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 | | | |

| | | | | | |

| | | | | | |

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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 |

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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)

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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. |

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| | | | | |

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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