Application - School Education

GOVERNMENT OF PUDUCHERRY
DIRECTORATE OF SCHOOL EDUCATION
Perunthalaivar Kamarajar Centenary Educational Complex, 100 Feet Road, Anna Nagar,
Puducherry – 605 005
***
APPLICATION FOR THE POST OF PRIMARY SCHOOL TEACHER – 2015
(Note : i) Read instructions before filling in the application
ii) To be filled in by the Candidate in BLOCK LETTERS
iii) Put  mark against the relevant box wherever necessary
iv) Self Attested Copies of relevant certificates should be enclosed
Affix a recent
passport size
photograph
attested by a
Gazetted
Officer
1. Name of the Applicant
2. Father’s / Husband’s Name
3. Date of Birth
4. Age as on
:
DD/MM/YY
17.06.2015 :
5. Sex
:
Years
Months
Male
Female
Days
6. Educational and Professional Qualifications :
Sl.
No.
Name of the
Total
Total
Board
maximum
marks
Year of
marks in
obtained in
passing
all
all
subjects
subjects
Month &
Qualification
1.
S.S.L.C.
2.
H.S.C.
3.
D.T.Ed
Name of TET
Month and Year
of passing
Maximum
marks
7.
Language Studied up to Secondary Level:
8.
Employment Registration Code No:
Number of
Percentage
attempt(s)
of marks
Marks obtained
in TET
Percentage
:2:
DD
9. Date of Registration
MM
YYYY
:
SSLC
:
H.Sc
:
D.T.Ed :
Date of Next Renewal
10.
Nationality
:
:
INDIAN
OTHERS
11. Whether Native / Resident of U.T.of Puducherry :
12. Religion
:
HINDU
YES
MUSLIM
NO
CHRISTIAN
OTHERS
13. Community
:
GEN
OBC
14. If belongs to SC, whether he/she is
declared SC as per the Constitution
(Pondicherry) Scheduled Castes Order, 1964 :
15.
Whether differently abled
Person
:
Yes
Yes
SC
No
No
16. Address for Communication:
Pincode
Phone No
Mobile No.
DECLARATION
I have carefully read the instructions contained in the prospectus. I hereby declare that
the information furnished above by me is true and correct to the best of my knowledge and I
understand that my application is liable to be rejected if any information given above is found to
be false.
SIGNATURE OF THE APPLICANT
DATE:
PLACE: