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Online Application: KVS 2013

Application Form for the post of Trained Graduate Teacher (TGT) - WE

* Application No. 4911640730 Examination Centre Examination Centre City Choice1: Delhi selected Choice2: Jaipur Language in which Question * English Paper is required * * Post Applied for Personal Particulars * Name * Date of Birth * Gender DEEPAK VERMA 05-Jan-1991 Male Trained Graduate Teacher (TGT) - WE

* Address for communication s-2/42 swarn park mundka nangloi delhi

* City * State * Email-ID Contact No. * Religion *

delhi Delhi deepakvermaeee@gmail.com 91 -9268229012 hindu

* Pin Code

110041

* Mobile No. * Category * Are you in Govt. Regular Service?

9268229012 OBC NO if yes, No. of year of Service: 0

Are you a KVS permanent NO employee? Are you Resident of State * of J&K (Domiciled during NO 01.01.1980 to 31.12.1989)? * Are you person with disabilities? NO INDIAN NO

If yes, indicate the nature of disability and Percentage % of disabilty If Ex-Serviceman, No. of year of service

* Nationality * Whether Ex-Serviceman? *

Do you have proficiency in teaching in Hindi and YES English media Whether applying/applied * for any other post(s) under None this advertisement? .................................. Signature of Candidate

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Online Application: KVS 2013

Application No.: 4911640730 Qualification Details Percentage Month Duration of Marks# Qualification Name of the Main & Year Name of the Marking Marks Maximum (in (Upto two Level Qualification Subject(s) of University/Board Scheme Obtained Marks Months) decimal Passing places) Degree BTECH Electrical 36 Jul-2013 GGSIPU Marks 4465 5800 76.98
#Note: In case the Marking Scheme is Grade, please enter the equivalent percentage.

Mode of Payment: --> Cash Challan * Indian Bank Challan No. * MU0006125486 * Challan Date * Amount Paid 8/17/2013 9:59:07 AM + 750/- (Application Fee) 30/- (Service Charge)

Challan Payment Received Status: Received : Journal No:114033300

I hereby certify and declare that:

1. I am an Indian National. 2. I have re ad the provisions give n in the Adve rtise m e nt. 3. All state m e nts m ade and inform ation give n by m e in this application are true , com ple te and corre ct to the be st of m y k nowle dge and be lie f. In the e ve nt of any inform ation or part of it be ing found false or incorre ct be fore or afte r the e x am /inte rvie w or appointm e nt, action can be tak e n against m e by the KVS and m y candidature /appointm e nt shall autom atically stand cance lle d/re patriate d/te rm inate d. 4. I furthe r de clare that I fulfill all the conditions of e ligibility re garding age , e ducational, profe ssional/te chnical qualifications, e tc. pre scribe d for the post applie d. The e sse ntial qualifications pre scribe d are posse sse d by m e , the proof of which has be e n e nclose d. 5. In case m y application is not re ce ive d by KVS within the stipulate d date due to postal de lay or othe rwise , KVS will not be re sponsible for such de lay. 6. I will not lay any claim for re fund of non-re fundable application fe e from KVS unde r any circum stance s. Undertaking: I have gone through the advertisement and the General Conditions mentioned therein and fulfil all the conditions/requirements specified therein. I he re by Acce pt and confirm the Unde rtak ing.

Signature of the candidate

Print

Home

(Please Print the form for Further Reference)

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Online Application: KVS 2013

CERTIFICATE FROM THE PRESENT EMPLOYER (Wherever applicable) (For candidates serving in Central Govt./State Govt./Public Sector Undertaking/Autonomous bodies) Certified that the above mentioned information furnished by the officer is true and there is no Vig./Disp. Case pending against him/her. (Signature & Seal of Employer)

.................................. Signature of Candidate Important Instruction for Candidates: 1. Print Version of Application Form received without Self attested documents viz. Qualification, Age, Certificate for respective category, disability etc. will be rejected. 2. Send the duly completed Print Version of Application Form in single envelope affixing the address label generated so as to reach on or before 12 September 2013 to:

Post Box No: 3076, Lodi Road, New Delhi-110003

3. The applications received after the closing date will not be entertained 4. Self attested Photostat copies of documents in proof of Age; Qualifications (including all mark sheets clearly indicating the division of passing/%age of marks & certificate/degree), Certificate for respective category, disability etc. should be attached with the printout of Application Form having auto generated Application Number. The information furnished in the Application Form and Original certificates will, however, be scrutinized / verified at the time of interview.

Application No.: 4911640730

Name: DEEPAK VERMA Address: s-2/42 swarn park mundka nangloi delhi delhi-110041 Delhi

Test Date: (To be announced later)

Signature of Candidate (in the space provided)

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Online Application: KVS 2013

Please Cut & Affix the Address Label given below on the envelop for sending Application Form (print version of Online Application Form) alongwith relevant Self Attested copies of certificates/testimonials

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Application for KVS TGT - WE (Application No.: 4911640730)

To Post Box No: 3076, Lodi Road, New Delhi-110003

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