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 SAMAGRA SHIKSHA KERALA
Application for the post of ……………………………………. STARS
in State Office, SSK, Thiruvananthapuram

1 Name of applicant :

2 Age & Date of Birth :

3 Permanent Address :

4 Present Address :

5 Mobile Number

6 E-mail

Educational Qualification University/Board

1. General :

7 2. Professional :

3. Additional :

8 Details of previous experience :

9 Other details if any :

I …………………………………………. do hereby declare that the particulars furnished above is correct

and I agree with the terms and conditions laid down for contract employees.
Place :
Date : Signature of Applicant