कॆं द्रीय विद्यालय क्र.
3 िायु सेना स्थल चकेरी कानपुर
KENDRIYA VIDYALAYA NO. 3 AFS CHAKERI KANPUR
APPLICATION FORM FOR PART TIME / CONTRACTUAL TEACHERS/INSTRUCTORS/COACHES/EXPERTS/
DOCTOR/ NURSE SPECIAL EDUCATOR AND COUNSELOR, ETC.- 2025-26
Important notes: 1. All entries should be in capital letters
2. Use separate form for each post.
3. Enclose attested copies of testimonials with each form. (If applied for more than one)
post)
1. POST APPLIED SUBJECT APPLIED
Apply for any one of posts mentioned below :- (Write subject in case you have applied for the
(PGT/TGT/PRT/Computer Instructor/Coach/Experts Yoga Post of PGT / TGT)
Teacher /Doctor / Nurse/Counselor/Special Educator)
POST : __________________________________ SUBJECT : ____________________________
2. Candidate’s Name (in capital letters) (Please keep one box blank between First name, Middle name & Last name)
3. Father’s /Husband’s Name (in capital letters) : Father Husband
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4. Gender : Male / Female __________ 5. Date of Birth:
6. Cast Category : Gen. / OBC / SC / ST ______________
7. Age as on 31.03.2025 Year Month Days
8. Candidate’s Correspondence Address
Please affix one recent
Name : ___________________________________________________________ Photograph
Father/Husband’s Name : ____________________________________________
Address : _________________________________________________________
_________________________________________________________________
_________________________________________________________________
City/Town : ________________________________________________________
State & PIN _______________________________________________________
Phone/Mobile No.___________________________________________________
Signature of Candidate
9. Academic Qualification (Starting from High School level)
(Please give information as applicable. (Attach attested copies of Mark sheets and Certificates)
Name of Write name Board/ Year of Duration Subjects / AGGREGATE MARKS
Examination of Examination Univers passing of course Specialization Max. Marks % age
(with complete name passed ity (in months) Remarks
Marks obtained of
of course passed) marks
High School (Class X)
Intermediate (Class
XII)
Graduation
(Name of Course)
Post-Graduation
(Name of Course)
Others if any
(Specify)
10. Professional Qualification (Attach attested copies of mark sheets & certificates)
Write name Duration AGGREGRATE MARKS
Name of Examination Year
of Board/ Subjects of course %age
(with complete name of of Max. Marks Remarks
Examination University /Specialization (in of
course passed) passing Marks obtained
passed months) marks
CTET
JBT/ B.E.ED / D.E.C.Ed
(specify)
B.ED /B.ED Theory
(Nursery) /
B.Ed (Special
Practical
Education)
BE/B.Tech(CS)/MBBS
Degree/Diploma in
Nursing
Other if any
(specify)
11. Experience (Attach separate sheet, if columns are insufficient)
Period of service No. of
Name of Class Scale of pay and
Post completed Subjects taught Remarks
Institution From To taught salary per month
months
12. For teaching posts:-
a. Are you able to teach in English and Hindi medium? YES NO
(Please mark √ tick in the appropriate box)
b. Do you have knowledge of computer applications? YES NO
(Please mark √ tick in the appropriate box)
UNDERTAKING
I hereby certify that all the information given above is true and correct to the best of my knowledge. I
have attached attested copies of my testimonials in support of the entries made above. I also agree that
mere eligibility does not confer right to be called for interview/selection. My candidature may be
cancelled in case any information is found to be incorrect on verification.
Date: _______________ Signature: _______________________
Place: ______________ Name:__________________________
Contact No. _______________________
________________________________________________________________________________________
For office use
Eligible / Not Eligible
Merit point (if any)__________ Signature of the verification committee member_____________
Experience points (if any)___________ Name of the verification committee member _______________
