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Adarsh Bal Niketan

Senior Secondary School

IIT Roorkee, Roorkee 247667, Uttarakhand

APPLICATION FORM for TEACHING position

 APPLICATION FOR THE POST OF: ____________________________________________

In response to ABN School Advertisement No. _______________________________

1. Name of the applicant: ______________________________

2. Sex (Male/Female) :______________

3. Date of Birth (DD/MM/YY) :_________________________

4. Age as on 01.03.2016:____________________________

5. Category: _____________________

6. Marital Status: ______________________________

7. Family member details: __________________________________________________

 _____________________________________________________________________

7. Have you been found guilty of any offence during your professional service? ________

If yes, specify:__________________________________________________________

8. Demand Draft Details: ___________________________________________________

9. Address for:

(i) Correspondence________________________________________

 _____________________________________________________

 _____________________________________________________

(ii) Permanent address:_____________________________________

 _____________________________________________________

 _____________________________________________________

(iii) Mobile no.:____________________________________________

(iv) Email ID: _____________________________________________

(Affix recentpassport sizephotograph)

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10. Present Employer: ____________________________________________

Position held: ________________________________________________

Nature of responsibilities: ______________________________________________

 ___________________________________________________________________

11. Have you qualified CTET: _________ Year:______ Score: ______________

12. Educational Qualifications (in chronological order from Class-X onwards).

Sl. No. Examination

passed

 Year of

passing

Board / University Subjects taken % marks

obtained

13. Work Experience (in chronological order):

S.No.

Postheld

Organization Duration Length ofservice

Pay scalewith its

break-up

Nature ofduties

From To

12. Are you proficient in use of MS office? Excellent/ Good/ Average/ Poor

13. Have you organized NCC / Cultural / Sports activities: __________________________

 ____________________________________________________________________

 ______________________________________________________________________

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14. Special Programs/ Workshops Organized or Attended: _________________________

 _____________________________________________________________________

 _____________________________________________________________________

 ______________________________________________________________________

15: Your reason for applying to ABN School: ____________________________________

 ______________________________________________________________________

 ______________________________________________________________________

16. Two References with contact address/ Email ID/ Mobile No.

(i) _______________________________________________________________

 _____________________________________________________________________

(ii) _______________________________________________________________

 ______________________________________________________________________

D E C L A R A T I O N

I solemnly declare that the statements and details given above and attached as

enclosures with this application form are correct to be best of my knowledge and belief.In case any if the details are found false at a later stage, I am aware that mycandidature / appointment may be cancelled / withdrawn.

Date & Place:____________________ (Signature of the candidate)

CHECK LIST

o  This application form complete in all respectso  Self-attested copies of Certificates/ Mark sheets/ Awards from class X

o  Copy of recent salary slip (if you wish to protect your salary).

o  Demand Draft in the name of “Manager, ABN School”

o  A copy of your CV

o  One page vision document sharing your vision as a teacher

o  Two testimonials from educationalists who have known you