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Government. ofthe Punjab
oN scvtoo1 zDUcaTION DEPARTMENT
1s [APPLICATION FORM FOR EDUCATORS (2016-17) Paste one
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Diary No. Dated:
Name ofthe Post Applied Application Submited to:
Aopld apsinstquots: [Tp atnoriy [posable C-aosicasio Ja.nutoxza []s.open meri
PERSONAL INFORMATION
CHIC Number: ET] Aopicant Name
Father's Name: ote of ih
[Gender(Ger Swale LJ 2 Female L] Talon ated [_Jenonvwusim (rea [Joel
lvartastous: ase] 2>mariew E] susbond's Name foppabe:
loom of apptcant: Disrit UCN: village
Joomisteot her Husband apeiabl) Distr vce: Vilage
lc oF Her husband E
‘Adres as per Domicile
Mailing Adres:
[ACADEMIC QUALIFICATION
are
ena] Set! [rimestcenney] ctrcsatdateron | asa | ronne | ate | rat |... lowsowendi] —aper
eres | bee rionss.vnttie | stew | "vo | oct | wore cos | necrtiment
ole 201637
DOCUMENTARY PROOF
[Docoments tobe attachod wit the Appcavon Form, ek he Teen oH]
[hrcniccony LJ2aomiciecoey — [_Jositahnamacopy [}susands bomie []s-certcate/eares
Fsostoinycerteate — ]rservee Record incase ofinserice employes) ]8-DeparmentaPemision (NOC) Fany
[psenicerecotincaseothule17e —— [ioceicotertustors [I] atrermisson caries inca afemployee
Thzuistot, schools forthe post of,
[APPLICANT DECLARATION
Teartfy Ba the information mentaned Tr WH appTEaON TOT Te
and correct to best of my knowledge and bel. understand that statements found Signature:
tobe fatse/incorret shall dsqualfy me fromthe recrultment process and would _O>y___ Month Yaar
make me able for criminal action under Criminal Procedure Code/Patetan Penal TTT.
code.
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sy RECRUITMENT OF EDUCATORS (2016-17) Date
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APPLICATION FOR THE POST OF
Application Submited to
Applied agsint quote: Ji. inorty — z.oisabie [amuies7a Ja. open tert
CNC Number: pate ofits
Applicant Name Father's Name
Husbands Name if applcable Tore. ofchak apts
Teh Unie or OFicaT ee
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