Delhi Public School, Firozabad E-mail:
[email protected] Website:www.dpsfirozabad.in
Post applied for:……………………………………………………………………………………. Personal Information 1.
Name in block letters Miss/Mrs./Mr………………………………………………………………….………….
2.
Date of Birth (in figures):………….……………………………………………………………………………………….. (in words):…………..………………………………………………………………………………………..
3.
Contact address with telephone number(s) :………………………………………………………………... …………………………………………………………………………………………………………………………………….……… …………………………………………………………………………………………………………………………………….………
4.
Place of Birth:……………………………………………….
5. Nationality: ………………………………
6.
Marital Status : ……………………………………………
7. Number of Children:……………….
8.
Language spoken at home (i)………………………… (ii)……………………….. (iii)……….……………….
9.
Name of father/mother/spouse:………………………………………………………………………………………
10.
Occupation father/mother/spouse:………………………………………………………………………………… Address and telephone Number:……….…………………………………………………………………………..
11.
Details of foreign travel & Year:……………………………………………………………………………………... ………………………………………………………………..…………………………………………………………………….……… ………………………………………………………………..…………………………………………………………………….……… Page 1 of 4
Academic Information:
12. S.No
Qualification
Discipline/ Subjects
Name of School College/University
Year of Passing
Mode Distance/ Regular
% of Marks
Division
13.
Professional Qualifications:
14.
Total Experience (in years): ………………………………………………………………………………………………
15.
Teaching: …………………………………..………………………………………………………………………………………
16.
Administration: …………………………………..……………………………………………………………………………
17.
Any other: …………………………………………..……………………………………………………………………………
18.
Proficiency in Languages (write mother tongue at S.No. 1) S.No.
Language
Read
Write
Speak
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Particulars of Present Job: 1.
Name and full address of present organization with contact numbers:…………………... ………………………………………………………………..…………………………………………………………………….……… ………………………………………………………………..…………………………………………………………………….……… ………………………………………………………………..…………………………………………………………………….………
2.
Present designation:…………………………………………………………………………………………………………..
3.
Date of Joining:…………………………………………………………………………………………………………………..
4.
Present place of posting:…………………………………………………………………………………………………..
5.
Total emoluments Pay in PB
6.
Grade Pay
Basic Pay
DA
Total
Other Benefits HRA
Tpt Allow.
DPS Grade Pay
Grand Total
Are you under Service Bond: …………………………………………………………………………………………. If Yes, give details:………………………………………………………………………………………………………………….
7.
Exact period after which you can join if selected:………………………………………………………..
Other Information: (i) Seminars and courses attended: S.No.
(ii)
Seminar/Course
Date
Description
Names of three books recently read with names of authors:
S.No.
8.
Duration
Title
Do you suffer from any major ailment / medical problems?
Authors
Yes/No:……………………
If Yes, give details:
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9.
Have you ever been convicted by any court of law or any disciplinary proceeding / enquiry is against you or any penalty has been imposed upon you. Yes/No.:…………………………………… If Yes, give details:
10.
Give details of two references (other than relatives) in the field of education, or from the member of Delhi Public School Society. Name
Occupation
Address (Official)
Tele. Nos
Thereby certify that the information provided is true and to the best of my knowledge and belief. If any information is found to be false / incorrect it will disqualify me for employment in any of the schools of the Delhi Public School Society.
Date:…………………………………
Signature of the Candidate
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