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APPLICATION FORM FOR THE POST OF SECONDARY GRADE TEACHER

1.

Name of the Candidate


(in Block letters)

2.

Father's Name

3.

Nationality

4.

Sex: Male/Female

5.

Post applied for

6.

Passed in Teacher Eligibility Test: Yes/No

Affix Passport size

If Yes Date & Year of passing

Photograph duly
self attested by the
Candidate

Reg. No

7.

Category belongs (URIOBC/SC/STIPHlEx-Serviceman))


(Tick whichever is applicable)

8.

Address for Communication

.
.

Mobile No

9.

Date of Birth (In Christian era)

10.

Age as on 22.10.2016
year
Month

Days

11.

Educational Qualification (with percentage of marks) ., .... " .....

12.

Technical Qualification

13.

Experience if any

.
UNDERTAKING

I hereby certify that there is no criminal proceeding pending/contemplated/held

against me.

I hereby declare that all the statements made in this application are true and complete to the best
of my knowledge and belief. Iunderstand that action can be taken against me by the department
if I have furnished wrong information.
(List of documents attached with the application)
1.
2.

Signature:
Name

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