01422, 722m Applicant Print JHARKHAND STAFF SELECTION COMMISSION POST GRADUATE TRAINED TEACHER COMPETITIVE EXAMINATION - 2022 (PGTTCE -2022) APPLICATION FORM Registration No. Registration Completed Date. Applied Post ‘Are you an Indian Citizen? Applicant Name Date of Birth (00-47) Father's Name Mother's Name Gender Marital Status ‘Are you a local resident of Jharkhand? District of local residence Unique Certificate number of your local residence of Jharkhand Issuing Authority Date of issue of your certificate of local residence Matriculation & Intermediate from affiliated School/College/ Institutions situated within geographical area of Jharkhand State? Reservation Category Vacancy type Are you an Ex-serviceman - Army/Air Force/Navy? Do you claim reservation under Sports Quota? Physically handicapped(PH)? Aadhaar Card No. Visible Identification Mark 1 Knowledge of Local Customs, Language and Surroundings of Jharkhand State? B.Ed Result Status Do you have 3 years teaching experience as ‘Secondary School Teacher in the Schools of Jharkhand Government: hitps:/sc.onlinereg.nishantireg22!AppicationPri.aspx?regno=bobqKCRNSn@nsgRautkMel Gp HzdsoUbkrzMOSIoEKY=#no-back button 25046328 04-10-2022 19:21:24:293 PGT-English Yes SANJANA BHATTACHARYA 26-10-1995 TAPAN BHATTACHARYA SEMA BHATTACHARYA Female UNMARRIED Yes RANCHT JHRC/2018/564652 spo 10-06-2018 Yes UR Regular No 223743658188 MOLE ON NECK Yes COMPLETED No 18toiai22, 722m Applicant Print Communication Details Correspondence Address ‘Address Line 1 FLAT NO 1¢ Address Line 2 JAYATE APPARTMENT. Address Line 3 CHUNA BHATTA Address Line 4 KOKAR City/Village RANCHI District : RANCHI State : JHARKHAND Pincode : 834001 Permanent Address Address Line 1 USHA COMPLEX Address Line 2 ‘OPPOSITE DAILY MARKET Address Line 3 MAIN ROAD ‘Address Line 4 - City/Village RANCHI District RANCHI State JHARKHAND Pincode 834001 Mobile No : 6200220820 E-mail 1D + bhattacharyasanjana2@gmail.com Are you under Regulation 2007/2014? ves (As per the Brochure Para No ~6, Section ~ (%)) year of regulation : 2014 Educational Details, Name of the vero] meet tame of Examination | Schooi/Calege/Instution | Board/University | N22" ot | warns | subject (Mention State also) I | obtained Matriculation/10 | HIGH SCHOOL,RANCHI,JHAR | MIC COUNCIL RANC | 2011 79.2 - HARKHAND ACADE rmtermeaiate/io+z_ | URsuanemTencoLtsse, | mrecauncn Rane | 2013 | 64 | scrence Graduation RANCHI JHARKHAND YY RANCHI 2016 63.13 H von) BANGHE WOMENS COLLEGE, | RANCHI UNIVERSTT : SETHESDA WOMEN TeacHER ees STRAINING COLLEGE WaNC | PANCHEUNIVERSIT | 30,5 | g4.3q | EDUCAT Payment Deals Term 1009 oe foa0az 109.0 Declaration : UIpereby declare that all statements made in this application are true, complete and correct to the best of my knowiedge and belie. 1 Understand that inthe event ef any information being found false at any stage ar net satisfying the eligibility criteria according tothe requirements lof the post, my candidature’ appotatment is liable to be cancelled/terminated. Candidates are advised to take a print of his/her application form and keep-it with him/her along with electronically generated bank receipt in support of payment of his/her examination fee fr future communication inthis regard, Place:RANCHI — Ip:157.35.19.164 Application Print Date:04-10-2022 hitps:/sc.onlinereg.nishantireg22!AppicationPri.aspx?regno=bobqKCRNSnGnsgRautkMel Gp HzdsoUbkrzMOSIoEKY=#no-back button 28toiai22, 722m Applicant Print hitps:/sc.onlinereg.nishantireg22!ApplicationPri.aspx?regno=bobqKCRNSn@nsgRautkMel. Gp HzdsoUbkrzMOSIoEKY=#no-back button 38