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CENTRAL BOARD OF SECONDARY EDUCATION, DELHI

CONFIRMATION PAGE FOR CTET - JAN 2012

Registration No 6529207
You have successfully submitted Application On-Line. Kindly take the printout of this
page. Paste your one recent photograph and sign in the specified box. Send this form along
with original
Demand
Draft
(if
fee
paid
by
Demand
Draft)
to
The Assistant Secretary (CTET), CBSE, 'Shiksha Sadan', 17, Rouse Avenue, New Delhi
110 002 , in an envelop of size 12"x10" only and superscribing "APPLICATION FOR CTET
- JAN 2012" so as to reach latest by 30.11.2011.
Candidate's Name
Mother's Name
Father's/Husband's Name

PAWANA DEVI
SALOCHNA DEVI
JAI KARAN DAS

If Differently Abled

NO

Employment Status

Not Employed
Paper II (Classes VI to
Applied For
VIII)
Subject Offered for Paper-II Social Science

Date of Birth
Gender
Category
Status of Qualifying
Exam
Mobile No.
Question Paper
Medium

08/08/1977
Female
OBC
Appearing in
Final Exam
9418835174
Hindi

Minimum Qualifications for Graduation with at least 45% marks and passed or appearing in 1Classes VI to VIII
year Bachelor in Education (B.Ed), in accordance with NCTE
(Recognition Norms and Procedure) Regulations issued from time
to time in this regard
Choice of Exam Centres 1st : Hamirpur, 2nd : Chandigarh, 3rd : Delhi/NCR
Languages offered for
1st : Hindi, 2nd : English
CTET
College/Institution/University from which Degree/Diploma in Education/Elementary Education
etc. obtained:
%
State
Distt.
Name of College/Institution/University
Marks
Diploma
:
Degree :
Address
City
State
Pincode

Jammu &
Kashmir

Jammu

KCS College of Education Palura Jammu -

VILL.MAKROTI,PO
LADWARA,TEH.SHAHPUR,DISTT.KANGRA, KANGRA,
HIMACHAL PRADESH, INDIA, 176208
MAKROTI
HIMACHAL PRADESH
176208
DECLARATION

I hereby solemnly and sincerely affirm that all the particulars stated by me in this Application
Form are true and correct. 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 - JAN 2012 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 - JAN 2012 Information Bulletin, which I have duly gone
through.
Paste (do not staple) a
recent unattested
Photograph

Size 3.5 x 4.5 cm

Photograph must not
be larger than this box

Signature of the Candidate in running

hand (within the box only)
UNATTESTED
Details of Demand Draft (Write Registration No., Name and address at the back of Demand
Draft)
Draft No. :279539
Amount:Rs. 500/- Only
Date of Issue:23/11/2011
Bank Name :PNB
Bank Address :Jawala JI
Registration No: 6529207