Receipt No. ________________________ Post Applied for: ______________________________________________________________ Affix Passport size recent colour photograph 1. Personal Details:a. Name (CAPITAL LETTERS)________________________________________________________________________ b. Sex – M c. Present Address F ______________________________________________________________________ ______________________________________________________________________ d. Phone No. ______________________________________________________________________ e. Permanent Address ______________________________________________________________________ ______________________________________________________________________ 2. a. Date of birth ______________________________________________________________________ (in words and figures) ______________________________________________________________________ b. Age in year ______________________________________________________________________ C. Nationality ______________________________________________________________________ 3. Family:- 4. a. Father’s / Husband Name ______________________________________________________________________ b. Academic Qualification ______________________________________________________________________ c. Profession ______________________________________________________________________ a. Mother Tongue ______________________________________________________________________ b. Efficiency in written and spoken: Very Good/Good/Fair/None  English ______________________________________________________________________  Hindi ______________________________________________________________________  Any other Language ______________________________________________________________________ 5. Marital Status: Single/Married 6. Academic Qualification ______________________________________________________________________ S.No. Exam Passed 1 High School 2 Intermediate 3 B.A/B.Sc/ B.Com M.A/M.Sc/ M.Com Ph.D 4 5 6 7 B.Ed/M.Ed/ B.PEd/M.PEd Any Other Year of Passing School/College and University Class/Div & % Of marks Subject Offered Medium of Instruction 7. Games & Sports: a. Games Played 1.___________________________________ 2. _____________________________________ b. Level 1.___________________________________ 2. _____________________________________ 8. Which of the following areas you can train the students:Art, Music, Dramatics, Debate, Dancing, SUPW, NCC, NSS, etc 1. ______________________________ 2. ____________________________ 3. ________________________________ 9. Institution Served :S.No. Institution Duration Class Taken Subject Taught Medium Pay Scale 10. Research Experience (If any) Name of the University Duration Subject Result/Progress 11. Publications, If any to your credit:1. ___________________________________________________________________ 2. ___________________________________________________________________ 12. Minimum Salary Acceptable :13. Reference :1. _____________________________________________ 3. ______________________________________________ 2. ___________________________________________ 14. Notice Period required (if selected):- ______________________________________________________________ Mention Probable date of joining, if selected _______________________________________________________________ 15. Concept of Education (Attach an additional Sheet) Would you like to say something about your concept of education based Vedic culture and traditions and the way you would help your students to gain and develop an integrated personality. 16. I solemnly declare that statement made by me is correct to the best of my knowledge and belief. Place: Date: Signature: