2/25/24, 1:56 PM Haryana Staff Selection Commission : Registration Print

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

Registration Number 20011418

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

Father's Name SHEMSHAR SINGH

Mother's Name AMARAVATI

Date of Birth 15/1/1990

Age as on 21.09.2015 25 Year 8 months 6 days

Gender Female

Marital Status Un Married

Nationality INDIAN

Category BCA
District Mewat Cadre NO

Matric with Hindi/Sanskrit or

YES
10+2/B.A./M.A. with Hindi
as one of the subject ?
QUALIFICATION

Marks Obtained /
Class Name/Qualification Passing Year University/Board Subject
Total Marks
HIN. ENG. MATHS.
Matric 2005 HBSE 409 / 600
S.S. SCI. SANSKRIT
HIN. ENG. MATHS.
10+2 (Senior Secondary) 2007 HBSE 291 / 500
CHEM. PHY.
MCA (Regular three year
2014 MDU ROHTAK ALL 2128 / 2700
course)
Experience

Name of Salary (in From To Experience

Designation
Institution/Organization Rupees) Date(dd/mm/yyyy) Date(dd/mm/yyyy) (In Months)
COMPUTER
GSSS KILAZAFARGARH 10000 10/9/2013 22/3/2015 15
TEACHER
HTET DETAIL

HTET Passing HTET Marks

HTET Roll No. HTET Subject HTET passing Month
Year Obtained

OTHER

Birth Place and JIND HARYANA/

Haryana Domicile YES
Country INDIA
Whether Working as a
teacher in privately managed
Govt. aided, recognized and
Govt. Schools. Age
NO
relaxation to the extent of
service rendered as a
teacher subject to a
maximum of 5 years.
Password 3580150B5C
ADDRESS

Permanent Address
V.P.O. AHIRKA DIST. AND TEH. JIND, JIND, Jind, Pin-126102, Telephone No -9068983975, Email ID-
reenabhola90@gmail.com
Corresspondence Address

recruitment-portal.in/pgt_advt5/RegPrint.aspx 1/2
2/25/24, 1:56 PM Haryana Staff Selection Commission : Registration Print

E-96/D RAILWAY COLONY,ROHTAK, ROHTAK, Rohtak, Pin-124001, Telephone No -9466856379

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

Copyright © 2015
Home | Haryana Staff Selection Commission | Contact Us Designed by Haryana Staff Selection
Commission

recruitment-portal.in/pgt_advt5/RegPrint.aspx 2/2