UP Elementary Education

DIRECTORATE OF ELEMENTARY EDUCATION

Application form

Roll No :

Certificate Form No :

Name of candidate :

Mobile No :

If CTET Applied :

Post Applied For :

Date of Birth :

Address Line 1 :

Address Line 2 :

State :

District :

City/Town :

PIN Code :

Language-I :

Gender :

Caste :

Physically Handicapped :

Yes

Qualification	Year of passing	Marks Obtained	Total marks	Percentage (%)
1.) HSSLC
2.) Graduate
3.)TET/CTET Mark
4.) 2 Year D EL Ed / D.ED (Special Education)
5.) B.ED/ B.ED(Special Education)

Co-curricular activities

NCC

Sports

Cultural

* In case of sports and cultural activities the candidates must represent State or Nation

Are you applying through proper channel :

Yes

Are you an ex-serviceman :

Yes

District applied for :

If Below Poverty Line(BPL) :

Yes

IPO No	Amount-Rs. 200	IPO Date

Signature of candidate :

If CTET Applied :

Roll No :

Certificate Form No :

Name of candidate :

Mobile No :

Post Applied :

Date of Birth :

Address Line 1 :

Address Line 2 :

State :

District :

City/Town :

PIN Code :

Language-I :

Gender :

Caste :

Physically Handicapped :

Qualification	Year of passing	Marks Obtained	Total marks	Percentage (%)
1.) HSSLC
2.) Graduate
3.) TET Mark
4.) 2 Year D EL Ed / 2 Year Special Education
5.) B. ED

Co-curricular activities

NCC :

SPORTS :

CULTURAL :

Applying through proper channel :

Ex-serviceman :

District applied for :

If Below Poverty Line(BPL) :

Declaration

I hereby declare that the information submitted herein are true and correct. I understand that in the event of particulars or information given herein being found false or incorrect, my candidature for the recruitment is liable to be rejected or canceled. In the event of my misstatement/discrepancy in the particulars if detected, after my appointment, my service shall be terminated without any notice to me.

Signature of candidate