2/25/24, 2:37 PM Haryana Staff Selection Commission : Registration Print

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

Registration Number 20010118

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

Father's Name VINOD BABU

Mother's Name LUXMI DEVI

Date of Birth 19/6/1979

Age as on 21.09.2015 36 Year 3 months 2 days

Gender Male

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.(Desirable) 975001163764
QUALIFICATION

Marks Obtained /
Class Name/Qualification Passing Year University/Board Subject
Total Marks
BOARD OF
HINDI, ENG, MATHS,
SCHOOL
Matric 1996 S.ST., SCIENCE, 250 / 600
EDUCATION
ANIMAL HUSBANDRY
HARYANA
BOARD OF
HINDI, ENG, POL.
SCHOOL
10+2 (Senior Secondary) 1998 SCI.,ECO, 271 / 500
EDUCATION
GEOGRAPHY
HARYANA
DBMS, OOP,
COMPUTER
KURUKSHETRA
M.Sc. Computer Science GRAPHICS,
2005 UNIVERSITY 984 / 1600
(Regular two year course) ARTIFICIAL
DISTANCE
INTELLIGENCE,
S.A.D., O.S.
Experience

Name of Salary (in From To Experience

Designation
Institution/Organization Rupees) Date(dd/mm/yyyy) Date(dd/mm/yyyy) (In Months)
HINDU SR. SEC. SCHOOL P.G.T. COMPUTER 14745 1/7/2005 30/4/2008 34
S.M. HINDU SR. SEC.
P.G.T. COMPUTER 42000 1/5/2008
SCHOOL
HTET DETAIL

HTET Passing HTET Marks

HTET Roll No. HTET Subject HTET passing Month
Year Obtained
COMPUTER
3108455 2014 FEBRUARY 93
SCIENCE
OTHER

Birth Place and YAMUNA NAGAR

Haryana Domicile YES
Country HARYANA/ INDIA
Whether Working as a YES
teacher in privately managed
Govt. aided, recognized and
Govt. Schools. Age
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2/25/24, 2:37 PM Haryana Staff Selection Commission : Registration Print
relaxation to the extent of
service rendered as a
teacher subject to a
maximum of 5 years.
Password 06FED8E26D
ADDRESS

Permanent Address
H.NO. 228/200, 200 QTRS., PAPER MILL COLONY, YAMUNA NAGAR, Yamuna Nagar, Pin-135001, Telephone No
-9034232776, Email ID-rajeevyojna@gmail.com
Corresspondence Address
H.NO. 1516/31, STREET-2, PRAGATI NAGAR, NEAR KAJAL CABLE, SONIPAT, Sonepat, Pin-131001, Telephone
No -9034232776
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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