Personal Information

Name
Contact No.
Date of Birth*

Email Address
Nationality
Aadhar No.
Marital Status
Father/Husband Name
Father/Husband Contact

Correspondence Address

Academic Qualification

S.No.	Qualification	Stream	Name of School/Board/College/University	Year of Passing	% of Marks
1	10^th
2	12^th
3	Graduation
4	Post Graduation
5	Diploma
6	Other

Professional Qualification

S.No.	Qualification	Stream	Name of School/Board/College/University	Year of Passing	% of Marks
1	B.Ed
2	M.Ed
3	P.HD
4	Other

Work Experience

Fresher

Total Experience

Teaching (in years)
Administrative (in years)

Responsibilities Held Under Administrative Experience

Particulars of Present Job

Organization Name
Full Address
Organization Contact No 1
Organization Contact No 2
Present Designation
Date of Joining
Present Place of Posting

Total Emoluments

Current Salary Drawn
Salary Expected
Allowance
Other Benefits

Are you under bond?

Exact period after which you can join if selected

Interests

S.No.	Academics	Sports	Co-Curricular
1
2
3

Seminars and courses attended

S.No.	Workshops / Seminars Attended	Duration	Date	Description	Mode
1
2
3

Details of Scholarship / Awards / Honours (If any)

Do you suffer from any major medical ailment problems ?

Have you ever been convicted by any court of law or any disciplinary proceeding / enquiry is pending against you or any
penalty has been imposed upon you ?

Give details of two references (other than relatives) in the field of education

S.No.	Name	Occupation	Address (Official)	Telephone No.
1
2

I hereby certify that the information provided above is true to the best of my knowledge and belief.