2/25/24, 1:54 PM Haryana Staff Selection Commission : Registration Print

APPLICATION FORM | Haryana Staff Selection Commission (Advt. No. 5 / 2015 )

Registration Number 20009394

Post Applied For PGT Computer Science (Cat.No.1)
Applicant's Name MANJU

Father's Name DHARAM VIR SINGH

Mother's Name BIMLA DEVI

Date of Birth 14/10/1987

Age as on 21.09.2015 27 Year 11 months 7 days

Gender Female

Marital Status Married

Nationality INDIAN
Category General
District Mewat Cadre NO

Matric with
Hindi/Sanskrit or
YES
10+2/B.A./M.A. with
Hindi as one of the
subject ?
Aadhar Card No.
9439 5051 9078
(Desirable)
QUALIFICATION

Class Passing Marks Obtained /

University/Board Subject
Name/Qualification Year Total Marks
Matric 2002 HBSE HINDI,ENG,MATHS,SS,SCI.,SKT 361 / 600
10+2 (Senior
2004 HBSE ENG,HINDI,COMMERCE,ACCOUNTS,ECONOMICS 360 / 500
Secondary)
MAHARSHI
MCA (Regular three DAYANAND
2010 ALL MCA COMPUTERSCIENCE 2081 / 2700
year course) UNIVERSITY
ROHTAK
MAHARHSHI
DAYANAND
Post Graduation 2012 ALL MTECH. COMPUTER SCIENCE 2428 / 3000
UNIVERSITY
ROHTAK
Experience

Experience
Name of Salary (in To
Designation From Date(dd/mm/yyyy) (In
Institution/Organization Rupees) Date(dd/mm/yyyy)
Months)
MAHARAJA AGGRASEN
P.G. COLLEGE FOR LECTURER 9000 16/8/2012 15/4/2013 8
WOMEN
HTET DETAIL

HTET HTET Passing HTET Marks

HTET Roll No. HTET passing Month
Subject Year Obtained
computer
3209752 2016 June 90
science
OTHER

VPO. RITHAL
Haryana Domicile YES Birth Place and Country
HARYANA/ INDIA
Whether Working as a NO
teacher in privately
managed Govt. aided,
recognized and Govt.
Schools. Age
relaxation to the
extent of service
rendered as a
teacher subject to a

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2/25/24, 1:54 PM Haryana Staff Selection Commission : Registration Print
maximum of 5
years.
Password 196935DC97
ADDRESS

Permanent Address
149 DC COLONY ,STREET NO.1, BEHIND ITI ,NEAR GOVT.COLLEGE,BHIWANI, BHIWANI, Bhiwani, Pin-127021, Telephone No
-8814880346, Email ID-mnarwal87@gmail.com
Corresspondence Address
2861/4,SR CHHOTU RAM NAGAR,STREET NO 3,NEAR SUKH PURA CHOWK, ROHTAK, ROHTAK, Rohtak, Pin-127021,
Telephone No -8814880346
DECLARATION: I hereby declare that:-

1.All statements made in this application form regarding age limit,educational qualifications & experience etc. are true,
correct and complete to the best of my knowledge, belief, record and nothing has been concealed therein.
In the event of any information being found/detected false, incorrect, incomplete and ineligible before or after the
interview/selection/appointment then my candidature may be cancelled and any legal action as per law can be
intiated/taken against me.
2. I have read the terms and conditions prescribed in advertisement carefully and accordingly, I hereby undertake to abide
by them. I, also, fulfill all the conditions of eligibilty as per relevant rules and instructions prescribed by Government of
Haryana from time to time.
3. I have never been convicted by any competent court of law.

SIGNATURE

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