PROFORMA FOR RECOMMENGING THE TEACHERS FOR STATE AWARDS,2014
The details for assessment of work of the Teachers for selection by the Inspecting Officer are given below:
1.Name of the Teacher.:
2.Father/Husband Name.:
3.Date of Birth.:
4.Qualifications:-
a) Academic.:
b) Professional.:
5.Service Particulars:-
a) Date of joining into service.:
b) Length of continuous service :
as on 5th September.
c) Present designation.:
d) Name of the School in which:
he/she is working with postal
address and PIN CODE.
e) Permanent Postal Address:
(Residential and Telegraphic
Address with PIN CODE).
Mobile No.
f) Nearest Bank address.:
6. Details of service rendered:
Name of the School
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Whether belongs to Primary School or Secondary
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Management
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Period of service details from appointment date-to-date
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Service rendered in Agency/Slum area, if any
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Subjects taught
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1
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2
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3
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4
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5
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6
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7.Academic achievements:
Year
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Whether belongs to Primary School or Secondary
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Subjects taught
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S.S.C
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VII Class
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Other Classes
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Number appeared:
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Number Passed:
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Pass Percentage:
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Average Marks in the subject:
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Note: The above particulars should be furnished for the last five years.
8. Participation of the Teachers in the :
Activities of Parent-Teacher Association.
9. Special work done for raising the :
standards of Education (Work done by the
teacher should be noted in this proforma
against each item briefly, but not objective
type i.e., Yes or No.
a) Steps taken by the Teachers:
to increase enrolment in the school
and mobilization of out of School
Children and to avoid drop-outs.
b) Give enrollment/retention: Year Enrolment Retention
percentage figures for the last Percentage Percentage
3 years of the school.
10. Activities undertaken for strengthening:
National integration (Give details):-
a) N.C.C.:
b) Scout and Guides:
c) Jumboree:
d) Camps:
e) National Green Crops.:
f) Others activities, if any:
11. Inculcating interest if Co-curricular:
and Extra-curricular activities among the
students (Work done by the teacher
should be noted against each item briefly
but not objective type i.e., Yes or No).
a) Annual day function participation:held/Not held:
b) Culture programmes Participated :
and training given to students to
participate in competitions (furnish
details):-
i.School Level:
ii.Mandal Level:
iii.District Level:
iv.State Level:
c) Debates/Elocution/Quiz Competitions :
sports in which the student were
made to participate (Give details):-
i.Inter-School Level:
ii.Inter-District Level:
iii.State Level:
iv.National Level:
d) Excursion/Tours to the important:
places conducted (Mention the places
and periods):-
i.Within the state :
ii.Outside the state:
e) Participation in the community:
service (furnish details):-
i.Social work:
ii.Clean and Green:
iii.Health campaigns:
12. Contribution of the teacher for physical
Development of the school (Give details):
a) Accommodation:
b) Furniture:
c) Other Aids:
13. Contribution of the Teacher for :
Development of Students Educational
Standard:-
a). Innovating Methods of Teaching :
b) Activity packs :
c) Teaching Learning Material:
d) Evaluation tools developing:
14. Contribution of Teachers for promoting:
Literacy in general.
a) Participation in Akshar Sankarati:
(to be certified by Collector)
b). Back to School Programme:
15. Interest in helping the gifted/handicapped:
/ mentally retarded and backward students.
16. Educational Innovative Writings useful:
To the Students (Give details):-
i. if text book author, details of the :
book (S):
ii. Class:
iii. Subject:
b). Publication of Article in Name of the Year of
(Give details during last 3 years):- Journal Publication
i. State Level:
ii. National Journal :
17. Awarded received previously, if any :
(Give details)
18. Relationship with (PTA meetings):-
i. Students:
ii. Teachers:
iii. Parents:
19. Any other achievements not mentioned:
Above.
20. Brief note on criminal or other cases:
Against the Teacher and character of
Teacher.
21. Specific Remarks of the Inspecting Officer :
Justifying award for the teacher
(one para).
PLACE: SIGNATURE OF THE
ISPECTING OFFICER
DATE: WITH OFFICIAL SEAL
22. Remarks/Recommendation of the
DISTRICT EDUCATIONAL OFFICER:
(Specific remarks justifying the
recommendation)
PLACE: SIGNATURE OF THE
DISTRICT EDUCATIONAL OFFICER
DATE: WITH OFFICIAL SEAL
Note: Leaving the columns of proforma as blank and the proposals without
the passport size photographs duly attested at the backside of the
photo will not be considered for Awards. No proposals after the due
date will be accepted and action would be initiated against the
processing officer for the delay, if any.
CERTIFICATE OF ANTECEDENTS AND CHARACTER
This is to certify that ___________________________________________ recommended for State Award, 2014 by District Selection Committee has an absolutely clean record of service and faultless antecedents and that no enquires or legal proceeding of any kind, departmental or otherwise, are pending against him/her.
PLACE:
DATE:
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Signature of the Inspecting Officer(MEO/DyEO)
with official seal
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SIGNATURE OF THE
DISTRICT EDUCATIONAL OFFICER, WITH OFFICIAL SEAL
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CITATION
