NATIONAL INSTITUTE OF TECHNOLOGY, AGARTALA

TRIPURA
FACULTY APPLICATION FORM

(To be filled in by the office)

Application No.______________No. & Date of receipt______________
Post Applied for______________ Department______________
Specialization______________
Signature of Receiving Officer
__________________________________________________________________
DD No.

Date

Amount

Name of issuing Bank

Before filling of the application forms candidates should properly go through the
instructions
1. The application should be accompanied by Demand Draft of Rs. 300/- for
General category and Rs. 150/- for SC/ST/ OBC category in favour of
Registrar, National Institute of Technology, Agartala payable at State bank of
India, NIT, Agartala Branch (Code No-11491) or any Nationalised Bank
payable at Agartala.
2. The candidates are to send separate application and separate bank drafts for
each post in case any candidate wishes to apply for more than one post.
3. Self attested copies of all certificates/testimonials should be attached and
originals will have to be shown at the time of Interview.
4. Persons in employment should send their applications through proper channel.
However, they may send a copy in advance, but it must be on the prescribed
form & accompanied by the required Demand Draft, copies of
certificates/testimonials etc.
5. Applications received after the due date or found incomplete in any form will
be summarily rejected.
6. The application with all its enclosure securely fastened to it should be super
scribed Application for the post of---------------- and Department------- .
and addressed to The Director, National Institute of Technology, Agartala,
Tripura, PIN-799046

Photograph

1.

(a) Advertisement No.

: ________________________________________

(b) Post applied for

: ________________________________________-

(c) Department

: ________________________________________

(d) Specialisation

: ________________________________________

2.

Full name of the candidate :

(in block letters)
________________________________________

Date of Birth

4.

Fathers Name

________________________________________
: ________________________________________

Mothers Name

________________________________________

5.

Nationality

: ________________________________________

6.

(a) Category

SC

ST

OBC

UR

PWD

(Please attach the self attested copy of

Certificate for SC, ST, OBC & PWD)

(b) In case of OBC, whether :

belongs to Creamy layer
7.

Present Postal Address

(in block letters)

Yes/ No
(If No, enclose OBC Certificate)

: ________________________________________
________________________________________
________________________________________
E-mail: __________________________________
Phone: __________________________________
Mobile: _________________________________

8.

Permanent Postal Address

(in block letters)

: ________________________________________
________________________________________
________________________________________
E-mail: __________________________________
Phone: __________________________________
Mobile: _________________________________
2

9. Marital Status
: _______________________________________
10. Languages
known (Read
1. ______________________________________
Write , Speak)
2. ______________________________________
3. ______________________________________
11. (a) Education qualifications
Degree awarded/ Discipline
Examination
passed

Univ./ Board

Class

Percentage
of marks
obtained/
CGPA

Year of
passing

Subject (s)

High School
Senior Secondary
(Plus Two)
Bachelors Degree
Masters Degree
Ph. D. Degree
Others
(b) Have you cleared NET/ SLET (For Non-Engineering Disciplines)
..........
(c) GATE Score .. All India Rank Year .
12. Details of PG/ Ph. D. thesis
Degree
PG

Title of the thesis

Ph. D.

13. Field of specialization : ____________________________________________________

14. Professional Experience (Teaching/ Research/ Industrial) in chronological order up to the

present post)
Organisation

Designation

From

To

Last Pay band and

Grade pay

15. Academic Profile (Give details of the following in separate sheets)

(a) Publication details (Give numbers) (Attach reprints of best 5 recent publication)
Sl. No.
1.

Nature
Journals

Published

Accepted

National
International

2.

Conferences/
Presentations
(proceedings)

3.

Books

4.

Book Chapters

National
International

# Attach a separate sheet with the list of all publications/ presentation classified as National/
International along with Science Citation Index (SCI).
4

(b) PG Dissertations/ Ph. D. thesis guided/ co-guided:

(i)

No. of PG Dissertations guided

(ii)

No. of Ph. D. thesis guided

(iii)

No. of Ph. D. thesis Co-guided

(Attach the titles of the PG/ Ph.D.s guided

(c) No. of Workshop/ Training Programmes/ Summer/ Winter Schools/ Conferences

Attended/ Organised (use separate sheet if necessary):

(d) Awards, Patents, Prizes, Honours:

(e) Any other relevant information on your academic standing in brief:

16. Sponsored or Consultancy Projects:

Sl.
No.

Title of the Project

Amount
(in Rs.)

Funding
Agency

Period

Remarks
(Completed/
Ongoing)

1.
2.
3.
4.
5.
17. Patents:
Sl. No.

Patents filed with detail

Patent issued
(give details)

Patent Number

1.
2.
3.
4.
18. Administrative Experience (Department/ Institutional Level):
Sl. No.
1.
2.
3.
4.

Post Held

Function

Duration

19. Professional Affiliation, Indian and Foreign (Membership of Societies, etc.)

Organisation

Year of Induction

Grade of Membership

Remarks

20. Present Basic Pay _____________________________ Time required to join if post is

offered ____________________
21. Are you willing to accept the post on Lower Position, if offered? :

Yes/ No

22. Please provide two references (Not related to the candidate), who are well aware of
capability of candidate in the following format, Submit these details of two references in two
separate sealed covers along with the application.
Name of Candidate :
Name and Designation of Referee :
Contact Details :
I know . for .. yeas in my capacity as Guide/ Professor, according
to my evaluation the candidate is rated as below (1 to 10 scale)
(a) Academic Excellence
(i) Knowledge of fundamentals
(ii)Knowledge of latest trends
(b) Academic Delivery
(i)
Subject lecture preparation capability
(ii)

Communication capability for delivering lectures and handling of 100 students

(iii) Doubt clearing/ clarification capability

(iv) Student friendly approach
(c) Research
(i) Research planning
(ii)Research execution
(iii) Technical documentation capabilities
(d) Character/ Integrity/ Moral quality
6

I recommend him/ her for faculty position at NIT, Agartala

23. List of Documents enclosed:
1.
2.
3.
4.
5.
6.
7.
8.
9.
24. Declaration
I hereby declare that the information given above is correct and to the best of my knowledge
and belief. I fully understand that if it is found at a later date that any information given in the
application is incorrect/ false or if I do not satisfy the eligibility criteria, my candidature/
appointment is liable to be cancelled/ terminated.
Place:
Date:

Signature of the Applicant

25. Endorsement of the Present Employer:

The application of ____________________________________________________________
(Name and Designation of applicant) for the post of _________________________________
in the department of ______________________________________ NIT Agartala is
forwarded to the Director, National Institute of Technology Agartala, Tripura 799046.

Date:

Signature of the Head of the Institution with Seal

___________________________________________________________________________
N.B.: Every application must be accompanied by Self Attested Xerox copies of documents
in support of claims made by the candidate in respect of his date of birth, academic
qualifications, practical training, experience, caste, etc. A list of copies of certificates etc.,
attached to this application is to be given.
__________________________________________________________________________