KENDRIYA VIDYALAYA, BSF, JALALABAD (W) APPLICATION FOR PART TIME CONTRATUAL TEACHER/MISCELLANEOUS POST for SESSION 2015-16 Registration No. (For Office Use Only) ……………..….…………… Post Applied for: ................................................................................................................... *Registration No. with NCI: ..………………………………………………………. (*Applicable only for the Post of Doctor/Nurse) PHOTO 1. Name of Candidate: .................................................................................................................. 2. Father’s/Husband’s Name:-…………….……………………………………………………… 3. Date of Birth: ................................................................................................................................ 4. Address for Correspondence: ………………………………………………………………… …………………………............................................................................................................................................................................... 5. Telephone number: Mobile:…………………………………………… Landline:…………….………………………………… 6. Educational Qualification (from Class XII and onwards): S. No. Examination Year of Passing Board/University Subjects Offered Marks Obtained with Max. Marks % of Marks 1 2 3 4 5 7. Experience S. No. School/College/Institution Whether recognized or not Period Post Held From To Total Experience YY/MM/DD 1. 2. 3 8. Computer Skill: …………………………………………………………………………………………………………………………… 9. Whether CTET Qualified (applicable for the post of TGT and PRT only)…………………………………………. 10. Any other: ………………………………………………………………………………………...………………………………………... Declaration I certified that the above information is true to the best of my knowledge and belief. I am liable to be disqualified if any information given is found to be incorrect/incomplete or false. Place: ………………………….….. Date: …………………………..…. Signature of Applicant