| If CTET Applied : | ||
| Roll No : | ||
| Certificate Form No : | ||
| Name of candidate : | ||
| Mobile No : | ||
| Tet Category : | ||
| Are you a permanent Govt. Teacher : | ||
| POST Applied For: | ||
| 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 / D.Ed (Special Education) | ||||
| 5.) B.Ed/B.Ed (Special Education) |
Special Education
| DELED/DED/BED/BED(SE) Passing Date | |
| DELED/DED/BED/BED(SE) Type : | |
| DELED/DED/BED/BED(SE) University Name : | |
| DELED/DED/BED/BED(SE) University State : |
Co-curricular activities
| NCC : | |
| SPORTS : | |
| CULTURAL : |
| Applied through proper channel : | ||
| Ex-serviceman : | ||
| District applied for : | ||
| If Below Poverty Line(BPL) : | ||
| Signature of candidate : | ||