TEACHERS ELIGIBILITY TEST FOR LOWER PRIMARY AND UPPER PRIMARY

Apply for LOWER PRIMARY (LP)

Application No 1910474641
Full Name of the Candidate's ( As per Certificate ) : MD ABOU SHAHIM
Candidate's Father's Name / Husband Name MD ABDUL HOQUE
Candidate's Mother's Name HANUFA KHATUN
Gaurdain's Name MD ABDUL HOQUE
Candidate's Date of Birth (DD/MM/YYYY) 10/05/1981
Gender MALE
Address for Correspondence VILL BECHIMARI
Address 2 PO BECHIMARI
Address 3 PS DALGAON
City MANGALDAI
District 08-DARRANG
State ASSAM
Pincode 784514
Moblie No. of the Candidate 9864251996
Alternative Contact No. Telephone / Mobile 7086102859
E-mail Address of the Candidate smkhan477@gmail.com
Nationality of the Candidate INDIAN
Aadhar Card No. of the Candidate
ZONE 3-NALBARI, KAMRUP, KAMRUP METRO, DARRANG, MORIGAON,
Choice of Zone to Apply
NOWGAON, HOJAI
Choice of District for Examination 08-DARRANG
Specify subject if Applying for Upper Primary
Medium of Test Booklet ASSAMESE
First Language ASSAMESE
Category of the Candidate GENERAL
YES - Degree of disability :   50
Are you Physically Challenged
Physically Challenged (PH) Type :   VISUALLY IMPAIRED
Religion ISLAM
EDUCATION QUALIFICATION

Marks Marks Percentage Year of Year of

Exam Passed Stream Institution & Board/University
Obtained Out Of Of Marks Passing Admission

SIPAJHAR HS & MP SCHOOL,

HSSLC Or Equivalent (10+2) : 2 - SCIENCE 223 500 44.6% 07/07/1999
AHSEC

MANGALDOI COLLEGE,
Graduation : 2 - SCIENCE 553 1400 39.5% 23/05/2005
GUWAHATI UNIVERSITY

1 - D.EL.ED. (2
Professional Qualification in Teacher YEAR)
968 1400 69.14% 22/05/2019 04/11/2017 DUNI JR COLLEGE, NIOS
Education : Mode of Course
:

Candidates Declartaion:

I declare that the above entries in the Application Form has been filled up by myself and the entries made are correct as per my documents and
to the best of my knowledge and belief. I agree that if any statement is proved to be false then the Authority shall have the right to take legal
action against me and also cancel the application for submitting false information of statement. I further declare that there is no allegation of
misconduct against me and I have never been convicted for any offence involving moral turpitude.

Transaction Reference No: QHMP7990260472 Signature of Applicant

Order ID: 1910474641
Date: 25/09/2019 22:40:15