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    Advt Pgt Guest Teacher 2024

    Uploaded by

    pkprasantkumar621

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Advt Pgt Guest Teacher 2024

    Uploaded by

    pkprasantkumar621
    4 views4 pages

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    4 views4 pages

    Advt Pgt Guest Teacher 2024

    Uploaded by

    pkprasantkumar621

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 4

    APPLICATION FORM FOR THE POST OF GUEST TEACHER

    (ST&SC DEVELOPMENT, M&BCW DEPTT., DIST-KEONJHAR)


    Affix passport
    To size
    The District Welfare Officer, Keonjhar Photograph

    (TO BE FILLED IN CAPITAL LETTERS)


    CATEGORY OF PGT POST APPLIED FOR:- ________________________________
    (Advertisement No.3397/SSD/Dated.05.10.2024 )

    1. Full Name of the candidate:_______________________________________________________


    2. Name of the Father / Husband_____________________________________________________
    3. Permanent Address:-
    AT-_______________________________ PO-_________________________________
    VIA-______________________ District-___________________State_______________

    PIN- Mobile No.___________________________


    4. Present Address:-
    AT-______________________________ PO-___________________________________
    VIA- ___________________ __District- _____________________State_____________

    PIN-

    5. Whether ST/SC/SEBC/OBC/ Fresh candidate/ Retired Teacher _______________________


    6. Gender: Male Female ( Put √ mark)
    7. Date of Birth ( As recorded in Matric Certificate) :-_________________________________
    8. Age as on 01.10.2024 :- ________Years ________ Months ______Days
    9. Educational qualification:-
    Sl. Name of the Year of Name of Full Marks Mark secured % of marks
    No. Examination passing Board/University (without extra (without extra secured
    optional) optional)

    10. Teaching Experience if any (Copy of Experience Certificate / Service Certificate to be attached ):-

    N.B.- (i) Marks secured in Extra optional/ Ancillary/ Foundation subject should not be included for calculation.
    List of the enclosures:

    DECLARATION
    I do hereby declare that the statements made in this application are true, complete and correct to
    the best of my knowledge and based upon documentary evidence. I carefully read the details of
    Advertisement /Notice and declared that, I fulfil all the conditions of eligibility prescribed for the post. In
    case of any of the statements / particulars is /are found to be incorrect during or after the selection my
    candidature for the said post will be cancelled / forfeited and I shall be responsible for this in each and
    every aspects.

    Signature of the applicant


    Date:

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