DELHI PUBLIC SCHOOL

BHIWani

Post applied for________________________________

Photograph

PERSONAL INFORMATION

1. Name (in block letters)

Miss/Mrs./Mr……………………………………………………………………………

2. Date of Birth (in figures)……………………………………………………………….

(in words)…………………………………………………………………

3. Contact Address

……………………………………………………………………………………………

.……………………………………………………………………………………………

Telephone Numbers………………………………………………………………………

4. Place of Birth……………………………… 5. Nationality…..…………………..

6. Marital Status…………………………….. 7. Number of Children…………….

8. Language Spoken at Home a)…………….. b).………………. c)……………..……..

9. Name of Father/Mother/Spouse……………………………………………………..…

10. Occupation of Father/Mother/Spouse……………………………………………..….

Address ……………………...………………………………………………………….

…………………………………………………………………………………………….

…………………………………………………………………………………………….

Telephone No. ……………………………………………………………………………

11. Details of Foreign Travel

Year Country(ies) Purpose
ACADEMIC/PROFESSIONAL INFORMATION

1. Academic Qualifications
Sl.No. Qualification Discipline/ Name of Year of % of Division
Subject School/College/ Passing Marks
University

2. Professional Qualifications
Sl.No. Qualification Discipline/ Name of Year of % of Division
Subject School/College/ Passing Marks
University

3. Scholarships/Awards/Honours

4. Research Work/Publications
5. Proficiency in Languages (Write mother tongue at Sl. No.1)
Sl. No. Language Read Write Speak

6. Preferred Areas of Interest

From the following list, indicate the areas in which you have an interest in order of preference

Academics Extra Curricular Sports Activities

Accountancy Advertising Athletics
Art History Art Galleries Basketball
Anthropology Archaeology Badminton
Ancient Civilizations Banking Cricket
Business Administration Dramatics Football
Computer Science Film TV Journalism Gymnastics
Economics Fine Arts Horse Riding
Environmental Studies Gardening Hockey
International Relations International Organizations Judo
Literature Interior Designing Karate
Languages Literary Activities Lawn Tennis
Mathematical Sciences Music and Dance Shooting
Natural Sciences Museums Table Tennis
Physical/Applied Sciences NCC/Scouts/Guides Volley Ball
Social Sciences Photography Physical Fitness
Undecided Social Service Any other

1……………………. 1………………………. 1…………………….

2……………………. 2………………………. 2…………………….

3……………………. 3………………………. 3…………………….

WORK EXPERIENCE

1. Past Work Experience

Sl .No. Name of Institution From To Positions Held Subjects Classes
 Taught Taught

Total Experience (in years)……………………………….

Teaching……………Administration…………Any other…………………………………

2. Present Job

a). Name and Full Address of the Present Organization

………………………………………………………………………………………….

….………………………………………………………………………………………

Contact Telephone Number..…………………………………………………………

b). Present Designation……………………………………………………………………

c). Date of Joining………………………..………………………………………………..

d). Present Place of Posting……………………..…………………………………………

e). Total Emoluments………………………………………………………………………

Salary Details: Basic……………………….

…………………………………
Allowances……….…………..………………………………
Other Benefits…..………………..………………………….

f). If you are under a Service Bond, give details

……………………………………………………………………………………………

OTHER INFORMATION

1.Seminars/Courses Attended
Sl.No. Seminar/Course Duration Date Description

2. Names of three books you have recently read

Sl.No. Title Author

3. Do you suffer from any major ailment/medical problems? Yes/No. If yes, give details
4. Have you ever been convicted by any Court of Law or is there any disciplinary
proceedings/enquiry against you or has any penalty been imposed upon you? : Yes/ No. If
yes, give details

5. Give details of two references (other than relatives) in the field of education or from a
Member of the Delhi Public School Society

Name Occupation Address (Official) Telephone Nos.

6. Exact Date/Period by which you can join DPS Bhiwani, if selected

…….………………………………………………………………………………………….

I hereby certify that the information provided above is true and is to the best of my
knowledge and belief. If any information is found to be false/incorrect, it will disqualify me
for employment in any of the schools of the Delhi Public School Society.

Signature of the Candidate

Date:…………………….

Please send the completed form by courier or registered post to the following address:

Principal
Delhi Public School
Loharu Road
Bhiwani - 122570