KHULNA UNIVERSITY OF ENGINEERING & TECHNOLOGY Khulna-9203
(Application Form for the Post of Lecturer/Assistant Professor)
1. Name (English) :
(Bengali) : 2. a) Father’s Name (English) : (Bengali) : b) Mother’s Name (English) : (Bengali) :
3. Date of Birth :
4. Nationality :
5. Present/Mailing Address :
(With Mobile No. & Email Address)
6. Permanent Address :
7. Present Position :
8. Post Applied for :
9. Educational Qualifications (A candidate must not posses a Third Class/Division in Any Examination)
Year Board/University Certificate/Degree Division/Class % of marks/CGPA
10. Service Records Non-Teaching if any (Starting from First Appointment)
Organization Post From To Y M D
Total:
- 2 - 11. Higher Studies (for internal candidates):
Position Held During
Higher Studies From To Years Months Days Nature of
Leave*
Total
*1. Deputation, 2. Study Leave, 3. Leave without Pay, 4. Others.
12. Teaching Experience (if any) :
Post/Institution From To Years Months Days
Total
13. Active Teaching Experience (if any) :
Post/Institution From To Years Months Days
Total
14. Publications in Journals/Proceedings (if any):
No. Sl. Title of the Paper Name of the Journal
with Vol. No. pp Year and country
of Publication Name of Author(s)**
**Please identify (supervisor and co-supervisor) 15. Other Experiences (if any):
16. Name of 2 (Two) Referees (not related to the applicant):
(1) (2)
17. Money Receipt No.: Date:
Date: Signature of the Applicant
