1. Title : Prof./Dr./Mr./Mrs./Ms.

2. Name in Full : …………………………………………………….…………….

3. Designation / Position : …………………………………………………………………..

4. Date of Birth (d/m/y) : …………………………………………..…. Sex: Male / Female

5. Date of Superannuation : …………………………………………………………………….

6. Mother Tongue : …………………………………………………………………….

7. Other Languages you : Indian (i)…………………………. (ii)………….………………..

Can read, write & speak : Foreign (i)………………………….(ii)…………………………..

8. Academic Qualifications :

A. Post Graduation a) Degree………………………………… b) Year……………………

c) Subject………………………………………………………………

d) University………………………………………………………..

e) Supervisor………………………………………………………..

f) Research topic (if any)………………………………………………

B. Doctorate a) Degree………………………………… b) Year…………………

c) Subject……………………………………………………………

d) University………………………………………………………..

e) Supervisor………………………………………………………..

f) Research topic …………….…………………………………………

C. Post Doctorate a) Degree………………………………… b) Year…………………

c) Subject………………………………………………………………

d) University………………………………………………………..

e) Supervisor………………………………………………………..

f) Research topic …………………………………………………………

9. Discipline / Subject : …………………………………………………………………….

10 Present area of Research / : …………………………………………………………………….

Crop / Commodity : …………………………………………………………………….

11 Field of Specialization : …………………………………………………………………….

12 Professional Experience : a) Research………….…………….. b) Teaching…………………

(Number of Years) c) Management……………………. d) Extension………………….

13 Professional Accomplishment: a) Research Paper …………….…b) Books……………………

(Write only the numbers) c) Tech. Reports……………………..d) Others……………….

14. Awards / Honours

(A) National 1)………………………………………… Year………………………

2)………………………………………….Year….………………..

3)………………………………………….Year….………………..

(B) International 1)………………………………………… Year………………………

2)………………………………………….Year….………………..

3)………………………………………….Year….………………..

15. Name of other professional societies of which you are a fellow / member.

1. ……………………………………………………………………………………………………

2. ……………………………………………………………………………………………………

3. ……………………………………………………………………………………………………

16. Hobbies / Special Interests………………………………………………………….…………..

………………………………………………………………………………………………………

17. Any other information / suggestion, which you may like to provide.

………………………………………………………………………………………………………

………………………………………………………………………………………………………

18. Address.

(A)Office……………………………………………………………………………………………

………………………………………………………………………………………………………

………………………………………………………….. Pin……………………………………….

Phone (with STD Code)…………………………………Fax…………………………………………

Email…………………………………………………….Mob…………………………………….

(B) Residence……………………………………………………………………………………….

………………………………………………………………………………………………………

………………………………………………………….. Pin…………………………..……………

Phone (with STD Code)…………………………………Fax…………………………………………

Email…………………………………………………….Mob…………………………………….

(C)Permanent……………………………………………………………………………………….

………………………………………………………………………………………………………

………………………………………………………….. Pin……………………………………….

Phone (with STD Code)…………………………………Fax…………………………………………

Email……………………………………………………__________.Mob…………………………………….

Address for journal and other correspondence.

………………………………………………………………………………………………………

………………………………………………………………………………………………………

………………………………………………………………………………

Declaration: I affirm that the information furnished in the above proforma is true and correct to

the best of my knowledge and belief.

Station ………………………. Date ………….. Signature