: (a) M.Tech.; Name of student:
6.

(a)
(b)

(c)

5.

(b) Ph.D. - Annexure - V

Thesis title ; Year; Co-Supervisor, if any .

Details of Sponsored/Consultancy Projects handled during past five years -Annexure -VI

Title, Funding Agency, Amounts, Duration and Co-workers, if any.

7.

Details of technology development, transfer patents - Annexure -VII

Note:

Candidates for the posts of Assistant Professor/Associate Professor should attach copies of grade marks in courses taken during M.Tech./Ph.D. programmes and abstract of Ph.D. thesis. All candidates should enclose two copies of the reprints / preprints of three most significant recent research publications. Please mail SUMMARY SHEET Soft Copy of MS-EXCEL file to registrar@nitham.ac.in Use Subject Line (Faculty Recruitment)

NATIONAL INSTITUTE OF TECHNOLOGY, HAMIRPUR(HP)

ACKNOWLEDGEMENT

Advt. No.____________________Registration No. _________________________________________ Sub: Recruitment to the post of _____________________Deptt. /Center__________________________ Received an application from Dr./Mr./Mrs._________________________________________________ (Candidate to write his/her name above in capital letters) for the above mentioned post. For any correspondence in future, candidate must quote the registration number given above.

Date __________________

Office Superintendent (Establishment / Recruitment)

To ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________

(To be filled by the candidate his/her present address)

FORM NO. FAC/ 2A

NATIONAL INSTITUTE OF TECHNOLOGY HAMIRPUR

SUMMARY SHEET
(To be filled by the Candidate) 1. Name ______________________________________ 2. Date of Birth _________________________________ 3. Post _______________________________ 6. Education: Degree Displine University / Board High School (Class- X) Higher Secondary ( +2 ) Bachelors (B.A./B.Sc.) (B.E./B.Tech) Masters (M.A./M.Sc.) (M.E./M.Tech.) Doctorate (Ph.D./D.Sc.) Others (JEE Rank, GATE Score, GRE Score etc.) 7. Employment (in descending chronological order starting with the present employer): Post Pay Scale Period of Employment From Previous Review, if any, at NIT, Hamirpur To Year Division / Grade/ Percentage of Marks Remarks if any (Rank, Hons etc.) 4. Department / Centre ___________________________ 5. Specialization & Present Research Area _________________________________________________________

Employer

FORM NO. FAC/ 2A-1

10

8.

Summary of Performance: U.G. Courses Developed (No.) P.G.

Research Publications

In Journals Past five years Total

In Conferences/Symposia Past five years Total

Published (Nos.) Communicated (Nos.) Thesis Supervised Completed In Progress Sponsored Projects Sponsored/Consultancy Projects Completed In Progress Proposals under Authored Books Edited Consultancy Projects

M. Tech./ M. Phil

Ph.D.

review

9.

Special Training / Assignment / Any other relevant Particulars

11