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CENTRAL BOARD OF SECONDARY EDUCATION, DELHI CENTRAL TEACHER ELIGIBILITY TEST CONFIRMATION PAGE FOR CTET - JULY 2013

Registration No.:

2040210

You have successfully submitted the Online CTET-JULY 2013 Application. Kindly take the PRINTOUT of this confirmation page. Paste your one recent photograph and sign in the specified box. Send the original printout of CONFIRMATION PAGE through Registered / Speed Post only along with CBSE copy of Challan of the prescribed fee, if fees paid through challan so as to reach latest by 22.04.2013 in the CBSE office to THE ASSISTANT SECRETARY (CTET), CENTRAL BOARD OF SECONDARY EDUCATION, PS 1-2, INSTITUTIONAL AREA, I P EXTENSION, PATPARGANJ, DELHI-110 092 Candidate's Name: Mother's Name: Father's/Husband's Name: If Differently Abled : Employment Status: Languages offered for CTET: Apply For: Minimum Qualifications for Classes VI to VIII: Subject Offered for Paper-II: Choice of Exam Centres:

PANKAJ KUMAR VERMA SHARBATI DEVI BABU RAM No Not Employed 1st : Hindi, 2nd : English Paper II (Classes VI to VIII)

Date of Birth: Gender:

05/02/1986 Male Category: SC Status of Qualifying Exam: Passed Mobile No.: 8896174780 Email Id: verma.pankajkumar44@gmail .com Question Paper Medium: Hindi

Graduation with at least 50% marks and passed or appearing in 1-year B.Ed. (Special Education) Social Science 1st : Lucknow, 2nd : Kanpur, 3rd : Bareilly

College/Institution/University from which Degree/Diploma in Education/Elementary Education etc. obtained:


State Diploma Degree Uttar Pradesh Uttar Pradesh Distt. Mathura Mathura Name of College/Institution/University s m degree college s m degree college Pincode 281001 281001 % Marks 62 62

Candidate's mailing address


Address: Locality / Mohalla: City / Town / Village: District: State: Pincode:

H NO B 1 NAHAR COLONY SITAPUR SITAPUR UTTAR PRADESH 261001

DECLARATION
I hereby solemnly and sincerely affirm that all the particulars stated by me in this Application Form are true and correct and I have verified my eligibility to apply for CTET - JULY 2013. I have not concealed any information. However, if any information furnished herein is found false, wrong, incorrect or inaccurate, I understand that my candidature for CTET - JULY 2013 will be cancelled and lead to cancellation of the test result, forfeiture of certificate and even prosecution. I agree to abide by the Rules and Regulations governing the Examination as contained in the CTET - JULY 2013 Information Bulletin, which I have duly gone through.

Signature of the Candidate in running hand (within the box only)

Paste (do not staple) a recent unattested Photograph Size 3.5 x 4.5 cm Photograph must not be larger than this box

UNATTESTED

Details of Payment through Syndicate Bank Challan


Amount :250 /Branch Code :8957 Transaction Id No. :10 Branch Name :sitapur Deposit Date :21/03/2013

Registration No.: 2040210


Note: While sending the Confirmation Page to CBSE do not enclose any photocopy of Educational or Caste Certificate along with this Confirmation Page. Applications sent through courier will not be received.

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