The document is an application form for the Headmaster Secondary Education Examination 2011 filled by Sabbir Mohammad Bhati from Nagaur, Rajasthan. It includes personal details, qualifications, and a disclaimer confirming the accuracy of the provided information. The applicant has a total of five years of experience in the field and has completed his B.Ed., among other qualifications.

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