Teaching Staff Abn
Teaching Staff Abn
Teaching Staff Abn
3.
2.
4.
5.
6.
7.
Age as on 01.03.2016:____________________________
(Affix recent
passport size
photograph)
Category: _____________________
7.
Have you been found guilty of any offence during your professional service? ________
8.
9.
If yes, specify:__________________________________________________________
Address for:
(i)
Correspondence________________________________________
_____________________________________________________
(ii)
(iii)
(iv)
_____________________________________________________
Permanent address:_____________________________________
_____________________________________________________
_____________________________________________________
Mobile no.:____________________________________________
10.
___________________________________________________________________
Have you qualified CTET: _________ Year:______ Score: ______________
12.
13.
Sl. No.
S.
No.
12.
13.
Examination Year of
passed
passing
Post
held
Organization
Board / University
Duration
From
To
Subjects taken
Length of
service
Pay scale
with its
break-up
% marks
obtained
Nature of
duties
____________________________________________________________________
______________________________________________________________________
14.
_____________________________________________________________________
_____________________________________________________________________
______________________________________________________________________
15:
______________________________________________________________________
______________________________________________________________________
16.
(i)
_______________________________________________________________
(ii)
_______________________________________________________________
_____________________________________________________________________
______________________________________________________________________
DECLAR ATION
I solemnly declare that the statements and details given above and attached as
enclosures with this application form are correct to be best of my knowledge and belief.
In case any if the details are found false at a later stage, I am aware that my
candidature / appointment may be cancelled / withdrawn.
Date & Place:____________________
CHECK LIST
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