Anna University
APPLICATION FOR THE POST OF VICE-CHANCELLOR, ANNA UNIVERSITY
(Applicant is requested to type the information in this format only. More lines can be added in the format, if required)
1. General information of the applicant:
|Name | |
|(in Capital letters) | |
|Date of Birth (dd/mm/yyyy) | |
|Age (as on 30.06.2021, mm/yy) | |
|Place of birth | |
|Nationality | |
|Category |OC / BC / MBC / SC / ST / PH / Any other …….. |
|Mother tongue | |
|Address for Correspondence | |
|Permanent Address | |
|Phone / Mobile No | |
|Email | |
2. Present position:
|a |Designation | |
|b. |Organization | |
|c. |Pay scale or Consolidated pay per month | |
|d. |Date of appointment to the present post | |
|e. |Total experience in the current position (in years & months) | |
3. Educational Qualification (in chronological order from highest)
|S. No |Degree Awarded |University/ |Year |Major Subject |Marks/ Grades (if any) |
| | |Institute | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
4. (a) Administrative Experience
|S. |Position |Name of Post |Duration |Experience |
|No. | |& Affiliation | |(in years & |
| | | | |months) |
| | | |From |To | |
|1 |Head of the Institute/ University | | | | |
|2 |Head of the Division (Dean, etc.,) | | | | |
|3 |Head of Department | | | | |
|4 |Head of Centres | | | | |
|5 |Chairman, Board of Studies | | | | |
|6 |Others (specify) | | | | |
(b) Member of Councils and Professional Bodies:
|S. |Post |Organization / |Duration |Experience |
|No. | |University | |(in years & |
| | | | |months) |
| | | |From |To | |
|1 |Member, Board of Studies | | | | |
|2 |Member of Academic | | | | |
| |Council | | | | |
|3 |Member of Executive Council | | | | |
|4 |Member of Professional / Academic Bodies | | | | |
|5 |Others (specify) | | | | |
5. (a) Full-time Academic/Teaching Experience (in chronological order from latest to oldest)
|S. |Post |Organization/ |Duration |Experience (in years & |
|No. | |University | |months) |
| | | |From |To | |
|1 | | | | | |
|2 | | | | | |
|3 | | | | | |
|4 | | | | | |
|5 | | | | | |
(b) Other contributions in higher education
| |Organization |Nature of Duty |Period |
|Chair Professor | | | |
|Visiting Professor (Full Time) | | | |
|Resource person | | | |
|Membership in National / | | | |
|International Higher Education | | | |
|Committees | | | |
|Others (Specify) | | | |
(c) Involvement with formulation of academic programs:
|S. No. |Nomenclature of innovative Academic Programs (UG/PG Level)|University/ Institute implemented |Date of approval by Academic |
| |formulated | |Council / Implementation |
| | | | |
| | | | |
(d) New courses introduced:
|S. No. |Name of the Course |Course level (UG/PG) and Program |University / Institute |Date first offered |
| | | |implemented | |
| | | | | |
| | | | | |
(e) Important MoUs formulated for academic collaborations:
|S. No. |Name of Agencies / Departments involved |MoUs formulated (Research/Teaching/Others) |Year of MoU |
| | | | |
| | | | |
6. (a) Details of research papers presented in International / National conferences
|Category |Number of Presentations |
|International Conferences (held in India) | |
|International Conferences (held outside India) | |
|National Conferences | |
|Total | |
(b) Details of research or academic events conducted at international level (mention the role such as organizing chairperson, secretary, treasurer, organizing committee member and advisory committee member):
|S. No. |Title of event |Organization/ |Date |Role |
| | |University | | |
| | | | | |
| | | | | |
7. (a) International academic exposure (Fulltime), if any:
|S. |Post/ |Organisation/ |Nature of duty |Duration |
|No. |Assignment |University | | |
| | | | |From |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
8. Scholarly Achievements:
(a) Kindly provide list of Research Publications / Papers published after acquiring Ph.D. in the journals listed in UGC–CARE (refer )
Total Number of Publications: ………
|S. No |Authors Name |Title of Paper |Journal Name, Year, Vol. & Page |Number of Citations |
| | | |No | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
(b) List of Books Authored
|S. No. |Authors’ Name |Title of Book |Name of the Publisher |Year |Number of Citations |
| | | | | | |
| | | | | | |
| | | | | | |
(c) Contributions to Journals:
|S No. |Role |Provide details |
|1 |Editor in chief | |
|2 |Editorships | |
|3 |Peer reviewer | |
|4 |Member of the International Advisory Board | |
|5 |Others (Specify) | |
10. (a) Patents Published / Awarded
|S. No. |Title of the Patent |Published / Pending Award |Awarded |
| | | | |
| | | | |
| | | | |
(b) Technology Transfer Agreements Signed
|S. No |Technology Transferred |Name of the Industry / |Date of Signing the |
| | |Organisation |Agreement |
| | | | |
| | | | |
| | | | |
c) Participation and contribution in National / International fora in the area of your academic and professional expertise:
| |Number(s) |
|Plenary Lectures/ Invited talks Delivered |International | |
| |National | |
|Ph D Level Examinership, etc. |International | |
| |National | |
|Others (specify) |International | |
| |National | |
d) Sponsored Research projects:
|S. No. |Title of Project |Sponsor Name |Duration of the |Amount of Grant |PI / Co-PI |
| | | |project |(Rupees) | |
| | | | | | |
| | | | | | |
| | | | | | |
(e) Establishment of Centres / FIST Projects / TBI etc.,
|S. No. |Title |Sponsor Name |Duration |Amount of Grant |Role |
| | | | |(Rupees) | |
| | | | | | |
| | | | | | |
| | | | | | |
(f) Industrial Consulting Experience:
|S. No. |Client/Organization’s name |Nature of Assignment |Duration |Value (in Rs) |
| | | | | |
| | | | | |
| | | | | |
g) Honors /Awards & Fellowships:
|S. No. |Name of Award or Fellowship |Elected / Honorary Fellow |Awarded by |Year of Award |
| | | | | |
| | | | | |
| | | | | |
h) No. of Ph. D Research Scholars Successfully Guided:
|S. No. |Name of scholar |Affiliated University/ |Year of Award |Guide or Co-Guide |
| | |Institute | | |
| | | | | |
| | | | | |
| | | | | |
11. Explain why you think you are best suited to be the Vice-Chancellor of Anna University (in 300 words):
| |
12. Your Vision for the University (up to 500 words)
| |
13. Details of Two Referees who are aware of your professional contributions
|S. No |Name of Referee |Post held by the Referee & affiliation |Email |Mobile No. |
| | | | | |
| | | | | |
BONAFIDE AFFIDAVIT
I, , hereby declare that all the statements/particulars made/furnished in this application are true, complete and correct to the best of my knowledge and belief. I also declare and fully understand that in the event of any information furnished being found false or incorrect at any stage, my application/candidature is liable to be summarily rejected and if I am already appointed, my services are liable to be terminated without any notice from the post of Vice-Chancellor as per Act / Statutes etc., and other applicable rules.
I, also declare, that I have never been convicted for any offence and that there are no criminal/departmental proceedings pending/contemplated against me.
Place :
Date : Signature
|SUMMARY SHEET |
|Name of Applicant | |
|Date of Birth |DD /MM /YYYY |Age |Years |Months |
| | |(as on 30th June 2021) | | |
| | | | | |
|Nationality |Indian (Yes / No) |Others |
|Place of Birth | |
|Current Position | |
|Current Affiliation | |
|Details of Doctoral Degree|Institute / University | |
|Received | | |
| |City | |
| |Country | |
| |Year of Award | |
| |Area |Engineering / Technology / Science (Any discipline of Science relevant to Anna |
| | |University) |
| | |Years |Months |
|Work Experience | | | |
| |Total Work Experience | | |
| |Teaching Experience as Professor | | |
| |Total Experience after PhD | | |
| |Administrative Experience | | |
|Research Contributions | |Numbers |
| |Journal Publications (UGC-CARE approved list) | |
| |Number of Journal Publications after Ph.D (UGC-CARE approved list) | |
| |Citations | |
| |Presentations in International Conferences | |
| |Books Published | |
| |Patents Awarded | |
| | |Total Value (Rs) |
| |Sponsored research | |
| |Industrial Consultancy | |
|I, hereby declare that all the statements/particulars made/furnished in this application are true, complete and correct to the best of my knowledge and |
|belief. |
| |
| |
| |
|Signature with Date |
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