teacher-profile-form

DIRECTORATE OF SCHOOL EDUCATION
Govt. of Mizoram
TEACHERS PROFILE REPORT FORM
INSTRUCTIONS
1. Only Teachers, including Headmasters and Principals must be recorded in this Form/database.
2. Name should be as recorded in the Service Book or Educational Certificate.
3. Number of family members must be as declared in the service book.
4. Hindi Teachers are instructed to write their general educational qualifications in addition to qualifications in Hindi.
5. Controlling officers are requested to ensure the correctness of the information given by the teachers by comparing with
their service books and other records available with them.
6. New incumbents are requested to report using this form only.
7. Any change in individual profile may be reported to this Directorate though e-mail:mis.dsemizoram@gmail.com
8. The completed form must be submitted to MIS Cell, Directorate of School Education.
A. PERSONAL INFORMATION
1) Name of Teacher:________________________________ 2) Gender: Male/ Female___
3) Date of Birth: ______________ 4) Aadhar No.(optional):_____________________
5) Designation: (eg.Headmaster /Hindi Teacher /Principal /Vice Principal /Teacher /Art
Instructor/ H&P Instructor/Lecturer,etc..)_________________________________
6) Name of Father:__________________________ & Mother : _____________________
7) Marital Status: Single/Married 8) If married, Name of spouse: ____________________
9) Profession of Spouse & Designation: _________________________________________
10) No. of family members:___ 11) EPIC No______________ 12) Blood Group: ____
13) Contact Numbers: a) Mobile:_______________________
b) Landline with STD Code:_______________ c) E-mail:_________________________
14. a) Present Address: _______________________________________________________
_______________________________________________________
b) Permanent Address:_____________________________________________________
_______________________________________________________
B. SERVICE INFORMATION
1. Type of Present Appointment (e.g Contract /CSS /Deficit /RMSA /SSA /Government/
Adhoc Aided)
2. Serial or Rank No.in the appointment order (if known to you): ______
3. Subject of Appointment or Subject being taught: __________________
4. Teacher Grade:(e.g Selection/Senior): ______________________
5. Dates of Appointment as (whichever is applicable)
1) A contractual (or CSS) Teacher: __________ & Date of Joining: _______________
2) Aided Teacher:___________ Date of Joining: _______________
3) A Deficit Teacher: __________ Date of Joining: _______________
4) A Government Teacher:__________ Date of Joining: _______________
5) Date of Confirmation: ___________
7. Type of Pension:- a) No Pension b) New Pension c) Pension (tick one)
8. a) GPF A/C No.___________ b) New Pension Scheme Permanent No._______________
c) New Pension Scheme Temporary No. _________________
C. SCHOOL INFORMATION
1. Name of School: _________________________________________.
2. Management(e.g Deficit Mission/ Deficit/ Government/ SSA/ RMSA/ Adhoc Aided/ Grant
in Aid/ Local Body/ Lumpsum Aided) ___________
3. Stage where teaching is done:(e.g Primary/Middle/High School/Hr.Sec)
4. Type of School: (e.g Co-educational/Girls/Boys)_______________
5. Medium of teaching/ instruction in the school: ________________
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6. Designation of the DDO: ____________________________________________
& Office Address:_______________________________________________________
________________________________________________________
7. DEO/ SDEO/ Education Officer & Address: ___________________________________
______________________________________________________________________
8. School Address:___________________________________________
Village :____________________; District: _____________ ; Pin: __________
Phone with STD Code: ____________ E-mail:___________________
RD Block:_________________
D. EDUCATIONAL & PROFESSIONAL(Teacher Training) INFORMATION

1. Highest Educational Qualification in Arts _______________ Science _________________
Commerce ____________ Computer/IT_______________ Hindi ____________________
Others ____________
2. Professional Training: Dip.Ed/ B.Ed/ M.Ed/ Hindi Shikshan Diploma/ B.Ed(Hindi)
_______________ & Year of completion _____
E. POSTING INFORMATION
Name of School Place of Desig DEO/SDEO/EO Village With
S.No
Working nation effect

from
(add rows if necessary)

The information given above are true to the best of my knowledge.
Date:- Signature:
Name of the Teacher:
The information furnished by Mr/Ms/Mrs. _____________________________ are checked and

found correct according to the records available with us.
Date: Signature:
Name of the Head of Institution:
Countersigned by Education Officer/SDEO/DEO with date
Page 2 of 2

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DIRECTORATE OF SCHOOL EDUCATION

D. EDUCATIONAL & PROFESSIONAL(Teacher Training) INFORMATION

Working nation effect

(add rows if necessary)

The information furnished by Mr/Ms/Mrs. _____________________________ are checked and

Countersigned by Education Officer/SDEO/DEO with date

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