12/10/14                                                                 TET
GOVERNMENT OF ASSAM
                                       SECONDARY EDUCATION DEPARTMENT
             TEACHERS ELIGIBILITY TEST (TET) OF MADRASSA EDUCATION
             FOR THE UNRESERVED POSTS IN PROVINCIALISED MADRASSA
                                   INSTITUTIONS
   Application No. :
                                              104415
   Applicant's Nam e :                        NAZMUL HAQUE ALI
             Father's Nam e :                 TAMUZ ALI
             Mother's Nam e :                 NURSHENI BEGUM
             Gaurdian Nam e :                 TAMUZ ALI
   Address for Com m unication :              C/O: TAMUZ ALI VILL: DOBOK NO 2 P.O: DOBOK P.S: RANGIA PIN:781380
                                              DIST:KAMRUP(RURAL) STATE:ASSAM
             Village/Tow n :                  DOBOK NO 2
             District :                       16 - KAMRUP RURAL
             Police Station :                 RANGIA
             Pin Code :                       781380                                                  Photograph and Signature
                                                                                                            of Candidate
   Perm anent Address:                        C/O: TAMUZ ALI VILL: DOBOK NO 2 P.O: DOBOK P.S: RANGIA PIN:781380
                                              DIST:KAMRUP(RURAL) STATE:ASSAM
             Village/Tow n :                  DOBOK NO 2
             District :                       16 - KAMRUP RURAL
             Police Station :                 RANGIA
             Pin Code :                       781380
      Mobile Num ber :                        9707823751                                            Telephone num ber :
      Em ail Address :                        nazmulh480@gmail.com
   Gender :                                   MALE                                                  Date of Birth : 06/04/1989
   Applied For :                              ASSISTANT TEACHER H.S. (PRE-SENIOR SECTION)
   Academ ic Qulification :
                                                                                                                        Marks
                                 Stream /                                                               Year Of
           Exam Passed                         Board/University/Council             Subject                            Obtained
                                 Degree                                                                 Passing
                                                                                                                        / Total
      HSLC Or Equivalent
                                                           SEBA           ENGL,MIL,GSC,SS,MATH,ARABIC     2005      428 /     600
            (10)
             HSSLC Or
                                2 - SCIENCE               AHSEC           ENGL,MIL,CHEM,PHYS,MATH,BIO     2008      326 /     500
           Equivalent (12)
                                                                           COMP SC(M),PHYS,MATH,ENV
            Graduation             B.Sc             GAUHATI UNIVERSITY                                    2011      618 / 1000
                                                                                      SC
      Other Qualification                                                                                                 /
           Professional
                                 4 - NONE                                                                                 /
            Qulification
   Are You Orthopaedically / Locom otor Im paired? NO                                               Degree Of Disability %
   Social Category : GENERAL                                                                        Religion : ISLAM
   Nationality : INDIAN
184.95.41.73/TETMadrassa/webpages/Application.php                                                                                   1/2
12/10/14                                                                   TET
   Have you ever been convicted for any offence involving m oral turpitude : No
   Declaration :
   I declare that the above entries in the Application Form has been filled up by myself and the entries made are correct as per my
   documents and to the best of my knowledge and belief. I agree that if any statement is proved to be false then the Authority shall have
   the right to take legal action against me for submitting false information of statement. I further declare that there is no allegation of
   misconduct against me and I have never been convicted for any offence involving moral turpitude.In the consequence stages of
   recruitment I shall not request RMSA ASSAM to modify the entered information here
                                                                                                                   Signature of the Candidate
184.95.41.73/TETMadrassa/webpages/Application.php                                                                                               2/2