Physics Chemistry Maths Biology Computer Sc Serial No. of Certificate Marks obtained/ Percentage total marks
.
/ 6. Nationality : ________________ 8. MARITAL STATUS: Married Unmarried
7. Date of Birth (DD/MM/YY) 9. Have you been discharged from armed forces before? Yes
10. Have you ever been enrolled in armed forces before?
Yes
No
No
11. Visible Identification Marks (at least two):(a) (b) DECLARATION 1. I hereby declare that all the statements made in the application are true to the best of my knowledge and belief and the application has been filled up by me 2. I have never been debarred from appearing in any examination nor, have I ever been withdrawn from Defence Training Establishments on disciplinary grounds, nor have I ever been arrested, prosecuted or convicted by criminal court or involved in any other case registered by the police. I have not submitted more than one application for this batch. 3. I undertake not to make any claim for compensation if at any stage of selection, ineligibility for my candidature is detected and my candidature is cancelled as a result thereof. 4. Any willful misrepresentation of facts and concealment of information will result in the cancellation of the candidature and may debar me permanently or for a specified period from applying for future examinations
Place:…............................... Date : ........................ ......
Signature of Parent
Signature of Applicant
List of Documents: The following documents are to be attached by punching and tying firmly with a strong thread to the application in the sequence below: Attested copy of (a) Matriculation certificate.( for verification of Date of Birth) (b) 10+2 certificate (c) 10+2 mark sheet (d) Domicile certificate. Two self-addressed envelops of size 22 x 10 cms with Rs 10/- stamp affixed on one envelope. Note: - All the above certificates are to be attested by Gazetted Officer (The name of attesting officer should be legible).
........................................................................................................................................................................................................................ IDENTIFICATION FORM Paste your Application No. Date of Birth (DD/MM/YY) recent Name coloured photograph (Do not Fathers name staple) Visible Identification Marks (at least two):(a) (b)
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Aug 15, 2013 - He earned a Master in Business. Administration degree from Boston College and a Master of Professional. Studies degree from Salem State University. Mr. Wentworth has been an intermediate classroom teacher in both Topsfield and Lawrence
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