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Adv ApplicationForm 07 06 2024

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37 views3 pages

Adv ApplicationForm 07 06 2024

Uploaded by

guptabkt18
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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REGIONAL INSTITUTE OF EDUCATION, BHOPAL

(A Constituent Unit of NCERT, Ministry of Education, Govt. of India)


Shyamla Hills, Bhopal – 462002 (M.P.)

Application form for the Various Posts


Note: Before filling the form, please read the detailed advertisement carefully.

1. Post Applied For & Subject 2. Category 3. Gender 4. Nationality


(UR/SC/ST/OBC)

5. Candidates Name (In capital letters) (for Sl. No. 5, 6 & 7 keep one box blank between name and
surname)

6. Mother’s Name (In capital letters)

7. Father’s/Husband’s Name (In capital letters)

8. Address for communication

Name

Father/Husband’s
Name
Affix Photograph here
Address:

State
Pin
Mobile Number

E- Mail id
9. Date of Birth 10. Age as on date (01-06-2024)

D D M M Y Y Y Y Y Y M M D D

10. Area of Specialization ______________________________________________________

Educational / Professional Qualifications (Starting from Class XII onwards)

Examination Discipline/Specialization/ Board/ Year of Duration Division % of


Passed Subject University Passing of marks
Course

10th

12th

Graduation

Post-
Graduation

M.Phil

Ph.D

NET with JRF

NET

SLET/SET

11. Additional Qualifications :-

12. Research Publications :-

13. Teaching/Post-Doctoral Experience :-


14. Awards :-
(A) International/National Level (Awards given by International Organisations/Govt.
of India/Govt. of India recognized National Level Bodies) :-

(B) State Level (Awards given by State Government) :-

15. Experience
(a) in NCERT, if any Total experience:____ Years______Months

Name and address Designation Scale of Length of service Total Nature of work,
of Employer pay/salary experience in brief
From To
per annum in months

(b) in other places, if any Total experience:____ Years______Months

Name and address of Designation Scale of Length of Service Total Nature of work,
Employer pay/Salary Experience in brief
From To
(Also indicate whether per annum in Years
Central Govt./State
Govt./Autonomous
Bodies/Private Sector)

16. Any other information :-

17. Declaration to be signed by the Candidate


I hereby certify and declare that (1) I am an Indian National, (II) I have read the provision
given the Advertisement, (iii) All statement made and information given by me in this
application 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 at any stage action can be taken
against me and my candidature/ engagement shall automatically stand cancelled / terminated,
(iv) I further declare that I fulfill all the conditions of eligibility regarding age, educational,
professional qualification, etc. prescribed for the post applied for.

Place: ………………………………

Date: ……………………………… (Signature of the Applicant)

Enclosed : Xerox copy of all relevant Testimonials duly self Attested.

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