College of Engineering Pune

APPLICATION FORM FOR FACULTY POSITIONS

(Candidates aspiring to apply for faculty position should Carry in person hard copy of their
application form at the time of interview and also email it to [email protected] on or before
27th June 2018 till 5:00 p.m )

Post Applied For:-

(Applicants desiring to apply for more than one post should send separate applications for each
post.)
Photograph

1. Name in full (in capital

letters) (Underline Surname)
2. Father’s / Husband’s Name

3. a. Marital Status b. Male / Female :

4. a. Permanent address b. Address for correspondence (if different from permanent
address)

Mobile No. E-mail ID

5. Date of birth *
6. Nationality
7. Domicile status of candidate

8. If candidate is Physically Handicapped,

state percentage of disability with
Certificate of District Civil Surgeon.

9. Please state your category

(SC/ST/OBC/General)*

10. If you are employed, please state your

present basic pay & scale of pay*

*Duly attested true copy of the documentary proof will have to be submitted.

1
11. Details of educational qualifications: Please give particulars of all examinations passed and degrees obtained commencing with the High School Leaving Examination
(10th standard / Matriculation). For Ph.D., please give details, even if it is not complete*.
Sl. School / College / Institute Date Date of Name of the Examination Distinction Subjects (Please mention Percentage Year of
No. of leaving Board / Degree / / Class field of specialization, of marks or passing
Diploma / honours, etc, where
entry / University / applicable) CPI/ CGPA
Institution passed Division

12. Details of employments: Please give particulars of your present and past employments in chronological order, starting with the present one*:
Sl. Organisation / Institute Position Nature of duties / work Date Date of Last Pay & Additional remarks
No. held of leaving Scale of about experience, if
joining pay any.*

*Duly attested true copy of the documentary proof will have to be submitted.

2
13. Research & Development, Training, Project, Publication etc.:

(a) Please attach a list of your Research & Development / Industrial/Training experience

(b) Please state the following in the format below:

No. of No. of Ph.D. thesis guided No. of Projects involved in No. of Patents
UG/PG
Completed On-going Sponsored Consultancy
projects
guided

(c) Please state no. of publications (Published/Accepted) in the format below:

In Journals (refereed) In
Conferences Technical
Reports /
Refereed Un-refereed Monograms
National International
National International National International

(d) Citation of your published papers:

(e) Please list most recent / important research publications in the format below :

Month & year of

Name of the journal publication Title of the research Single or with Co-
paper author(s)

(f) Books published:

(g) Book chapters written:

(For each of the above items, please give full details in separate sheets if required)

14. (a) Teaching experience No. of years: No. of different courses taught:

Please give a list of courses taught on a separate sheet with course titles, level (UG/PG) and number
of times taught

(b) Areas of specialization

(c) Title of your Ph. D. Thesis

3
 (d) Name of your Ph.D. Supervisor

(e) Please describe briefly your Ph.D. work. Also detail the areas of interest with work done in each case
(if any).

(f) Laboratory Experience: Please describe, in brief, your experience in (i) Setting up teaching and
research laboratories (ii) Conducting laboratory courses & (iii) Using different types of instruments,
systems, computers etc.

15. (a) Awards and honours:

(b) Fellow of professional bodies:

(c) Member of professional bodies:

(d) Editorial board memberships:

(e) Seminars/conferences organized:

16. Did you previously apply for

any post in this Institute? If so,
give particulars and date:

17. Additional Remarks:

(Applicants may mention here any
special qualifications or experience,
e.g. in organisations which have not
been included under the heads
given above)

4
 18. Name, Designation and Address 1.
(along with phone no/ email) of
three
referees who are acquainted
with your
research work. 2.

3.

19. Research plan for COEP

20. In what way as a teacher would

you like to contribute in curricular
and co-curriculuar activities at
COEP
21. Mention your hobbies

22. Mention "Innovative Ways" in

which you have facilitated your
teaching-learning process in your
current assignment. Freshers
may suggest innovative ways in
teaching that they would like to
adopt at COEP.
Note : Incomplete applications will not be entertained.

I hereby declare that, all statements made in this application are true, complete and correct to the best of my
knowledge and belief. I understand in the event of any information being found false or incorrect at any stage or not
satisfying the eligibility criteria according to the requirements of the relative advertisement, my candidature/
appointment is liable to be cancelled/ terminated.

I Certifiy that:

i) No vigilance case is either pending or contemplated me.

ii) No minor/major penalties have been imposed upon me during my Service career.

Place :
Date : Signature of the
Candidate

NOTE:
a) Candidates submitting applications for faculty positions to submit their applications in this form
through proper channel and email it to [email protected]
b) While sending the applications through email, the subject should be clearly mentioned
“APPLICATION FORM FOR FACULTY POSITION OF "Assistant Professor / Adjunct
Faculty in the__________________________ Department ”.

5
 DATA SHEET FOR THE APPLICANTS FOR FACULTY POSITIONS

Academic Qualifications Research & Teaching Publications in Remark

DD/MM/YYYY
Date of Birth
(GEN/OBC/
App. Name & Address Post experience including Journals/Conferenc s (For

SC/ST/PD)
Category
No. Applied For Degree % of Year of current status es/ books Award/ Official
(For marks Passing Citation/Patents(Giv Use)
Offic obtaine e Number(s) only)
e d
Use)
Name: In Journals-
X 1.
National
International
Mailing Address: 2.
In Conferences-
XII
National
International
3. Book chapters:
Undergra
duate

4.
Book(s) Written:
Postgrad
PIN Code: uate
Patent(s):
Phone and Mobile Number: Doctoral. 5.
Univ/Instt.: Citation(s):

Email ID: Specialization: Award(s):

Post Doctoral
Univ/Instt.:

Specialization:

Date: ................................ Signature of the Candidate