MAHARASHTRA STATE COUNCIL OF EXAMINATION, PUNE

360136
Recruitment of Cluster Head (KENDRAPRAMUKH)

Registration Number : 298049211

Full Name : ANKUSH VISHWANATH
CHAVAN

Name of the Zilla parishad applied for : Hingoli Zilla Parishad

Name of the Zilla Parishad School working : Hingoli Zilla Parishad

SHALARTH ID : 02DEDAVCM8702

Category : VJ-A
Are you a Person with Benchmark Disability : NO
of 40% and above ?
Disability category : -

Type of Disability : -

PWBD certificate Number :

Date of issue : -

Are you as per PWBD guidelines eligible to : -

use compensatory time at the time of
examination ?
Are you suffering from cerebral palsy and : -
your writing speed is affected : ?
If Yes, Do you need compensatory time at : -
the time of examination?
Whether your dominant (Writing) hand is : -
affected?
If Yes, Do you need compensatory time at : -
the time of examination?

Are you as per PWBD guidelines eligible to : -

use the services of a scribe and wish to avail
the same ?

Whether you belong to Religious Minority : NO

Community
Religion to which you belong : Hindu
Aadhaar Card Number : XXXXXXXX1875

Nationality : Indian
Centre of Examination : PARBHANI
Application Fee / Intimation charges
Payment In : ONLINE
Amount : 950.00

Payment Status : PAID

Reference ID : YHD42166453553
Transaction Date : 07-12-2023

Personal Details
Date of Birth : 28-01-1987

Age completed as on 08.12.2023 : 36

First Name (Candidates Name as per S.S.C. : ANKUSH
(10TH) Certificate)
Middle Name : VISHWANATH

Last Name : CHAVAN

Gender : MALE
Do you have twin brother / sister ? : NO
Name of the twin : -
Gender of the twin : -

Marital Status : Married

Father's Name : VISHWANATH
Mother's Name : LAXMIBAI
Spouse's Name : BABITA
Address for Correspondence
Address 1 : AT BORGAON BKPOST
CHATORI
Address 2 : TQ PALAM DIST PARBHANI
District : PARBHANI
State : MAHARASHTRA
Pincode : 431536

Permanent address
Address 1 : AT BORGAON BKPOST
CHATORI

Address 2 : TQ PALAM DIST PARBHANI

District : PARBHANI
State : MAHARASHTRA
Pincode : 431536

Contact Details
Mobile No : +91 7219793388

Alternative Number : +91 7219793388

(Mobile No/Landline No)
 Email ID : chavanankush287@gmail.com

Educational Qualification as on 08.12.2023

Exam Passed Board/University/Institute Degree/Stream Date of % of Marks Passing Class

Passing

S.S.C. Maharashtra State Board Of Ssc 22-06-2004 69.06 First Class

Secondry And Higher
Secondary Education,Pune
H.S.C. / Equivalent Maharashtra State Board Of ARTS 05-06-2006 77.83 First Class
Secondry And Higher
Secondary Education,Pune
Graduation YCMOU-Yashwantrao Arts 13-07-2015 62.42 First Class
Chavan Maharashtra Open
University, Nashik
Professional Maharashtra State Council DED 21-01-2009 81.70 First Class
Diploma Of Examination
Others Maharashtra State Board of Mscit 18-06-2008 62.00 First Class
Technical Education

Are you working as a Trained Graduate : YES

Teacher (Primary) for minimum of Six
years continuous service (including
'Shikshan Sevak' Period) without any
break in the concerned Zilla Parishad ?
Are you appointed as Trained Teacher : YES
(Primary) and completed a minimum of
Six years service (including 'Shikshan
Sevak' Period) without any break from
the date of acquiring a qualification ?

Details of Work Experience (as on 08.12.2023) (Start from present Employer)

Name of the School Designation Total Period of Service Nature of Reason of Years of
& Zilla Parishad From To Duties leaving Experience
(YY/MM/DD)

Presently : YES
working?

Zpps adgaon Hingoli 24/11/2018 07/12/2023 Teacher - 5/0/14

Zpps wadchuna Hingoli 29/12/2010 23/11/2018 Teacher Transfer 7/10/26

Total Experience in months : 155

Other Details :

Languages Known Read Write Speak

Marathi YES YES YES

 English YES YES YES

Hindi YES YES YES

Uploaded Document Details :

1. Left Thumb Impression

2. Hand Written Declaration

Declaration:

I hereby declare that all the statements made in this application are True, Complete and Correct to the best of my
knowledge and belief. I understand that in the event of any information being found untrue or incorrect at any stage or I am
not satisfying any of the eligibility criteria stipulated, and also in case of creating influence/undue pressure regarding
recruitment shall tantamount to cancellation of my candidature.

• UPLOAD THE SIGNATURE

WITH WHITE BACKGROUND

WITH BLUE/BLACK INK.

YOUR SIGNATURE IS

ACCEPTED BEYOND VALID

CONDITIONS. IN CASE OF

IDENTITY CHECK FAILURE

AT ANY LATER STAGE OF

THE PROCESS, IT COULD

LEAD TO

DISQUALIFICATION

Date: 07-12-2023
Left Thumb Impression

Hand Written Declaration