date of

ist
appointm
ent /

V (A).L-V(Ex-Cadre).[Link] MLE.
NAME

Whether the Teacher is PwD

GT Arts.L-IV GT Sc..L-V(B).L-
engagem

L-III HM PS. L-IV HM PS. L-IV

Educational and training

(physically Handicapped)
Designation(L-III HM UPS.
OF THE
ent of

[Link](MLE)[Link])
GP of

name of the block

Date of name the

Superannuation
Name of NAME the name of
Male / Female

of The parent
Qualification

Date of Birth
([Link])

([Link])
Joining of name of teacher

UDISE Code
the OF THE parent native
Name of the in the native native (Appoint

Date of

School
School CLUST school village
Sl Teacher presen GP/wa block/ ment if
where ER of (in case /town
No Posted in the t rd no. mplty 1st appt.
posted the of of the
School School of the of the is
(parent parent Block) teache
([Link] teache teacher regular
school) school / Ward r
.YYYY) r &
No.(In
engagem
case of
ent if 1st
Mplty)
engagem
ent is
non
regular)

Signature of the Teacher

 Name of
Name of period period if at
the

name of the block/mplty

the of stay of stay present NAME
School
School NAME in the NAME in the working OF THE
2nd authority

deployed School
1st OF THE school ( OF THE school ( on GP/ name of
previou who has

UDISE Code

UDISE Code
previous GP (in from GP (in from deploym Ward the Date
UDISE name of s approved

School
of The

of The
school case of date to case of date to ent in No. of block/ from
Code the school the
where Block)/ to date) Block)/ to date) other the mplty to which
of The block/ where deploymen
worked Ward (for Ward (for school school which Deploye
School mplty worked t with
prior to No.(In example No.(In example please to deploye d.
prior to order no.
posting case of 10.03.2 case of 10.03.2 mention which d
posting & date
in the Mplty) 025 to Mplty) 025 to name of deploye
in the
present 30.08.2 30.08.2 the d
present
school 025) 025) school.
school

Signature of the Teacher