Brij Bhushan Lal Public School” Co-Educational Senior Secondary School, Affiliated to C.B.S.E., New Delhi Alakhnath Road, Bareilly-243003.Ph. : 91-581-2514522 Pilibhit Road, Bareilly-243122. Ph. ; 91-581-2602133 D. D. Puram, Bareilly-243122.Ph. ; 91-581-2311528 www.bblschool.com ISO 9001:2008 Certifi APPLICATION FORM Section A. - General Post Applied for Post Code Name Affix your latest colored photograph Mobile No. .. Gender DOB... (wbiumrryyy) Aadhar No. ..... Nationality Religion Hobbies : Key Skills / Competency If physically challenged, give details Section B. — Personal Information Father’s Name Qualification : Occupation Designation Name of Spouse (if married) Qualification Occupation Designation SN. Children’s Name Age| Sex |Class School / College B.B.L. Public School Page 1 of 4 Doc. No. BBLPS/HR/02Section C. - Language Command Sr Language Read | Write | Speak To some) Just Remarks No Perfect extent | Know 01. | English 02. | Hindi 03. 04. V Tick the appropriate column/s Section D. — Academics Medium of Education Result Details rxam | Yetof |CGPA] Board / & Ta ° assing | or % | University Name of Institution at s farks aX, ale if which Studied Subjects [obtained | Marks High School Inter- mediate Graduation Post Graduation State reason for gap in education (if any) BBL. Public School Page 2 of 4 ] Doc. No. BBLPS/HR/02Section E. - Employment Details (mention from the latest employment) Name & Address Designa- ties| Date of of Institution tion Joining Date of Leaving| Reason of Salary Leaving | per month State reason for gap in employment (if any) Section F. - Workshops / Honours / Research / Publications Workshop attended Year Topic Give Details of your Research Work / Honours / Publications B.B.L. Public School Page 3 of 4 Doc. No. BBLPS/HR/02Section G. - Extra Curricular Work / Activity as a Teacher ‘Year of Responsibility Responsibility Description Section H. - Contact Details Present Address STD Code Phone Resi. City & State Pin . .. Email ID Mobile No. Permanent Address : .... STD Code Phone Resi. City & State Pin . .. Email ID Mobile No. Section I. - Reference Details (Give reference under whom you have either worked or who know you professionally) N Nature of ] Organisation c Detail ame Association |& Designation ontact Details Address Mobile AdMEESS 5 sccscstseeeetnenntntntsenaeseenes Mobile. Section J. - Declaration @ referred to the corresponding employer. @ knowledge & belief. ii) Date I will have no objection if my verification of any of the past employments as mentioned in this Application Form, is I declare that the entries made and information submitted by me in this Application Form, are true to best of my If any information is found to be false / incorrect, it will disqualify me for employment in your institution. Signature of Applicant Section K. — Direction for filling the Application Form The application form is to be filled by the candidate in his / her own handwriting, neatly and legibly oa (ii) All the entries in Section A & B should be in BLOCK Letters. (ii) Self attested copies of testimonials and other supportive documents should be submitted ww) School, payable at Bareilly. ‘Submit the duly filled application for along with a demand draft of Rs. 300/- in favour of Brij Bhushan Lal Public Code 01 ~ Principal / Vice-Principal Code 03 -TGT Code 05 — Office Staff Code 02 = PGT ‘Code 04 - PRT B.B.L. Public School Page 4 of 4 Doc. No. BBLPS/HR/02