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Document Sample
To be Written by Verification Team :
Board No.______ Application Sr.No.________
NAVODAYA VIDYALAYA SAMITI
(REGIONAL OFFICE), Bay No.26-27, Sector-31-A, CHANDIGARH
PART-I BIO-DATA
1A. Application for the post of : ___________________________(on contract basis)
B. Date of Interview : _____/07/2011
2. Tel.No. (with STD Code)/Mobile no.: ____________________________
3. Name : ____________________________ Paste Latest
photograph
4. Father’s/Husband Name : ____________________________ here
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/Departmental
Candidate/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. Course of Study Max. Marks Marks % age of marks
No. Obtained
1. 10th
2. 12th
3. Graduation (BA/B.Sc.)
(Others Please specify)
4. Post Graduation in the subject
5. B.Ed. (Theory & Practical)
(Kindly enclose proof in respect of conversion of grades into marks. P.T.O….2
:: 2 ::
A. Only for TGT(Mathematics)
Ist year IInd year IIIrd year Total Maximum
Course Subject %age Subject %age of Subject %age Marks Marks
of offered of offered marks offered of obtained allowed
study marks obtaine marks (all years (all years
obtaine d obtain together) together)
d ed
Maths Maths Maths
B.Sc. 1
Physics Physics Physics
2
Chemistry Chemistry Chemistry
3
B. Only for TGT (Science)
Ist year IInd year IIIrd year Total Maximum
Course Subject %age of Subject %age of Subject %age of Marks Marks
of offered marks offered marks offered marks obtained allowed
study obtained obtaine obtaine (all years (all years
d d together) together)
Chemistr Chemistry Chemistry
B.Sc. 1 y
Botany Botany Botany
2
Zoology Zoology Zoology
3
C. Only for TGT (Social Studies)
Ist year IInd year IIIrd year Total Maximum
Course Subject %age of Subject %age of Subject %age Marks Marks
of offered marks offered marks offered of obtained allowed
study obtaine obtaine marks (all years (all years
d d obtain together) together)
ed
History History History
B.A. 1
Geography Geography Geography
2
Economics Economics Economics
3
Pol. science Pol. science Pol. science
4
D. Only for TGT(English)
Course Subject Ist year IInd IIIrd Total Maximum
of year year Marks Marks (all
study %age of %age of %age of obtained years
marks marks marks (all years together)
obtained obtained obtained together)
Eng.
B.A. 1 Elective
E. Only for TGT(Hindi)
Course Subject Ist year IInd IIIrd Total Maximum
of year year Marks Marks (all
study %age of %age of %age of obtained years
marks marks marks (all years together)
obtained obtained obtained together)
Hindi
B.A. 1 Elective
F. Only for TGT(Punjabi)
Course Subject Ist year IInd IIIrd Total Maximum
of year year Marks Marks (all
study %age of %age of %age of obtained years
marks marks marks (all years together)
obtained obtained obtained together)
Punjabi
B.A. 1 Elective
P.T.O….3
::- 3 -::
G. Only for TGT(Urdu)
Course Subject Ist year IInd IIIrd Total Maximum
of year year Marks Marks (all
study %age of %age of %age of obtained years
marks marks marks (all years together)
obtained obtained obtained together)
Urdu
B.A. 1 Elective
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
