INSTRUCTIONS FOR APPLYING TO STATE TEACHER AWARD (

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1 INSTRUCTIONS FOR APPLYING TO STATE TEACHER AWARD ( 1. For the state teacher award, the teacher can recommend himself/herself or can be recommended by his/her Head of School or Block/District Officer(,, 2. Please read the complete State Teacher Award Policy (available on the website of Directorate of Elementary Education to know the eligibility criteria for applying for State Teacher Award ( ढ़ 3.1 All JBTs, TGTs, C&Vs, PGTs, Lecturers, PETs and DPEs would be evaluated on the following five criteria (JBTs, TGTs, C&Vs, PGTs, Lecturers, PETs औ DPEs 5 : i Reputation in Local Community ( - ii Academic Efficiency and Desire for Improvement ( iii Involvement in Social Life of Community ( iv Special Efforts towards school/children ( / v Brief of service in Hard/Tribal Area ( / 3.2 All Headmasters and Principals would be evaluated on the following four criteria (Headmasters औ Principals 4 : i Academic Efficiency and Desire for Improvement ( ii Involvement in Social Life of Community ( iii Special Efforts towards school/children ( / iv Brief of service in Hard/Tribal Area ( / 4 Please see the list of documents (available on the website of Directorate of Elementary Education that you would be required to submit as proofs along with the application (

2 1/5 PROFORMA FOR RECOMMENDING A PRINCIPAL/HEADMASTER FOR STATE TEACHER AWARD ( हम चल द श श क प र र प - सपल / ध न पक SN BASIC INFORMATION HEAD ANSWER Details of recommender: The teacher can recommend himself /herself or can be recommended by his /her Head of School or Block/District Officer (न म कन करन व ल क ज नक र : श क य ख द क न म कत कर सकत ह, अथव उनक न म कन उनक ल, अथव ख ड य ज़ल अ धक र र कय ज सकत ह Name PMIS Code of Recommender (य द आपक PMIS क ड नह पत त अपन Establishment ऑ फस पर स पक कर Designation Office Address Pin Code Id Mobile Number Details of teacher being recommended (न म कत ह न व ल श क क ज नक र : Name of Teacher PMIS Code of Recommender (य द आपक PMIS क ड नह पत त अपन Establishment ऑ फस पर स पक कर Date Of Birth Date of Appointment as teacher Designation Id Mobile Number Present Address Pin Code Permanent Address, if different Pin Code School Landline Number PASTE PASSPORT SIZE PHOTO HERE (Also attach 2 attested photos with the form/फ म क स थ 2 स पत फ़ ट भ लग ए List the schools where the teacher has taught for more than 3 months in the past 5 years (उन ल क स च जह श क न पछल 5 वष म 3 मह न स अ धक समय पढ़ य ह मह प ण : सबस पहल उस व लय क न म लख जह उ न ह ल म पढ़ य और आ खर म उस व लय म जह उ न ब त दन म पढ़ य : UDISE NAME START DATE (DD/MM/YYYY END DATE (DD/MM/YYYY DESIGNATION Entries from Servicebook attested by Deputy Director (Deputy Director र स पत servicebook व य ACADEMIC EFFICIENCY AND DESIRE FOR IMPROVEMENT (श णक द त तथ ग णव प ण श स ध र ह त इ 18 Write the result of Class 12th Board Class (ब ड क 12 क पर फल-प रण म लख (य द ल ह ड न पहल वषय श क क क य कय ह, त श क र पढ़ य गय वषय क लए ह ब ड क क पर फल-प रण म पर ग र कय ज य ग : अगर श क न एक श णक वष म 1 स द ल म 3 मह न स द व क लए पढ़ य ह त स र ल क प रण म क average नक ल Pass Percentage of Board Classes Taught Percentage of Students with Distinction Record from school register ( ल र ज र स ब ड क ओ क प र फल- प रण म क त ल प

3 2/5 19 Write the result of Class 10th Board Class (ब ड क 10 क पर फल-प रण म लख (य द ल ह ड न पहल वषय श क क क य कय ह, त श क र पढ़ य गय वषय क लए ह ब ड क क पर फल-प रण म पर ग र कय ज य ग : अगर श क न एक श णक वष म 1 स द ल म 3 मह न स द व क लए पढ़ य ह त स र Pass Percentage of Board Classes Taught ल क प रण म क average नक ल Percentage of Students with Distinction Record from school register ( ल र ज र स ब ड क ओ क प र फलप रण म क त ल प INVOLVEMENT IN SOCIAL LIFE OF COMMUNITY(स म जक ज वन म भ ग द र तथ भ मक 20 For all the schools mentioned at Sr. No. 17, steps taken by teacher to increase school enrollment (स रयल स. 17 क जव ब म लख गए व लय म श क र छ न म कन बढ़ न ह त क य क ज नक र द: Increased School Enrollment? Answer the following only for the school where the teacher has worked to increase school enrollment ( क वल उ क लए उ र द, जह श क न छ -न म कन बढ़ न क लए क म कय ह Percentage increase in enrollment Steps Undertaken to increase enrollment (in max 50 words Official Enrollment record (आ धक रक न म कन रक ड For all the schools mentioned at Sr. No. 17, details of co-curricular/ other activities organized in school and performance of students in these activities (स रयल स. 17 क जव ब म लख गए व लय म प म-स ब धत ग त व धय / अ ग त व धय क तथ इनम ब क दशन क ववरण द : Activities in school ल No. of prizes won at District Level No. of prizes won at State Level No. of prizes won at National Level Steps Undertaken(in max 50 words 1 Proof from school record about the activities organized (ग त व धय स ब धत ल रक ड 2 Official record of Award (प र र क आ धक रक रक ड क त ल प 3 Photos (त र For all schools mentioned at Sr. No. 17 where the teacher has served as HoS, details of different activities that have been hosted in the school premises (स रयल स. 17 क जव ब म लख गए व लय म जह श क न ल ह ड क क य नभ य ह, व भ ग त व धय क थल भ र क प म ल क भ ग द र क ववरण: School used as venue incharge? Answer the following only for the school where the school has been used as venue incharge ( क वल उ ल क लए उ र द, जह ल न थल भ र क प नभ य ह Level at which conducted (Options: Type of Block Level Activity District Level conducted State Level Certificate /Copy of Order (आद श / अ

4 3/ Order (आद श / अ म णप क त ल प SPECIAL EFFORTS TOWARDS /CHILDREN ( ल / ब क त वश ष य स 23 Details of teacher's own ward studying/studied in Government School (सरक र व लय म पढ़न व ल श क क ख द क ब क ववरण: Teachers ward in Govt School Answer the following only if the teacher 's ward studied in govt. school (अगर श क क ब सरक र व लय म पड़ ह, तभ उ र द following options: UDISE (of school where studied CLASSES STUDIED (Options: Class 1st to 5th/ Class 1st to 8th/ Class 1st to 10th/ Class 1st to 12th/ Class 6th to 8th/ Class 6th to 10th/ Class 6th to 12th/ Class 9th to 12th Certification from Head Of School ( व लय क ह ड र स पत म णप 24 For all the schools mentioned at Sr. No. 17, Total money received and spent by the school in the past 5 years where the HoS served more than three months and till the end of an academic year (स रयल स. 17 क जव ब म लख गए व लय म, जह श क न त न मह न स अ धक समय तक एव श णक वष क अ त तक ल ह ड क स व कर ह, व लय र और खच क गय धनर श: Teacher served as HoS till end of Academic Year? Answer the following only for the school where the teacher has served as HoS (क वल उ ल क लए उ र द, जह श क न ल ह ड क स व कर ह Amount Pending (Options: None Pending Upto 10% Pending More than 10% pending 1 Last page of Cashbook and Passbook (क शब क और प सब क क अ तम प 2 Photos of things money spent on ( जन च ज पर प स खच कय ह, उनक त र - य द उपल ह 25 For all the schools mentioned at Sr. No. 17, mobilization of resources (in cash or kind from the community (not Govt Funds for physical development of school or other activity (स रयल स. 17 क जव ब म लख गए व लय म, व लय क वक स/उ न तथ कस भ अ ग त व ध क लए सम ज/सम द य स (ग र-सरक र नकद य व स स धन क ववरण : Mobilized Resources from Community? Answer the following only for the school where the teacher has mobilized resources from the community (क वल उ ल क लए उ र द, जह श क न सम ज/ सम द य स नकद य व स स धत क ह Amount Received Steps underaken to raise money (in max. 50 Words Amount Spent For (in max. 50 Words (i Proof from Schoolrecord about donations received ( द न / स क लत च द क म ण,

5 4/ स क लत च द क म ण, (ii Bill Voucher as proofs for amount spent ( खच कय गय प स क लय बल व उचर; and (iii Photos of things money spent on ( जन च ज पर प स खच कय ह, उनक त र - य द उपल ह List of books authored (or co-authored/articles (published in newspaper/magazine/journal/periodical by the teacher ( श क र ल खत (सह-र चत प क / ल ख क स च जनक अखब र / स म यक प क ओ म क शन आ ह : अ धकतम 5 SN Year Published Publisher Type Topic Proof to be Submitted following options: a Article b Book In case of article: Attach article (य द नब ध / ल ख क शत ह त नब ध / ल ख क त ल प In case of a book: No proof needed (य द कत ब लख गय ह त, 27 For all schools mentioned at Sr. No. 17, extra ordinary contribution by teacher to school/students (स रयल स. 17 क जव ब म लख गए व लय म श क क व लय / छ क लय वश ष य गद न उद हरण थ : श त ब क हम चल ब ड य अ कस स थ स क ई Merit Certificate, छ व इ द: Any other extra ordinary contribution? Answer the following only for the school where the teacher has undertaken any other extra ordinary contribution (क वल उ ल क लए उ र द, जह श क न वश ष य गद न दय ह Level of Performance(Options - School, Block, District, State, National Details of work done(in max 50 words 1 Photocopy of merit certificate or other concerned proofs (Merit Certificate, छ व इ द अ स ब धत म णप 28 BRIEF OF HARD/TRIBAL AREA SERVICES (क ठन इल क / आ दव स म स व क य Service in Hard/Tribal Area since appointed as a teacher (क ठन इल क / आ दव स म स व क य जह पर श क न नय क ब द कभ भ पढ़ य ह : क ठन इल क / आ दव स क नव स क अपन ग ह/नगर स कम स कम 15 km क द र पर क य रत ह न अ नव य ह No. of Years Served (Options - Less SN UDISE NAME than one year, One year, Two Years, Three Years, Four Years, Five Years, More than five years Entries from servicebook attested by Deputy Director (Depity Director र स पत servicebook व य

6 5/ व य

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