आवेदन फॉर्म / APPLICATION FORM
पदनार्/ Post Applied: ________________________(सवविं दा आधारित/Contractual Basis) Affix a passport
सी.टी.ई.टी./CTET पात्रता/Qualified: हााँ /नही YES / NO size photograph
(यदि हााँ तो पी.आर.टी./टी.जी.टी. अथवा िोनोों हे तु/ If Yes for PRT/TGT or both)
1. नाम/Name : ___________________________
2. पत्राचार का पता/Address for Communication / Contact : ___________________________
__________________________________________
3. फोन न. /Mobile No.: ______________________ ईमेल / Email ID: ____________________
4. जन्म दतदथ/Date of birth: __________________, दलोंग/Sex. __________________
5. दपता/पदत का नाम/Father's Name / Husband's Name : ___________________________
6. आधार न. /Aadhaar No. (If any): ______________________________
7.पैन न./PAN No. : __________________________
8. शैदिक/व्यवसादयक योग्यता/Academic/Professional Qualifications) Commencing from Class 10th
(Beginning from +2 level. Attach Xerox copy.)
S. Name of Year of Total marks Aggrega Subjects offered % in Board /
No. examination/ Passing obtained/ te % concerned University
Degree Maximum Marks subject
Marks
07. अनुभव/Experience: फोटोकॉपी सोंलग्न करें / Attach Xerox copy of certificate(s) issued by the Head of the
Institution.
S. Post Held Name of the Institution Period Number of Subject and
No. Completed Classes taught
From To
Months
08. कोई दवशेष उपलब्धि/Any Special Achievements: ________________________________________
_______________________________________________________________________________________
09. क्या आप िे हरािू न सोंभाग में कहीों भी कायय करने के इक्छु क है ? Are you willing to work anywhere in
Dehradun region? : YES/NO
10. क्या आपका कोई नजिीकी ररश्तेिार केंद्रीय दवद्यालय में काययरत है? यदि हााँ तो उनका नाम, पिनाम एवों
दवद्यालय का नाम/ Is your near relative (Father/Mother/Brother/Sister/Husband/Wife) is working in KV? If
yes, name, Designation and KV of the relative.
______________________________________________________
11. 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 contractual teachers for academic session
2018-19 whose services may be utilized as per vacancy. More appearing in interview does not claim any right for
appointment.
दिनााँ क/Date: ............... अभ्यथी के हस्तािर/Signature of the
Candidate:____________
Checker’s Name and Sign :