के ीय िव ालय ए.एम.सी.

लखनऊ
Application form for contractual teachers for the session
2023 – 24

Important notes: 1. All entries should be made in capital letters.

2. Separate form for each post, if applied for more than onepost.
3. Active mobile number and valid email id must be furnished in theapplication.
1.
POST APPLIED FOR
(Please indicate whether PGT / SUBJECT APPLIED FOR
TGT/PRT/Others) (In case of PGT/TGT)

2. Candidate’s name (in capital letters) (please keep one box blank between first name, middle name & lastname)

3. Father's / husband's name (in capital letters). Father Husband

(Please keep one box blank between first name, middle name& Last Name

4. Date of 5. Gender M F
Birth. (Please Tick)
Day Month Year

Day Mon Years

6. Age as on 31.03.2023

7. Candidate Address (in Capital Letters)

Name:
Please affix one
recent
Address for Communication_________________________________
Photograph self
attested

City/Town: Pin:

Ph/MobileNo:1__________________ 2

Email-Id: Signature of Candidate

8. Academic Qualification (Starting from High Schoollevel)
(Please give information as applicable. (Attach self attested copies of Mark Sheets and Certificates)
Name of Examination Write Year AGGREGATE MARKS Subjects/Specializati Duration Board/
name of of on of Universit
Examina Passi Max. Marks %ag Course(in y
ti on ng Mark obtaine e of months)
passed s d Marks
High School
(Class X)
Intermediate
(Class XII /PUC)
Graduation
(B.A/B.Sc/B.Tech/B.E etc)
Post Graduation
(M.A/M.Sc/MCA/M.Tech)
Others if any (Specify)
9. Professional Qualification .(Attach attested copies of Mark Sheets andCertificates)
Name of Write Year AGGREGATE MARKS Subjects/Specializatio Duratio Board/
Examination(wi name of of n n of Universit
t h complete Examinati Passi Max. Marks %age Course(i y
name of on passed ng Mark obtaine of n
course passed) s d Marks months)
JBT/B.El.Ed/D.E
d
(specify)
Theory
B.Ed
Practical

BE/B.Tech(CS)/

CTET

Others if any
(Specify)
10. Experience. (Attach separate sheet, if columns areinsufficient)
Post held Name of Period of service No.of Class taught Subjects Scale of
Institutio completed taught pay and
n From To Years & salary
months per
month

11. Are you able to teach through English and Hindi or both? YES NO
(Please mark( ✓ ) tick in the appropriate box) For teaching
posts

12. Do you have knowledge of computer application? YES NO

(Please mark(✓ ) tick in the appropriate box) For teaching posts

UNDERTAKING
I hereby certify that all the information given above is true and correct to the best of my knowledge. I have
attached attested copies of my testimonials in support of the entries made above. I also agree that mere
eligibility does not confer right to be called for interview/selection. My candidature may be cancelled in case
any information is found to be incorrect onverification.
Place

Date
Signature

Name

Verified & found eligible for the Post:-

Signature:

Name: