PGOVERNMENT OF ANDHRA PRADESH

DEPARTMENT OF SCHOOL EDUCATION

APPLICATION FOR TRANSFER
Personal Details:-

1. District : --------------------------------------------------------------------------------------------

2. Zonal Code : ----------------------------------------------------------------------------------------------

3. Mandal : ------------------------------------------------------------------------------------------------

4. Name of the individual seeking transfer: ------------------------------------------------------------------------------------------------

5. Employee Code Number : School Education Dept. CODE -------------------------------------------------------------------

6. Date of Birth : -------------------------------------------------------------------------------------------------------

7. Gender : --------------------------------------------------------------------------------------------------------

8. Martial Status : ------------------------------------------------------------------------------------------------------------

9. Category of the post : -----------------------------------------------------------------

10. Subject : --------------------------------------------------------------------

11. Medium of School : --------------------------------------------------------------------

12. Management of the School : M.P.P / Z.P. / LOCAL BODY / GOVT,

13. Name of the School : ----------------------------------------------------------------------

14. School Code (as per DISE FORM) : ----------------------------------------------------------------------

15. Category of the School : IV / III / II / I

16. Name of the Panchayat/Municipality/ Municipal Corporation in

Which the school mentioned in item 13 is located : ----------------------------------------------------------------------

17. Whether the individual has completed 8 years of service as on 1st June YES/NO
in all categories of posts including the service rendered in the school prior to
up gradation or bifurcation and also in all schools in a Pachayat/Municipality/Municipal Corporation DOJ IN SCHOOL/PANCHAYAT/MPLITY*MC :

18. Date of First Appointment in Service : ----------------------------------------------

19. Date from which the individual is working in the present school in all
categories of posts including prior to up gradation / bifurcation : ---------------------------------------------------------------------------

20. Whether he/she is President or General Secretary of the District/State of Recognized Association: YES / NO

21. Whether he/she is affected by Rationalization : YES / NO

22. Whether the teacher availed the benefit under special category for spouse
during the last 8 years as on 01-June-2011 : YES / NO

23. Whether spouse is employee of State Govt./Central Govt./Public Sector undertaking/

Local body/Aided Institution in the same district(in the same zone for Gazzetted Head Master,Gr.II in Govt.schools): YES / NO
24. Performance Parameters (2009-10)

a) Participation (SGF/sciencefairs0 : ----------------------------------------------------

b) Achievement (studentawards) : --------------------------------------------------
c) Achievement in SSC Public Exams (2009-10) :
----------------------------------------------------
25.Whether the individual availed the benefit under Preferential category
during the last 8 years as on 1st June-2011 : YES / NO

26. Whether the individual wants to claim under preferential category (yes/No) : YES / NO

27. Mobile Number : ------------ ------------------------------------------------

Signature