Strictly Confidential Received on………………..………………

MODERN SCHOOL VASANT VIHAR

POORVI MARG, NEW DELHI-110057

APPLICATION FOR APPOINTMENT

Post ………………………………………….

Grade ………………………………………

Subject …………………………………….

1. PERSONAL DETAILS

NAME ____________________________________________ SEX ____________________ AGE _______

DATE OF BIRTH __________________ PLACE OF BIRTH _____________ STATE______________________

MARITAL STATUS Married Unmarried Divorced Separated Widowed

PRESENT ADDRESS (For communication) PERMANENT ADDRESS ________________________________________ ______________________________________

________________________________________ ______________________________________

________________________________________ ______________________________________

________________________________________ ______________________________________

TEL _____________________________________ TEL ___________________________________

E-mail Id _________________________________ E-mail Id _______________________________

2. LANGUAGE PARTICULARS

Spoken Languages _______________________________________________________________________

Spoken, Read and Written ___________________________ Fluent enough to teach ___________________

To be filled and returned in original. Attach extra sheets where necessary, or for additional information.

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PHOTOGRAPH

MODERN SCHOOL, VASANT VIHAR, NEW DELHI-110057

3. FAMILY DETAILS

NAME OF SPOUSE Mr. /Mrs. _________________________________________________ Age______________

Educational Qualifications ___________________________________________________________________

Occupation _____________________Organisation ____________________Designation __________________

FATHER’S NAME _________________________ Age __________________Occupation ______________________

MOTHER’NAME _________________________ Age __________________ Occupation ______________________

CHILD’S NAME Age Sex Education School/College/Occupation _____________________ _____ _____ ____________________ _________________________

_____________________ _____ _____ ____________________ _________________________

_____________________ _____ _____ ____________________ _________________________

4. EDUCATIONAL HISTORY (In chronological order) Enclose self-attested copy of certificates

School/College & University Location Year Degree Subjects Marks%

___________________________ _________ ______ ______________ __________________ _________

___________________________ _________ ______ ______________ __________________ _________ ___________________________ _________ ______ ______________ __________________ _________ ___________________________ _________ ______ ______________ __________________ _________ ___________________________ _________ ______ ______________ __________________ _________ ___________________________ _________ ______ ______________ __________________ _________ ___________________________ _________ ______ ______________ __________________ _________ ___________________________ _________ ______ ______________ __________________ _________

5. ACHIEVEMENTS AND DISTINCTIONS DURING EDUCATION

Achievement/Distinction Description Year

____________________ ________________________________________________ ___________

____________________ ________________________________________________ ___________

____________________ ________________________________________________ ___________

____________________ ________________________________________________ ___________

____________________ ________________________________________________ ___________

MODERN SCHOOL, VASANT VIHAR, NEW DELHI-110057

7 .EMPLOYMENT DETAILS

7. EMPLOYMENT DETAILS

DATE OF JOINING_________________________________ PRESENT/LAST REMUNERATION

Grade on joining (PGT, TGT etc.)__________________ Basic Monthly Salary Rs.__________________

Designation on joining__________________________ Dearness Allowance Rs.__________________

DATE OF CURRENT APPOINTMENT__________________ House Rent Allowance Rs. __________________

Current Grade_________________________________ Other perks(please specify)__________________

Current Designation____________________________ ________________________________________

CLASSES TAUGHT _______________________________ ________________________________________

SUBJECTS TAUGHT ______________________________ Total Remuneration Rs.__________________

ADDITIONAL PORTFOLIO (If applicable) ___________________________ <,_______________________________

JOB RESPONSIBILITIES (Brief description)

______________________________________________

______________________________________________

______________________________________________

______________________________________________

______________________________________________

______________________________________________

______________________________________________

______________________________________________

______________________________________________

______________________________________________

_____________________________________________

6. PRESENT/LAST EMPLOYER

NAME & ADDRESS OF INSTITUTION BOARD AFFILIATED TO ______________________

______________________________________________ NUMBER OF BRANCHES ____________________

______________________________________________ CLASSES FROM ____________ TO _____________

______________________________________________ NUMBER OF TEACHERS _____________________

TEL __________________________________________ NUMBER OF STUDENTS _____________________

CLASSES FROM TO

NUMBER OF TEACHERS

NUMBER OF STUDENTS

8. REMUNERATION EXPECTED____________________________________________________________________

ORGANISATIONAL (REPORTING) CHART

MODERN SCHOOL, VASANT VIHAR, NEW DELHI-110057

9. PAST EXPERIENCE (In reverse chronological order) Year Name & Location Post held Classes Subjects Reasons

of Institution taught taught for Change

From To

From To

From To From

To From

To From To From To

10 .SEMINARS / WORKSHOPS /TRAINING COURSES ATTENDED Description Organisation Year

______________________________ __________________________________________ _______________

______________________________ __________________________________________ _______________

______________________________ __________________________________________ _______________

______________________________ __________________________________________ _______________

______________________________ __________________________________________ _______________

______________________________ __________________________________________ _______________

______________________________ __________________________________________ _______________

______________________________ __________________________________________ _______________

MODERN SCHOOL, VASANT VIHAR, NEW DELHI-110057

11. ANY PAPERS/ ARTICLES/ BOOKS WRITTEN OR PRESENTED BY YOU Paper/ Article/ Book Subject Year

__________________________ _______________________________________________ ________________ __________________________ ______________________________________________ ________________ __________________________ ______________________________________________ ________________ __________________________ ______________________________________________ ________________

12. A BRIEF NOTE ON ICT KNOWLEDGE & SKILLS __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________

13. MEMBERSHIP OF CULTURAL, SOCIAL, RELIGIOUS OR POLITICAL ORGANISATIONS Name of Organisation Objectives of Organisation Your Status Joined in

_______________________ ____________________________ ________________ ______________

_______________________ ____________________________ ________________ ______________

14. ANY HOBBIES, SPECIAL SKILLS OR INTERESTS __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________

15. DETAILS OF ANY DISABILITY/ SERIOUS ILLNESS

Description Consequences Year Period ____________________________ ____________________________________ _______________ __________________ ____________________________ ____________________________________ _______________ __________________

16. ANY OTHER RELEVANT INFORMATION/INSIGHT _______________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________

17. REFERENCES (Two persons not related, at least one from your line of work who may be contacted)

NAME ________________________________________ ___________________________________________

OCCUPATION ________________________________________ ___________________________________________

ORGANISATION ________________________________________ ___________________________________________

ADDRESS ________________________________________ ___________________________________________

________________________________________ ___________________________________________

________________________________________ ___________________________________________

PHONE ________________________________________ ____________________________________________

E-mail Id _______________________________________ __________________________________________

DECLARATION I certify that the above information is correct and complete to the best of my knowledge, and that nothing has been concealed. If at any time I am

found to have concealed or misrepresented any information, my appointment is liable to termination without notice or compensation. I declare that I am of sound mind at the time of signing this document.

Date ___________________ Place_______________________ Signature________________________