GUEST TEACHER REGISTRATION KA FIRST PAGE

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Guest Faculty Registration Form

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Personal Information

Educational Qualification

Present Place of Posting

Period Details

Service Details

In Service Training & Awards

Previous Years Class Results

Leave Details

Disciplinary Description

Elaborate Yourself

Personal Details

Employee ID : 

Title *
First Name *	Middle Name
Last Name *	Father's Name *
Mother's Name *	Date of Birth (dd/mm/yyyy) *
Email Address	Mobile Number
Gender * Male Female	Marital Status * Married Unmarried (If Yes)
Correspondence Address *	Permanent Address *  Select if permanent address is same as correspondence address.
Category Name *	Other Category ESM DESM Dependent of Freedom Fighter
Protected Category Widow/Widower Deserted Divorcee Suffering from serious ailment	PAN Number *
Bank Name (Having Account) *	Bank Account Number *
Whether Physically challenged/ Handicapped * Yes No (Please specify the type) (Percentage of handicappedness)	Whether holder of Passport * Yes No Passport Number
GPF/PRAN * Yes No GPF/PRAN Number
Upload Protected Category Certificate Max Size: 50KB, Type : (jpeg,jpg)	Upload Photograph * Max Size: 50KB, Type : (jpeg,jpg)
Upload Signature * Max Size: 50KB, Type : (jpeg,jpg)	Upload PAN Card Max Size: 50KB, Type : (jpeg,jpg)
Upload Physically Handicapped Certificate Max Size: 50KB, Type : (jpeg,jpg)	Upload Category Certificate (if any)(ESM, DESM, DFF, ST, SC, BC) Max Size: 50KB, Type : (jpeg,jpg)

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