D:\MD\anil-estt\contract appointment\Contract-2014\Format\app_form_con_tr_2014.

doc
NAVODAYA VIDYALAYA SAMITI NAVODAYA VIDYALAYA SAMITI NAVODAYA VIDYALAYA SAMITI NAVODAYA VIDYALAYA SAMITI
(REGIONAL OFFICE), Bay No.26-27, Sector-31-A, CHANDIGARH
PART-I BIO-DATA
1 Application for the post of : ___________________________(on contract basis)
2. Tel.No. (with STD Code)/Mobile no.: ____________________________
3. Name : ____________________________
4. Fathers/Husband Name : ____________________________
5. Date of Birth (DD/MM/YYYY) : ____________________________
6. Full Address for : ____________________________
Communication
____________________________
7. Home District : ______________________________________
8. Preference of state for Positing : ______________________________________
(J&K, Punjab, HP State)
9. Category to which belong :- : ______________________________________
Gen/SC/ST/PH/OBC/Navodaya Spouse
10.In case of Navodaya Vidyalaya Spouse, give full details:
A. Name of spouse : ______________________________________
B. Post Held : ______________________________________
C. Place of Posting : ______________________________________
11. Educational Qualification:
S.
No.
Course of Study Max. Marks Marks
Obtained
% age of marks
1. 10
th
2. 12
th
3. Graduation (BA/B.Sc.)
(Others Please specify)
4. Post Graduation in the subject
(Mention subject)
5. B.Ed. (Theory & Practical)
6. CTET conducted by CBSE
(Kindly enclose proof in respect of conversion of grades into marks. P.T.O.2
Paste Latest
photograph
here
D:\MD\anil-estt\contract appointment\Contract-2014\Format\app_form_con_tr_2014.doc
:: 2 ::
A. Only for TGT(Mathematics)
Ist year IInd year IIIrd year
Course
of
study
Subject
offered
%age
of
marks
obtaine
d
Subject
offered
%age of
marks
obtaine
d
Subject
offered
%age
of
marks
obtain
ed
Total
Marks
obtained
(all years
together)
Maximum
Marks
allowed
(all years
together)
B.Sc. 1
Maths Maths Maths
2
Physics Physics Physics
3
Chemistry Chemistry Chemistry
B. Only for TGT (Science)
Ist year IInd year IIIrd year
Course
of
study
Subject
offered
%age of
marks
obtained
Subject
offered
%age of
marks
obtaine
d
Subject
offered
%age of
marks
obtaine
d
Total
Marks
obtained
(all years
together)
Maximum
Marks
allowed
(all years
together)
B.Sc. 1
Chemistr
y
Chemistry Chemistry
2
Botany Botany Botany
3
Zoology Zoology Zoology
C. Only for TGT (Social Studies)
Ist year IInd year IIIrd year
Course
of
study
Subject
offered
%age of
marks
obtaine
d
Subject
offered
%age of
marks
obtaine
d
Subject
offered
%age
of
marks
obtain
ed
Total
Marks
obtained
(all years
together)
Maximum
Marks
allowed
(all years
together)
B.A. 1
History History History
2
Geography Geography Geography
3
Economics Economics Economics
4
Pol. science Pol. science Pol. science
D. Only for TGT(English)
Ist year IInd
year
IIIrd
year
Course
of
study
Subject
%age of
marks
obtained
%age of
marks
obtained
%age of
marks
obtained
Total
Marks
obtained
(all years
together)
Maximum
Marks (all
years
together)
B.A. 1
Eng.
Elective
E. Only for TGT(Hindi)
Ist year IInd
year
IIIrd
year
Course
of
study
Subject
%age of
marks
obtained
%age of
marks
obtained
%age of
marks
obtained
Total
Marks
obtained
(all years
together)
Maximum
Marks (all
years
together)
B.A. 1
Hindi
Elective
F. Only for TGT(Urdu)
Ist year IInd
year
IIIrd
year
Course
of
study
Subject
%age of
marks
obtained
%age of
marks
obtained
%age of
marks
obtained
Total
Marks
obtained
(all years
together)
Maximum
Marks (all
years
together)
B.A. 1
Urdu
Elective
P.T.O.3
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::- 3 -::
14. Experience in Govt. recognized/ Duration Period
CBSE/ICSE Affiliated Schools From To From To
i) Day School ______ _______ ______ _____
ii) Residential School ______ _______ ______ _____
15. Participation in sports :
National / Yes/No. _________
State / University Yes/No. _________
I solemnly undertake that in the event of my appointment on contractual basis in
the Samiti, my services are liable to be terminated without notice if any of the foregoing
information furnished by me in my application form is found to be wrong or suppressed. I
further understand that this appointment is purely on contract and does not confer the
right for regularization.
Dated: SIGNATURE OF CANDIDATE
PART II CERTIFICATE (For office use)
Certified that I have scrutinized personally the information in Part I above with
originals and found it to be in order. Candidate is eligible for the post.
SIGNATURE OF THE DEALING ASSISTANT