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Application for engaging Part Time Instructors in Art / work Education on contract basis for the year 2015 - 16
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Name of the School & Mandal applied for:
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Name of the applicant:
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Father Name:
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Date of BirthDayMonthyear
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Age (as on 01.07.2015)DaysMonthsYears
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(Eligibility - above 18 years and below 39 years of age as on 01.07.2015. SC/ST/BC candidates - 44years, physically challenged candidates - 49 years (Certificate should be enclosed)
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Gender
Female / Male
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Category (put tick mark)OC / SC / ST / PH / BC - A, BC - B, BC - C, BC - D, BC E
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Place of Residence
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Educational & Technical Qualiifcation
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Name of the CourseName of the Board / universityTotal Max MarksTotal Marks obtained%
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Academic
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Professional
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Technical -
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Address for correspondance
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Contact no. / Mobile No.
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Enclosures
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Enclosures (Atested by the Gazetted OfficersWhether Enlcosed Certified copy (Yes / No)
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For Art Education
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SSC Marks Memo or equivalent examination
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Diploma or a certificate in drawing commercial art, fine arts & architecture, painting, sculpture, music, dance or a certificate in higher grade drawing certificate from a recognized institution
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Technical teacher certificate of Govt of AP
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For WorkEducation
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year Diploma in craft Technology or 3 year Diploma in Home science offered by state Board of Technical Education & training (or)
10th class or its equivalent examination
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Certificate in a trade viz., carpentry, weaving, sewing, tailoring, textile printing etc., issued by any ITI / DLTC from a recognized institution
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Technical teacher certificate of Govt of AP
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others
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Caste Certificate
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Proof of Residence (Ration card / Aadhar card / Bank pass book / Driving license / Residence certificate issued by MRO)
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IF PH - Certificate enclosed
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Any other information
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Declaration :
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 I here by declare that the above information furnished by me is true to the best of my knowledge. If any information is found incoorect, my application may be rejected
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Signature of the applicant
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