Application Form
   Application Number                       : 05051439874                                        Application Filled                  : 26/02/2012 5.10 PM
   Token Number                             : 1221020810005032                                   Reference Application               : 05051439874

1. Exam Details
   1.1 Examination                          :   HEADMASTER SEC EDUCATION EXAMINATION 2011
   1.2 Post                                 :   HEADMASTER SEC EDUCATION
   1.3 District Head Quarter for            :   AJMER
   1.4 Medium of Examination                :   Hindi
   1.5 Optional Subjects                    :

2. Applicant's Details
   2.1 Applicant's Full Name                :   SABBIR MOHAMMAD BHATI
   2.2 Applicant's Father Full Name         :   JUMA MOHAMMAD BHATI
   2.3 Date Of Birth (dd/mm/yyyy)           :   20/07/1981
   2.4 Gender                               :   MALE
   2.5 Marital Status                       :   Married
   2.6 Category                             :   BC
   2.7 Home State (Bonafide                 :   RAJASTHAN
   2.8 Home District                        :   NAGAUR


                                                                                                                                                               Photo & Signature
                                                                                                                                                                 Of Candidate
3. Other Special Categories
   3.1 Category for Disabled                :
   3.2 Specific Category for                :
   3.3 Other Category                       : Departmental Employee,Govt. service / Panchaytee Raj / Public Sector Employee

4. Correspondence Details
   4.1 Address                              : VILL POST PADU KALLAN ,
                                              PADU KALLAN ,Tehsil : MERTA,City/Village : PADU KALLAN - 341031
                                              Dist : NAGAUR, State : RAJASTHAN



   4.2 Email                                :
   4.3 Phone                                :
   4.4 Mobile                               : 9414414292

5. Qualification
                                                Year           Division/Grade
   5.1 Secondary                         : 1995                II
   5.2 Sr. Secondary                     : 1997                II
   5.3 Graduation                        : 2000                PASSED                              Passed
   5.4 Post Graduation                   :
6. Additional Qualifications/Specifications
   6.1 Other                                :
   6.2 Examination passed                   : B.Ed. or equivalent
   6.3 Internship Period                    : From :                    To :
   6.4 Experience                           : Year : 5         Months : 6              Days :
7. Identification
    7.1 Body Mark                           : INJURY MARK ON FOREHEAD

8. Disclaimer
I hereby declare that all information made in this application are true, complete and correct to the best of my knowledge and belief. In the event of my information
being found false or incorrect or the ineligibility being detected before or after the Screening Test/Interview, action can be taken against me by the Commission. I
have read the provisions of the relevant rules and the Advertisement carefully and I hereby undertake to abide by them. I further declare that I fulfill all the conditions
of eligibility regarding age limits, educational qualification and required experience etc. prescribed for admission to the Screening Test/Interview. Also I accept SMS
facility provided by the Commission.




Rajasthan Public Service Commission
Ghooghara Ghati, Jaipur Road, Ajmer                                                                                         Nodal Officer: Mr. G.S.Tilwani, Asstt. Sect. (0145-5151218)
Phone : +91+145+ 5151200, 5151240 & 5151090

05051439874

  • 1.
    Application Form Application Number : 05051439874 Application Filled : 26/02/2012 5.10 PM Token Number : 1221020810005032 Reference Application : 05051439874 1. Exam Details 1.1 Examination : HEADMASTER SEC EDUCATION EXAMINATION 2011 1.2 Post : HEADMASTER SEC EDUCATION 1.3 District Head Quarter for : AJMER 1.4 Medium of Examination : Hindi 1.5 Optional Subjects : 2. Applicant's Details 2.1 Applicant's Full Name : SABBIR MOHAMMAD BHATI 2.2 Applicant's Father Full Name : JUMA MOHAMMAD BHATI 2.3 Date Of Birth (dd/mm/yyyy) : 20/07/1981 2.4 Gender : MALE 2.5 Marital Status : Married 2.6 Category : BC 2.7 Home State (Bonafide : RAJASTHAN 2.8 Home District : NAGAUR Photo & Signature Of Candidate 3. Other Special Categories 3.1 Category for Disabled : 3.2 Specific Category for : 3.3 Other Category : Departmental Employee,Govt. service / Panchaytee Raj / Public Sector Employee 4. Correspondence Details 4.1 Address : VILL POST PADU KALLAN , PADU KALLAN ,Tehsil : MERTA,City/Village : PADU KALLAN - 341031 Dist : NAGAUR, State : RAJASTHAN 4.2 Email : 4.3 Phone : 4.4 Mobile : 9414414292 5. Qualification Year Division/Grade 5.1 Secondary : 1995 II 5.2 Sr. Secondary : 1997 II 5.3 Graduation : 2000 PASSED Passed 5.4 Post Graduation : 6. Additional Qualifications/Specifications 6.1 Other : 6.2 Examination passed : B.Ed. or equivalent 6.3 Internship Period : From : To : 6.4 Experience : Year : 5 Months : 6 Days : 7. Identification 7.1 Body Mark : INJURY MARK ON FOREHEAD 8. Disclaimer I hereby declare that all information made in this application are true, complete and correct to the best of my knowledge and belief. In the event of my information being found false or incorrect or the ineligibility being detected before or after the Screening Test/Interview, action can be taken against me by the Commission. I have read the provisions of the relevant rules and the Advertisement carefully and I hereby undertake to abide by them. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualification and required experience etc. prescribed for admission to the Screening Test/Interview. Also I accept SMS facility provided by the Commission. Rajasthan Public Service Commission Ghooghara Ghati, Jaipur Road, Ajmer Nodal Officer: Mr. G.S.Tilwani, Asstt. Sect. (0145-5151218) Phone : +91+145+ 5151200, 5151240 & 5151090