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5/18/2017 TeachersRecruitmentBoard

ApplicationNo. 137006

Candidate'sName JDINESHKUMAR

DateofBirth 02/06/1980

Age(Ason1st July,2017) 37years,0months,and29days

Gender Male

Community SC

Father'sName JAGANATHAN
Mother'sName AMBIGA
Areyoudifferentlyabled? No
EmailID dhinekumar@yahoo.com
MobileNo. 9943044041

NameOfExam Board/University MediumOfInstruction Month&YearOfPassing

SSLC StateBoard Tamil 101995

HSC StateBoard Tamil 091998

UG UNIVERSITYOFMADRAS English 042003

PG THIRUVALLUVARUNIVERSITY English 042006

B.Ed. THIRUVALLUVARUNIVERSITY Tamil 082007

Haveyoudoneanyoftheprescribedqualifications(UG/PG/B.Ed.)asan
No
integratedcourse?
Postappliedfor History
SubjectstudiedinUGDegree/IntegratedPGDegree History
SubjectstudiedinPGDegree/IntegratedPGDegree History
Doyouhavehighersecondaryclassteachingexperienceinthepost
appliedfor,aftercompletingalltherequiredqualificationsforthepostof No
PGAssistant?
HaveyouregisteredinProfessional&ExecutiveEmploymentExchange
aftercompletingalltherequiredqualificationsforthepostofPG Yes
Assistant?
DateofRegistrationinProfessional&ExecutiveEmploymentExchange
aftercompletingalltherequiredqualificationsforthepostofPG 24/08/2007
Assistant.
ChoiceofExamDistrict Villupuram
AddressforCommunication
aAddress1 79/46.A,ANNANAGAR9THSTREET
bAddress2 TIRUVANNAMALAI
cAddress3 TIRUVANNAMALAI
District TIRUVANNAMALAI
State TamilNadu
PinCode 606601
FeePaymentDetails

a.TransactionNumber211845599 b.DateofTransaction2017051514:17:11 c.Amount250.00(ConvenienceCharges&ServiceTaxasapplicable)

Declaration
1.Ihavegonethroughtheinstructionstothecandidatesandtheboard'snotificationforthisrecruitmentbeforefillinguptheapplicationform.
2.Iherebydeclarethatalltheparticularsfurnishedinthisapplicationaretrue,correctandcompletetothebestofmyknowledgeandbelief.
3.Iamawarethatintheeventofanyinformationbeingfoundfalseorincorrectatanystageormyineligibilitybeingdetectedatanytime,TRBisatlibertytodisqualifymycandidatureat
anystageandalsocancelmyselection,ifmade.
4.IherebydeclarethatIwillnotbeapartytoanykindofcanvassingonmybehalf.
5.Iwillproducethenecessarycertificatesordocumentaryproofrelatedtotherecruitmentatthetimeofcertificateverification,ifcalledforanduponselectionorthereafter.
6.Ihaveverifiedthecorrectnessoftheparticularsfurnishedintheapplicationandwilltakeaprintoutoftheapplication.

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