Demand Draft No. ……….. dated……. Drawn on………...Received on ......

DELHI PUBLIC SCHOOL MATHURA ROAD, NEW DELHI 110003

APPLICATION FORM (2017-18) (IV)

Post Applied for ......

1. Name : Mr/Mrs./Miss...... PHOTO

2. Date of Birth...... Age......

3. Nationality...... Religion…..…………. Category : SC/ST/OBC/GEN

4. Father’s Name ...... Designation......

5. Husband's Name...... Edn. Qualification......

Employed with......

Designation …..…………….………………………Contact No…………………..

7. Details of Children:SexDate of Birth NameClass

1......

2......

8. Permanent Address......

Correspondence Address......

Telephone (Land Line)...... Mobile No......

Email ID......

9. Academic Qualifications:

Examination / Year of Passing / Regular / Correspondence / Subjects / Marks
% / Medium of Instruction / School or College
and University

Whether TET qualified (by the appropriate Government) : YES/NO - Paper I (Class I to V)/ Paper II (Class VI to VIII) (Please tick the appropriate)

Please attach attested copies of Marksheets and Degrees year wise.

10. Details of experience in recognized school/institutions:

S. No. / Name of Institution / Period / Subjects & Classes taught
Temporary / Regular / From / To / Subjects / Classes
Total Experience ( in years) :

Please attach self attested copies of experience certificates.

11. Details of administrative experience, if any (for Administrative staff, please attach Annexure)

12 Salary and allowances currently drawn: Basic : Pay Band :Grade Pay : Rs.

Total Emoluments : Rs.

13. Knowledge of foreign language (if any) ......

14. Games (a) Names of Games which you play regularly: (i) ...... (ii) ...... (iii)......

15. Please MENTION any ACTIVITY in which you are really interested and in which you can train students………………….

16. Mention additional qualification on Computer Literacy and related skills……………………………………………………

17. Names, Addresses and contact number of two references:

(a)…………………………………………………… Contact No. ………………………………….

(b)…………………………………………………… Contact No. ………………………………….

18. Number of duly attested testimonials and certificates attached......

19. The exact period after which you can join, if selected......

I hereby certify that the statement made by me in answer to the foregoing questions is true, complete and correct to the best of my knowledge and belief. I understand that any mis-representation or material omission made in the personal information form or any other document requested by the organization renders a staff member / workman of organization liable to termination or dismissal.

Date...... Signature ......

______

Note: 1.Candidates are requested to clearly indicate the post applied for. In case it is not possible to determine the post applied for, the application will be considered invalid.

2. Only application on printed form put up in the school website will be entertained.

3. If employed, application should be sent through the employer.

4.All teachers to be appointed to teach Classes I to VIII should qualify/pass the Eligibility Test conducted by appropriate Government in accordance with the guidelines framed by the NCTE for this purpose.