APPLICATION FORM

Photograph

Post Applied: …………………………… (Contractual Basis)

Date of Advertisement: ………………………………………..

Employment Exchange No: ……………………………………

CTET Qualified: YES/ NO (If Yes for PRT or TGT)

01. Name / : ……………………………………………………………...
02. Address for Communication: ………………………………………………………………
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Contact No / : ……………………… E mail ID: ……………………….
03. Date of Birth / : …………………………………….. 04. Sex: …………..
05. Father/Husband Name / : ……………………………………………………………..
06. Category to which belongs / : ………………………………… … (General/SC/ST/OBC)
07. Academic/Professional Qualifications: (Beginning from +2 level. Attach Xerox copy)
S.No / Name of / Year / Total / % / Subjects / % in / Duratio / Board/
examinat / of / marks / aggreg / offered / concern / n of / University
ion/ / Passi / obtained/ / ate / ed / course
Degree / ng / Max / marks / subject
marks
1.
2.
3.
4.
5.
6.

08. Experience: Attach Xerox copy of certificate(s) issued by the Head of the Institution / Office.

S.No / Post / Name of the / Period / Number of / Subject and
Held / Institution / From / To / Completed / Classes taught
(Whether / months
recognized)
1.
2.
3.

9.  A Short Note: (For suitability to the post-Not more than 30 words)

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10.  Any Special Achievements: ………………………………………………………………..

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11.  Co-Curricular Activities: ..………………………………...... …………………

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12.  Are you willing to work anywhere in Silchar region: YES / NO

Date: ……………… Signature of candidate………………………

UNDERTAKING

I am fully aware of the fact that this interview is for fully temporary/contractual post and will not be confirmed at point of time. Further I know that this interview is for making a panel of teachers for academic session 2016-17 whose services may be utilized as per vacancy (as and when arise) and requirement of teachers in different KVs of Silchar region. Mere appearing in interview does not claim any right for appointment.

Date ………………….. Signature of Candidate …………………………