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View Examination Form-I

The document is a print application form for the Uttar Pradesh Secondary Education Services Selection Board for the post of TGT - Hindi, submitted by candidate Priyanka Kumari. It includes personal details, educational qualifications, bank transaction information, and a declaration of eligibility. The application is currently under processing as of June 23, 2022.

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Ravi K. Yadvendu
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0% found this document useful (0 votes)
11 views2 pages

View Examination Form-I

The document is a print application form for the Uttar Pradesh Secondary Education Services Selection Board for the post of TGT - Hindi, submitted by candidate Priyanka Kumari. It includes personal details, educational qualifications, bank transaction information, and a declaration of eligibility. The application is currently under processing as of June 23, 2022.

Uploaded by

Ravi K. Yadvendu
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Print Application Form

UTTAR PRADESH SECONDARY EDUCATION SERVICES SELECTION BOARD

I declare that I have Read the detailed User Manual and Notification

Notification Details (Examination)


Advertisement/Notification Number : 01/2022/ General

Applied For Post : Uttar Pradesh Secondary Education Service Selection Board, Prayagraj / TGT - HINDI

Applied Under : बालिका वर्ग -कॉलेज / संस्थान (Girls Category - College / Institute)

Candidate's Personal Details Photo and Signature

Application ID : UP0020102271005000014
Candidate Registration No. : UP00210050352254
Candidate Name : PRIYANKA KUMARI

Father's/Husband's Name : BINDESHWARI YADAV

Mother's Name : RANJU DEVI

Gender - Date of Birth : Female - 18/06/1991

Are you Domicile of UP? / Category : No / GENERAL

Are you Married? : Yes

Contact No./ Email-ID : XXX-XXX-0963 / ****anka1806kri@[Link]

Bank Transaction Details


Bank Name - Payment Mode : State Bank Of India - INB

Fees, Transaction ID - Date : Rs. 750.00 , CPABTZCVN5 - 23/06/2022

High School & Intermediate Board,Year of passing & Roll Number Details
Examination Passed Board Name Year of Passing Roll Number Obtained Marks Total Marks

High School JHARKHAND ACADEMIC COUNCIL 2006 0515 225 500

Intermediate BIHAR SCHOOL EXAMINATION BOARD 2008 30105 458 900

Essential Qualification Details


Sr. No. Essential Qualification Equivalent Affirmation State Name/ Year Of Certificate/ Roll Number Evalation Type Perc
Qualification Board/ Institution/ University Passing Issuance Date Obtained Marks/
Total Mark

1. B.A. Hindi and (intermediate with Yes BIHAR - 2012 4210936 PERCENTAGE 57.2
Sanskrit or equivalent examination) T.M. University, Bhagalpur- 812 007, Bihar. 26/12/2012
from a recognized university (State University)
established by law in India or

2. [Link] from a recognized university Yes JHARKHAND - 2015 1407115062 MARKS 67.8
established by law in India Degree Vinoba Bhave University, PB No. 31, 22/06/2015 678.00
or other equivalent degree or Hazaribagh-825 301, Bihar.(State 1000.00
University).

3. Single Subject Graduate (Note - - 0.00


Please enter the information of N/A
such degree where Candidates
have completed graduation in a
separate subject to fulfill the
qualification of the subject.)

4. Graduate and [Link] (for 4-year No - 0.00


integrated degree) from the N/A
concerned subject mentioned in the
qualification given in the Uttar
Pradesh Secondary Education Act
1921 Chapter-2 Regulation-1
Appendix (a).

Preferential Qualification Details


Qualification Acquired

[Link] Degree or LT Degree from a recognized University established by law in India. Yes

[Link]. degree from a recognized university established by law in India. No

[Link]. degree or Ph.D. qualification from a recognized university established by law in India. No
↓ Address Details ↓ Candidate's Permanent Address Candidate's Correspondence/Mailing Address

Name (C/O) : PRIYANKA KUMARI PRIYANKA KUMARI

House no./Village : CHANDANPURA CHANDANPURA

Street No./Post Office : ALINAGAR ALINAGAR

State / District Name : BIHAR BIHAR


LAKHISARAI LAKHISARAI

Tahsil : LAKHISARAI LAKHISARAI

Police Station : SURAJGARHA SURAJGARHA

Block : SURAJGARHA SURAJGARHA

Village : NA NA

PIN : 811106 811106

किस वर्ग के कॉलेज / संस्थान (बालक / बालिका ) के लिए आवेदन प्रस्तुत करना चाहते है?
(For which Category of College / Institute (Boys / Girls ), do you want to submit the Application? )
आप अपना आवेदन किस वर्ग के कॉलेज / संस्थान (बालक / बालिका ) के लिए प्रस्तुत करना चाहते हैं? बालिका वर्ग -कॉलेज / संस्थान (Girls Category - College / Institute)
For which Category of College / Institute (Boys / Girls ), do you want to submit your Application? :

आपके द्वारा भरा गया आवेदन पत्र के वल बालिका वर्ग -कॉलेज / संस्थान (Girls Category - College / Institute) के लिए ही चयन बोर्ड द्वारा अग्रिम कार्यवाही हेतु स्वीकार्य होगा | - Yes (हाँ)

Declaration
1. I hereby declare that I have read all the provisions in the notice/advertisement of the examination carefully and hereby undertake to abide by them.

2. I further declare that I fulfill all the conditions of eligibility regarding age limits,educational qualifications etc. prescribed for admission to the examination.

3. I decalre that my claim for reservation as SC /ST/OBC candidate's are true and correct and I am in possession of my caste certificate in the prescribed format given in the notice/advertisem
the examination .I also declare that as per Govt. order No.22/16/92/T.C.-III DATED 22-10-2008 I do not belong to the person/sections (creamy layer) mentioned in it.

4. I (for male candidates ) also declare that I have no more than one wife living/(for female candidates) have not married a man already having a wife living.

5. I also declare that I have never been convicted by any court of law. I also declare that no criminal case is pending against me. Further declare that I have never been dismissed or removed fr
Govt. Service or my service been terminated during probation.

6. I hereby declare that all the entries /statements made in this application are true ,complete and correct to the best of my knowledge and belief. In the event of any information being found fa
incorrect or ineligibility being detected before or after selection the Board can take action against me as per rules in case it is detected that I have mislead the Board on any issue then I will sol
responsible for all penal consequences thereof.

I accept the above declaration : Yes

↓ Current status of application ↓

Your application is under processing.

Application Form Submission Date : 23/06/2022 , Time : 11:04:52 AM

Application Form printing Date & Time : [ 23/06/2022 ,11:05

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