APPLICATION FORMAT
Affix passport size
photograph
Application for the post of Chairman in National Institute of Open Schooling (NIOS), an autonomous
organization, Ministry of Education, Department of School Education and Literacy, Shastri Bhawan, New
Delhi.
1. Name (in Block
letters)
2. Father’s
/Husband’s
Name
3. Date of Birth (in
Christian era)
4. Date of
superannuation
In parent
organization
5. Age as on the
last date
for receipt of
application
(20th January,
2025)
6. Sex
7. Nationality
8. Permanent
Address (in
Block Letters)
9. Present Address
(in Block
Letters)
10 Contact Details
. (Telephone/
Mobile Number
and email
address)
11 Address of
. present office
with telephone
No.(in Block
Letters)
12 Educational Examinati University/ Year Subjects/Area % of marks/grade
. Qualifications: on Passed Board
Graduation
Post Graduation
Research
Any Other
13 Details of Posts Office/ Post held From To Scale of Whether Nature
. Held (including Institution pay &basic Regular of
present post) in pay or Duties
chronological Temporar (in
order, (use an y detail)
extra sheet in
case you desire
to give more
information)
14 Publication, if
. any, in the
relevant field,
give brief
details
15 Nature of Nature With effect from
. the post
currently Adhoc
held
Permanent
16 State whether
. present
employment is
held on
deputation/contra
ct basis along
with date from
which the same
is held
17 Additional (i) Central Govt.
. details about
present (ii) State Govt.
employment
(iii) Semi-Govt./autonomous
Education organization
18 Professional
. training
(give details)
19 Work
. experience
other than
what has been
prescribed in
the Vacancy
Circular.
20 Additional
. Information, if
any
I, hereby declare that all the statements made in this application are true, complete and correct to
the best of my knowledge and belief. I also declare and fully understand that in the event of any
information furnished being found false or incorrect at any stage , my application /candidature is liable to
be summarily rejected at any stage and if I am already appointed, my service is liable to be terminated
without any notice .
Date:
Place: (Signature of the Candidate)
Forwarded. The information furnished above has been checked from the relevant records and found to be
correct. It is also certified that no disciplinary case is either pending or being contemplated against the
applicant.
(Signature of the Forwarding/Nominating Authority with Designation)