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Application form for Appointment of Visiting Faculty for ITT Centers of ICAI
* Indicated fields are mandatory.
Note:
Remuneration shall be paid as per Regulations/Qualification & experience
.
PERSONAL DETAILS
*
Name:
CA.
Dr.
Mr.
Ms.
*
Date of Birth:
*
Contact Address:
*
Phone No.:
*
Mobile No.:
*
Email-Id:
*
Preference for Regions / Cities for ITT Centre to take up teaching assignment work:
Region:
----REGION----
Northern – NRO
Central – CRO
Eastern – ERO
Western - WRO
Southern - SRO
Center:
----CENTER----
EDUCATIONAL DETAILS
*
Are you a CA?
---Please Select---
Yes
No
*
Membership No.:
*
Are you ISA qualified?
---Please Select---
Yes
No
Date of qualifying ISA Course :
*
Educational Qualification:
---EDUCATIONAL QUALIFICATION---
B.E
MCA
M.Sc(Comp.Sc)
M.Tech
B.Tech
M.Sc (IT)
OTHER EDUCATIONAL DETAILS
Degree(s)
Course
School/College/University
Year of Passing
% in Aggregate
Doctoral Programme
---Please Select---
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
Post Graduation/Diploma
---Please Select---
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
Graduation/Diploma
---Please Select---
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
10+2
---Please Select---
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
WORK EXPERIENCE
*
Academic Experience:
---TOTAL ACADEMIC EXP.---
25+
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
*
Professional Experience:
---TOTAL PROF. EXP.---
25+
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Total Work Experience:
(Total Work Experience = Academic Experience + Professional Experience)
Enter the Experience (in descending order starting from most recent)
S.No
Name of the Organization
Designation
Years of Experience
Year of Joining
Nature of Assignments undertaken
1.
---EXP. YEAR---
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
25+
---JOINING YEAR---
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2.
---EXP. YEAR---
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
25+
---JOINING YEAR---
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
3.
---EXP. YEAR---
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
25+
---JOINING YEAR---
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
4.
---EXP. YEAR---
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
25+
---JOINING YEAR---
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
*
How well versed are you in MS Office ?
Please Select
Excellent
Very Good
Good
Average
Poor
*
How well versed are you in TALLY?
Please Select
Excellent
Very Good
Good
Average
Poor
*
How well versed are you in e-filing ?
Please Select
Excellent
Very Good
Good
Average
Poor
*
How well versed are you in CAAT/GAS?
Please Select
Excellent
Very Good
Good
Average
Poor
*
Specialized Area of Interest for teaching in IT Centre :
*
How many hours per week can you teach?
---TEACH HOURS---
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
This is to certify that the information provided above is correct to the best of my knowledge & belief.
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