S.No……….
Affix your
passport size
photograph
here.
APPLICATION FORM FOR TEACHING STAFF
SESSION : 20___-20___
Post applied for : ________________________
(To be filled in candidate’s handwriting)
SECTION-A
1. Name Mr./Mrs./Ms. : __________________________________________________
2. Date of birth : ____________________ Present Age: __________________
3. Nationality : __________________________________________________
4. Marital Status : __________________________________________________
5. Number of children and their details:
DATE OF BIRTH
S.NO. NAME GENDER CLASS SCHOOL/ COLLEGE
AND AGE
6. Father/Spouse Name : _________________________________________________
7. Occupation of father/spouse: ___________________________________________
8. Home Address for correspondence: _______________________________________
____________________________________________________________________
9. Telephone/mobile number: _____________________________________________
10. Email Id: ____________________________________________________________
11. Permanent Address: __________________________________________________
___________________________________________________________________
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12. Any major ailments/health concerns. If yes, please give details:
__________________________________________________________________
__________________________________________________________________
13. Academic Qualifications
SCHOOL/BOARD/ MODE
YEAR OF MARKS MEDIUM OF
EXAMINATION SUBJECTS COLLEGE/
PASSING (%) INSTRUCTION REGULAR DISTANCE
UNIVERSITY
Secondary
Sr. Secondary
Graduation
Post-
Graduation
Any Other
14. Professional Qualification
YEAR OF COLLEGE/ MARKS MEDIUM OF MODE
QUALIFICATION SUBJECTS
PASSING UNIVERSITY (%) INSTRUCTION REGULAR DISTANCE
NTT
B.Ed.
M.Ed.
Any other
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15. CTET Qualification: Please provide the relevant information (applicable for post of PRT
and TGT)
CTET PAPER YEAR OF PASSING MARKS (%)
Paper 1
Paper 2
16. Knowledge of foreign language if any : _____________________________________
17. Names of two books recently read with name of authors:
_____________________________________________________________________
_____________________________________________________________________
18. Computer Proficiency: tick the applicable boxes.
o MS Excel
o MS Word
o MS Power Point
o MS Publisher
o MS Team/Zoom/Google Meet
o Any Other ______________
19. Please mention the strategies you will utilize if given a Class of:
a.) Students with special learning needs: ______________________________________
_____________________________________________________________________
_____________________________________________________________________
b.) Exceptionally gifted students: ____________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
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20. Please state your views on “Technology a boon for the new age educator”.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
21. Details of Awards/Citations/Appreciation Certificates/scholarships received, if any:
DETAILS OF DETAILS
AGENCY YEAR
AWARD/FELICITATION (AREA OF WORK)
22. Co-curricular activities ( Photography, Dramatics, Animation, Music, Dance etc.) in
which you can train students / Any other activity:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
23. Literary activities (Debate, Creative writing, Newsletters, Quiz, Newsletter, School
Magazine, Event Compering) in which you can guide students:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
24. Details of participation in sports activities and the level (School/College/Zonal/Inter
Zonal/State/National):
___________________________________________________________________
___________________________________________________________________
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25. Public speaking exposure or if you managed any responsibility earlier that required
public speaking :
___________________________________________________________________
___________________________________________________________________
26. Details of participation in Clubs/Committees/Associations/Organizations/ cultural
activities/literary activities and the level (School/ college/ zonal/ state/ national):
ACTIVITY ORGANIZED BY YEAR ACHIEVEMENT
27. Details of any event/exchange program that you initiated/organized/ managed:
___________________________________________________________________
___________________________________________________________________
28. Details of books/research papers/magazine articles/ blogs/ e-publications authored
by you:
____________________________________________________________________
____________________________________________________________________
29. Any action research conducted and documented:
____________________________________________________________________
____________________________________________________________________
30. The exact period after which you can join, if selected:
____________________________________________________________________
31. Mention any course you are pursuing at present. Will you require any leave on this
account?
____________________________________________________________________
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32. Please give details of two references (other than relatives) from the field of
education:
A.) Name: ____________________ Designation: ___________________________
Phone:____________________ Email id: ______________________________
Official address: ___________________________________________________
B.) Name: ____________________ Designation: ____________________________
Phone: ____________________ Email id: _______________________________
Official Address: ___________________________________________________
33. Are you a parent with us? If yes, please give details:
_____________________________________________________________________
_____________________________________________________________________
34. Are you an alumnus of the school? ________________________________________
(Full Signature of the Applicant): __________________________________________
35. Details of teaching experience (To be filled by applicants with teaching experience) :
NO. OF YEARS DESIGNATION
NAME OF CLASSES & WHETHER TOTAL
AND MONTHS, AND BRIEF REASON FOR
INSTITUTION SUBJECT PERMANENT/ EMOLUMENTS
FROM DESCRIPTION OF LEAVING
WITH ADDRESS TAUGHT TEMPORARY DRAWN/GRADE
----TO---- DUTIES HELD
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36. Continuous Professional Development: Mention courses from Government recognized
institutions/agencies (NCERT, SCERT, CBSE, DIKSHA British Council etc.) or other MOOC
courses.
WORKSHOP/SEMINAR/
AGENCY DETAILS DURATION
TRAINING ATTENDED
37. Details of any COE Webinar conducted as a resource person (attach the certificates):
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
38. Details of administrative experience/extra responsibilities shouldered by you besides
teaching:
_____________________________________________________________________
_____________________________________________________________________
39. Details of educational tours/study visits organized by you:
_____________________________________________________________________
_____________________________________________________________________
(Full Signature of the Applicant): ________________________
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SECTION-B
(Medical History)
1. Have you undergone any major surgery in last 05 years? (Mention the details, if any).
_____________________________________________________________________
_____________________________________________________________________
2. Have you been treated for any major ailment in last 05 years?
_____________________________________________________________________
_____________________________________________________________________
3. Please attach a self-attested certificate stating that no case or complaint has been
lodged against you under POCSO Act/Corporal Punishment/Abuse. (Copy attached)
_____________________________________________________________________
_____________________________________________________________________
4. Please attach copies of relevant documents (mark sheets, experience certificates,
training certificates, citations etc.)
_____________________________________________________________________
_____________________________________________________________________
Declaration:
I hereby certify that all statements made, and information given by me in this application
form are true, complete, and correct to the best of my knowledge and belief. In the event
of any information or part of it being found false or incorrect before or after the interview
or appointment, action can be taken against me by the School and my candidature/
appointment shall automatically stand cancelled/ terminated.
Place: ______________
Date: ______________
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TO WHOMSOEVER IT MAY CONCERN
I ______________________________, certify that no case or complaint has been lodged
against me under POCSO Act/Corporal Punishment/Abuse.
Name : _________________________________
Sign : _________________________________
Date : _________________________________
