Model Transfers Online Application Form

Government of Andhra Pradesh
Department of School Education
Application for Transfer
Date: 21/06/2012 
Time: 12:27:31 
Personal Details
1.District : ......................................................................
2.Zone Code : ......................................................................
3.Mandal: ......................................................................
4.Name of the individual seeking transfer : ......................................................................
5.Employee Code Number : ......................................................................
6.Employee Treasury Code : ......................................................................
7.Date of Birth : ......................................................................
8.Gender : ......................................................................
9.Maritial Status : ......................................................................
10.Category of the Post : ......................................................................
11.Subject : ......................................................................
12.Medium of School: ......................................................................
13. Management of the School (Government/Local Bodies): ......................................................................
14.Name of the School: ......................................................................
15.School Code: ......................................................................
16.Category Of the School (Ex:I,II,III,IV) : ......................................................................
17. Whether the individual has completed 8 yrs of service as on 1st July, 2012 in all categories of posts  including the service rendered in the school prior to upgradation or bifurcation :
(If Yes, Furnish the Date of Joining)
......................................................................
18.Whether the Individual is male Headmaster Grade-II/Teacher aged below 50 years as on 1st July, 2012 of the year and working in Girls High School : ......................................................................
19.Whether the Individual is working in a school  where the pass percentage in the S.S.C. Public Exam (March) is less than 10%. (Yes /No): ......................................................................
20. Date of First Appointment in service: ......................................................................
21. Date from which the individual is working in the present School in all categories of posts including prior to upgradation/bifurcation: ......................................................................
22 .Whether he/she is President or General Secretary of the District/State of Recognized Association (Yes /No): ......................................................................
23.  Whether spouse is employee of State Govt/Central Govt/Public Sector Undertaking/Local body / Aided Institution in the same district(in the same zone for Gazetted Head Master, Gr.II in Govt Schools)  (Yes /No): ......................................................................
24. Whether the teacher availed the benefit under special category for spouse during the last 8 years as on 01-July-2012 (Yes /No): ......................................................................
25. Whether the individual availed the benefit under Preferential category during the last 8 years as on 01-July-2012 (Yes /No): ......................................................................
26.  Whether the individual Wants to claim under Preferential category(Yes /No): ......................................................................
27.  Performance Parameters(Yes/No): ......................................................................

Note :A Copy of  certificate issued by the competent authority shall be enclosed to the Application form to consider their  cases under special category or Preferential Category  for the items  22,23,25,26.

DECLARATION
I hereby declare that the information furnished by me is correct. If any information found to be incorrect/false, my candidature can be cancelled and action may be initiated against me as per rules

Signature of the Applicant
CERTIFICATION
I hereby certify that the above particulars are verified and found correct.

Place: Signature of the HM/MEO/DyEO
Date:        Stamp                          

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