GOVERNMENT OF PUDUCHERRY DIRECTORATE OF SCHOOL EDUCATION Perunthalaivar Kamarajar Centenary Educational Complex, 100 Feet Road, Anna Nagar, Puducherry - 605 005 APPLICATION FOR THE POST OF TRAINEE PHYSICAL EDUCATION TEACHER -2010 Note : i) Read instructions before filling up the application ii) To be filled in by the Candidate in BLOCK LETTERS iii) Put . mark against the relevant box iv) Attested Copies of relevant certificates should be enclosed Affix a recent passport size photograph attested by a Gazetted Officer 6. Educational and Professional Qualifications : Sl. No. Qualification Month & Year of passing Name of the University 1. S.S.L.C. 2. H.S.C. 3. Bachelor' s Degree 4 B.P.Ed/ Diploma in Phy.Edn. 7. Main Subject in Bachelor's Degree : Total of maximum marks in all subjects Total marks obtained in all subjects Number of attempt(s) Percentage of marks 8. 9. Language Studied upto Secondary Level : Employment Registration Code No : :2: DD MM YY 10. Date of Registration : SSLC : H.Sc : BACHELOR'S DEGREE : B. P.Ed/Diploma in Phy.Edn. : Date of Last Renewal : 17. Address for Communication: DECLARATION I have carefully read the instructions contained in the prospectus. I hereby declare that the information furnished above by me is true and correct to the best of my knowledge and I understand that my application is liable to be rejected if any information given above is found to be false. SIGNATURE OF THE CANDIDATE DATE: PLACE: GOVERNMENT OF PUDUCHERRY DIRECTORATE OF SCHOOL EDUCATION HALL TICKET No. : (for Office use only) RECRUITMENT TO THE POST OF TRAINEE PHYSICAL EDUCATION TEACHER-2010 ADMISSION CARD Note : To be filled in by the Candidate in BLOCK LETTERS Affix a recent passport size photograph attested by a Gazetted Officer 1. Name of the Candidate : (in block capitals) 2. Father's Name : 3. Date of Birth : 4. Address for Communication : 5. Centre of the Recruitment Examination : (to be filled in by the Office ) 6. Date of Recruitment Examination : (to be filled in by the Office) Signature of the Candidate GOVERNMENT OF PUDUCHERRY DIRECTORATE OF SCHOOL EDUCATION ***** ACKNOWLEDGEMENT Received the application of Thiru/Tmt./Selvi............... .............................. for the post of Trainee Physical Education Teacher - 2010 and the receipt no is ..... Place : Date : Receipt Clerk