i APPLICATION FOR IHE POST OF GRADUAI-E TEACHER INCLI.

JDING LANGUAGE
TEACHERS CR HINDI TEACHER OR CLASSICAL TEACHERS iN PROVINCIALISTD
HIGH/ HIGHER SECONDARY HIGH N4ADRASSA SCHOOIS

t--------l
C,:icred Phott-.r

TliI PRI[.]C ?-r. *:-..,'->--' -\-..,-

I'O5T APPLIFD FOR

NAME OF THE APPLICANT

FATHER'S/MOTHER'S/HUSBAND'S NAME i

MAt[i riMALr"
I

i
"--+-
4 Pfl[5[NT ADDRISS OF COMMUNICATION WITH
CONTACT NUMBEIl
PERIVIANENT ADDRESS

ARE YOU A CII IZEN Oi: INDIA? IF SO, HOW

1

CATEGORY OF CASI'E 1. General, 2. OBC/MOBC,4. I

ST (P), 5. ST(H), 6
7 PWD (person with
SC,
dlsability) attach a copy of certifrcate from the
competent authorily (wheri: necessat ;i)

l\re you presently enrpioyed? !f yes, attacir .r i r-)py

i-i of NOC f rom your employer or Fleacl of off ice.

t_
lg Date of Birth as per ilSLC pass Ccrlifrcalc.

Age on 0i 01 2Lri 9.

t:d ucationa I QLra i ification-8.A /B.Com/t) Sc.

Professional Qualification B. Ed/B.f (furnish the
name of lnstitution. Also give fulldetails of
qLralification in aporopriate boxes in Pait'll)

Do you have NCC Certificate? lf ves, rnentiorred

tiie grade. (Attach a seli attested copy of the
ce rtificate ).
Did you have Assarnese/Hindi/Bengali as MIL at Assamese at HSLC
the IlSLC level or eqr:ivalent Certifii:atelDipioma ? Bengaii at i-lSLC.
lf yes, tick the appropriate Sl iiindi at i1!i {
 Pa rt- ll '),?)

Ed ucatio na I Qualificatio n : Please insert information :-

Examination Year of pass il :,( +
--:: Grade/Division Pass
/ percentage of ;

rISLC [::rrn
HSSLC Exarri
B.AlB.Sci
B.Com Exanr
B"ED/B.T Exam
(Name of
ln stit ut io n
recognized by
NCTE)
'IET
TET Exanr Name of Mar l<s secured Paper i:
in Paper ii

Other Qualification :

3. NCC.

4. Representation of State in Cultural and Sports events :

Full Signature of thq_ Ap!]-Lcgll!.

Qe!]gpliql:

l, do hereb'y declare that the information prr:vided in my application form is true and nothirrg has

been concealed. lf it is proved otherwise my candidature for the post is liable tr: be canceiled.

5is!a!u.Le-qt!rq4pp.lic r-t!