Application Format may be downloaded from Website vvwvv.qbu.

acin or
www.greaternoidaauthoritvonline.in or www.noidaauthorityonline.com

NOIDA & GREATER NOIDA EDUCATION SOCIETY

NOIDA District GAUTAM BUDH NAGAR (U.P.) - 201301
Important Notes: (i) All entries should be made in capital letters
POST NAME CATGORY DATE OF BIRTH GENDER AGE AS ON 01.07.2009
(uR/SC/ST/OBC) (MALE/FEMALE)
DAY MONTH YEAR DAY MONTH YEAR

Candidate's Name (in capital letters) (please keep one box blank between name, middle name & surname)

2. Farther's/Husband's name (in capital letters) (please mark (4) tick in the appropriate box) Father Husband

3. Candidate Address (in capital letters)

Please affix on recent
Name Photograph without
attestation
Father/Husband :

Address

City

State Pin Code:

Signature of Candidatei

4. Academic Qualification (starting from class 10 th )

(Please give information as applicable. Attach separate sheet if columns are insufficient.)
Name of Please Year of AGGREGATE MARKS % age Subjects/ Duration Name of
Examination write, Passing Max. Marks % age in Qualifica - of Board/
name of Marks Obtained of subject tion course University.
Examin- marks applied (Code) (in
ation
Passed
months)
Matriculation
(Class X)

Senior
Secondary
(Class — XII)

Graduation
/Diplloma
(name of
course)

Post
Graduation
(name of
course)
"O
- ther if any,
(Specify)

5.Professional Qualification

Name of Please Year of AGGREGATE MARKS Subject Duration Board/

Examination write, name Passing Max. Marks %age Offered of University
(write complete name of Marks Obtained of - course
of course passed as Examination marks (in months)
on1 2.10.2009) Passed
B.Ed.

M.Ed/ M.Phil/
Ph.D

Others if any
(Specify)

1 If code/numerical are indicated in the mark sheet in place of subject(s) studies, please
attach necessary details for such decodification.
2. If grades are given in lieu of marks, attach the gradation list with your marksheet

06. Experience (attach separate sheet, if columns are insufficient)

Post , Name of Whether Period of No. of Nature of Duties Scale
Held Institution/ Central Govt. / Service Completed of pay
Department/ State Govt. / From To years & and
Ministry Autonomous months salary
Body/ Public per
Sector/ month
Recognized/ (Rs.)
Un- recognized
(if applicable)

APARAFA:, •

I hereby certify and declare that:

I am an Indian National.
I have read the provisions given in the Advertisement.
 All statements made and information given by me in this application are true, complete and
correct to the best of my knowledge and belief. In the event of any information or part of it

♦ being found false or incorrect before or after the exam./interview or appointment, action can
be taken against me by the KVS and my candidature/appointment shall automatically stand
cancelled/repatriated/terminated.
I further declare that I fulfill all the conditions of eligibility regarding age, educational,
professional/technical qualifications, etc. prescribed for the post applied for . The essential
qualifications prescribed are possessed by me, the proof of which has been enclosed.
v). In case my application is not received by the soceity within the stipulated date due to postal
delay or otherwise, the society will not be responsible for such delay.

PLACE: Please affix on recent •

passport size
DATE: photograph with Signature of candidate
attestation