2/25/24, 2:21 PM Haryana Staff Selection Commission : Registration Print

APPLICATION FORM | Haryana Staff Selection Commission (Advt. No. 5 / 2015 )

Registration Number 20003546

Post Applied For PGT Computer Science (Cat.No.1)
Applicant's Name RENU

Father's Name SURESH

Mother's Name ANGREJO

Date of Birth 20/10/1991

Age as on 21.09.2015 23 Year 11 months 1 days

Gender Female

Marital Status Married

Nationality INDIAN

Category General
District Mewat Cadre NO

Matric with Hindi/Sanskrit or

YES
10+2/B.A./M.A. with Hindi as one
of the subject ?
Aadhar Card No.(Desirable) 760530070450
QUALIFICATION

Marks Obtained / Total

Class Name/Qualification Passing Year University/Board Subject
Marks
HIN ENG MATH SS
Matric 2006 HBSE 356 / 500
SCI SKT
HIN ENG GEO
10+2 (Senior Secondary) 2008 HBSE 349 / 500
MATH SKT
M.Sc. Computer Science (Regular
2014 MDU ROHTAK COMPUTER SCI 1441 / 2000
two year course)
Post Graduation 2014 MDU ROHTAK COMPUTER SCI 1441 / 2000
B.Ed. 2014 MDU ROHTAK COMPUTER SCI 697 / 1000
HTET DETAIL

HTET passing
HTET Roll No. HTET Subject HTET Passing Year HTET Marks Obtained
Month

OTHER

Birth Place and BHARAN HARYANA/

Haryana Domicile YES
Country INDIA
Whether Working as a teacher in
privately managed Govt. aided,
recognized and Govt. Schools.
Age relaxation to the extent of NO
service rendered as a teacher
subject to a maximum of 5
years.
Password ECBCBA1B52
ADDRESS

Permanent Address
RENU W/O SHIV KUMAR, VPO BIBIPUR, JIND, Jind, Pin-126102, Telephone No -8396079761, Email ID-
shivkumarjaglan@gmail.com
Corresspondence Address
RENU W/O SHIV KUMAR, VPO BIBIPUR, JIND, Jind, Pin-126102, Telephone No -8396079761
DECLARATION: I hereby declare that:-

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2/25/24, 2:21 PM Haryana Staff Selection Commission : Registration Print

1.All statements made in this application form regarding age limit,educational qualifications & experience etc. are true,
correct and complete to the best of my knowledge, belief, record and nothing has been concealed therein.
In the event of any information being found/detected false, incorrect, incomplete and ineligible before or after the
interview/selection/appointment then my candidature may be cancelled and any legal action as per law can be
intiated/taken against me.
2. I have read the terms and conditions prescribed in advertisement carefully and accordingly, I hereby undertake to abide
by them. I, also, fulfill all the conditions of eligibilty as per relevant rules and instructions prescribed by Government of
Haryana from time to time.
3. I have never been convicted by any competent court of law.

SIGNATURE

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