STAFF APPLICATION FORM
Important: Please answer all questions and print the information clearly in BOLD, using black or blue pen
APPLICATION FOR THE POST OF
Date
Note:
1. Only certified copies of Degree/Certificates/ Testimonials should be sent with
this Application Form. Originals must be produced at the time of interview only.
2. Applicants called for the interview shall bear their own travelling expenses
unless otherwise agreed in advance.
PERSONAL DATA OF CANDIDATE
Surname ____________________ First Name _____________________Middle Name _________________
Date of Birth DD/MM/YY Years _____________ Months ______________ Days _____________
Sex: Female ______ Male ______Nationality___________ Marital Status: Married ______Unmarried _____
Permanent Address :____________________________________, City, _______________Pin Code______
Home Tel# _________________Mob# _____________________Email address: ______________________
Father’s/ Husband’s Name: _____________________________Occupation: _________________________
Address : _______________________________________________________________________________
Number of Children: __________ Age Sex Grade/ Class and School in which studying
1. ____ ____ ____________________________
2. ____ ____ ____________________________
3. ____ ____ _______________________________
Major illness (es) past or present _________________________Physical handicap/ disability if any _______
Personal Habits: Do you Smoke? Yes____ No___ Do you drink? Yes ____ No____
Have you ever been convicted of any criminal offence? If so, give details _____________________________
Present Pay/ last salary drawn Basic pay Scale Allowances Total
ACADEMIC QUALIFICATIONS
SENIOR SECONDARY/ A LEVEL OR EQUIVALENT (PLEASE SPECIFY)
Examination Board Subjects Year Level Grade/ Percentage Total
UNIVERSITY OR COLLEGE
Degree Passed Subjects Year Division % if applicable University/College
EDUCATIONAL DEGREE/ DIPLOMA CERTIFICATE
Degree Passed Subjects Year Division % if applicable University/College
TEACHING EXPERIENCE
School Subject Grades/ classes Curriculum Fromdd/mm/y to dd/mm/y Total Reason for
taught leaving
PROFESSIONAL TRAINING AND EXPERIENCE (FOR NON-TEACHING POSTS)
TRAINING
Name of the Institution Course attended From dd/mm/y to dd/mm/y Total Shorthand/ Typing speed/
Grade
EXPERIENCE
Name of Organization Nature of work From dd/mm/y to dd/mm/y Total Reason for leaving
List games you play __________________________________________________________________
Special Distinctions achieved ___________________________________________________________
Name literary or cultural activities in which interested. Mention any distinctions achieved : _____________
___________________________________________________________________________________
Mention whether “Captain” Secretary”/President” of a Team/Club/Society. Give names of School/colleges
where these positions held.
____________________________________________________________________________________
Any other particulars/ achievements?
___________________________________________________________
REFERENCES Note: References must be able to comment on your professional performances and/ academic
achievements
1. Name _______________________ Designation ___________________ Telephone _______________
Address __________________________________City/State_______________ Pin Code ___________
2. Name ________________________Designation ____________________Telephone _____________
Ih
Address __________________________________City/State_______________ Pin Code ___________
How much notice required for joining _____________________________________________________
Minimum salary acceptable ______________________________________
Have you ever applied for any post in this School earlier? If so, when?___________________________
I hereby certify that the particulars furnished above are correct to the best of my Knowledge and belief . I
have not concealed any information likely to impair my fitness for employment. If it is revealed later that I
have given false details or concealed material information, my services are, liable to summary termination
without any notice or compensation.
If selected, shall produce:
a) Medical Certificate from a recognized Hospital/ Clinic/ Registered Medical Practitioner (indicating, in the
case of ladies, if they are pregnant)
b) Experience certificate from my last employer duly counter signed by the Zonal Education Officer or the
competent authority.
FOR OFFICE USE ONLY
Date: ______________Place_____________
Signature of Applicant: ___________________ Call for interview on ___________