Service Before Self APPLICATION FORM FOR TEACHERS

Post applied for .. Subject: .. (Mention only one specific subject)

Photograph
PERSONAL INFORMATION 1. Name in block letters Miss/Mrs./Mr...... 2. Date of Birth (in figures) (In words) . . 3. Contact address with telephone number(s) . . . 4. Place of Birth 5. Nationality...... 6. Marital Status 7. Number of Children

8. Language spoken at home 1..2..3. 9. Name of Father/Mother/Spouse 10. Occupation Father/Mother/Spouse Address and telephone no . 11. Details of foreign travel Address and telephone no . 12. ACADEMIC INFORMATION/PROFESSIONAL QUALIFICATIONS Sl No Qualification Discipline/ Subjects Name of School College/University Year of Passing % of Marks Division

DETAILS OF SCHOLARSHIPS/AWARDS/HONOURS/ RESEARCH WORK/PUBLICATION

PROFICIENCY IN LANGUAGES (WRITE MOTHER TONGUE AT S.NO. 1) Sl. No Language Read Write Speak

From the following list indicate the areas in which you have an interest in order of preference ACADEMICS Accountancy Art History Anthropology Ancient Civilization Business Administration Computer Science Economics Environmental Studies International relations Literature Languages Mathematical Sciences Natural Sciences Physical/Applied Sciences Social Sciences Undecided EXTRACURRICULAR Advertising Art Galleries Archeology Banking Dramatics Film TV Journalism Fine Arts Gardening International Organizations Interior Designing Literary Activities Music and Dance Museums NCC/Scouts/Guides Photography Social Service SPORTS ACTIVITIES Athletics Basket Ball Badminton Cricket Foot Ball Gymnastics Horse Riding Hockey Judo Karate Lawn Tennis Shooting Table Tennis Volley Ball Physical Fitness Any other

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DETAILS OF WORK EXPERIENCE: Sl. No Name of Institution From To Positions held Subjects and classes taught

Total Experience (in years) ............................. Teaching . Administration . Any other . PARTICULARS OF PRESENT JOB: 1. 2. 3. 4. 5. Name and full address of present organization with contact numbers. Present designation .. Date of joining . Present place of posting Total emoluments .. Salary details: Basic Allowances Other benefits Are you under Service Bond: . (If yes, give details). .. Exact period after which you can join if selected . Expected Salary.

6.

7.

8.

OTHER INFORMATION: (i) Sl. No Seminars and Courses intended: Seminar/Course Duration Date Description

(ii) Sl. No

Name of three books recently read with names of authors: Title Author

(iii)

Do you suffer from any major ailment/medical problems? If yes, give details

Yes/No

(iv) Have you ever been convicted by any court of law or any disciplinary proceedings/enquiry is against you or penalty has been imposed upon you. . Yes/No If yes, give details

(v) Give details of the references (other than relatives) in the field of education.

Name

Occupation

Address (Official)

Tel No.

Thereby certify that the information provided is true and to the best of my knowledge belief. If any information is found to be false/ incorrect it will disqualify me for employment in any of the schools of the DPS STS School Dhaka.

Date

Signature of the Candidate