|:Veer Bahadur Singh Purvanchal University, Jaunpur:|

TEACHER CODE
REGISTRATION

PERSONAL DETAILS

	Click to fill incomplete form or Duplicate Printout of Teacher Code Registration Form
Registration Type :*
Name :*
Father's Name :*
Mother's Name :*
Gender :*
Date of Birth (DD/MM/YYYY) :*
Phone No. (with STD code) :
Mobile No. :*
Email ID :*
Residential Address :* (District and Pin Code)
Aadhar Number :*
PAN Number :*
Bank Name :*
Bank Branch Name :*
Bank A/C Number :*
IFSC Code :*

INSTITUTIONAL DETAILS

Are you Associated with Veer Bahadur Singh Purvanchal University, Jaunpur :*

No Yes

Name of the University :*

Faculty :*

Name of college (District) :*

Department :*

Nature of College :*

Specilization 1 :*

Post Held :*

Specilization 2 :*

Nature of Appointment :*

Specilization 3 :*

Date of Appointment :*
Date of Confirmation :*

Approval from the University (Letter No.):*
Approval from the University(Date):*

Approval from Directorate of Higher Education (Letter No.):*
Approval from Directorate of Higher Education (Date) :*

Date of Retirement :*
Name of college Retired from :*

Experience of Teaching UG Classes :*

(in Years)

Experience of Teaching PG Classes :*

(in Years)

ATTACHMENTS

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Latest Photograph :
Signature :
Copy of Aadhar Card :
Copy of PAN Card :
Teacher Approval Letter issued by University :
Teacher Approval Letter from Directorate of Higher Education :
Experience Letter of Teaching issued by the Principal :
Proof of Retirement :

Confirmation:

The above information as filled in by me are correct to the best of my knowledge and I bear all responsibility thereto.' in place of 'Above information which is provided by me is true, and i responsible for that.

Note: * Fields are Mandatory

TEACHER CODE REGISTRATION

TEACHER CODE
REGISTRATION