View
2
Download
0
Category
Preview:
Citation preview
KENDRIYA VIDYALAYA SANGATHANREGIONAL OFFICE. BHUBANESWAR
DETAILs oF OFFER OF AppolNTMEr`IT IssuED TO THE cANDIDATEs INDIFFERENT POSTS UP TO THE YEAR 2018 0N DIRECT RECRUITMENT (MAINPANEL)NOTE -Offer of Appointment are being issued.
1. Candidates have been directed to report at the place of posting i.e. Kendriya Vidyalayas (asdetailed below) latest by 27.03 2019 positively alongwith original certificates as instructed inthe Offer of Appointment.
2. The acceptance in the prescriibed format(as given below) must be sent immediately but notlater than 20.032019 through e-mail to admnrobbsn@rmail.com duly signed.
3. Service Agreementeum-Suriety Bond on non-judicial stamp paper of Rs.100/-Orupees Onehundred only) per page to be executed. Text of Service Agreement-cum-Suriety Bond isattached herewith for the purpose.
Sl.No. Roll No. Name Date of Birth Gender Post Subjet KV wherePosted
PGT OnNGLlsH)L 53006930 SUDHIR SAHU 12.06.1986 RILE POT ENGLISH NO.l'BALASORE
2. 54401 149 SAMYA MITRA 27.04.1979 VALE POT ENGLISH BERHAMPUR3. 51300348 ARUP PURKAYASTHA 26.01.1981 MALE PGT ENGLISH NO.2,BOLANGIR
4. 5441 1255 SUSANTA LAHA 16.07. 1990 MALE PGT ENGLISH NO.1,BOLANGIR
5. 51006547 MANISH KUMAR 06.01.1980 RILE PGT ENGLISH DEOGARH6. 52110376 SHARIKA S BABU 22.09.1983 FEMALE PGT ENGLISH INS, CHILKA7. 51200639 VASAMSETTI JYOTHIPRAKASH 24.04.1989 RILE PGT ENGLISH MALKANGIRI
8. 53006498 SUBHALAXMI SAH00 05.03.1994 FEMALE PGT ENGLISH PARADIPPORT
9. 53000505 ADITYA KUMAR 01.07.1982 MALE PGT ENGLISH SUNDARGARHPATEL
10. 5 1076761 JYOTI 03.12.1989 FERALE POT ENGLISH GOPALPURMS
11. 53806576 HEM LATA 28.06.1988 FEMALE PGT ENGLISH NTPC'KANIHA
PGT urlNDI)12. 53806403 YOGESH KUMAR 16.09.1986 MALE POT HINDI NO.6,
SINGH BHUBANESWAR
13. 5 I 074 I 06 ALOK VARSHNEY 16.01.1987 RILE PGT HINDI BOUDH14. 54113365 VIKAS SINGH 12.10.1992 MALE PGT HINDI CHARBATIA15. 53908505 RAKESH KUMARYADAV 01.07.1991 MALE PGT HINDI MALKANGIRl
16, 53232697 MADAN LAL 14.10.1990 MALE PGT HINDI KENDRAPARA
17 54300532 NARENDRA SINGH 15.05.1986 MALE PGT HINDI KEONJHAR18. 53200282 KAPOOR CHANDMEENA 15.12.1984 RILE POT HINDI PURI
PGT (ECONOMICS)19. 52702514 EKANATH 15.07.1980 RILE POT ECONOMI BHAWAN]PA
POKHARKAR CS TNA20. 53000796 BALARAM DAKUA 17. I I.1993 RILE PGT ECONOMICS BONDAMUNDA
21. 53301174 muKESH 05.03.1994 MALE POT ECONOMICS SUNDARGARH
Cont'd......P.2
\edevl
PGT fl'HYSICS)22. 53001172 NARENDRA KUMAR 16.08.1984 MALE POT PHYSICS BONDAhIND
JAYANTI A23. 53001005 SRIMANTA KUMARTRIPATHY 03.07.1986 RILE PGT PHYSICS BARGARH
24. 53001153 SWA STI RANJANNAYAK 12.05.1992 MALE PGT PHYSICS NO. I , ANGUL
25. 53001274 ASHOK KUMARPATNAIK. 14.05.1981 RILE PGT PHYSICS KANDHMAL
26. 53001083 RAJANIKANTA 16.07.1992 VALE PGT PHYSICS KENDRAPARBEHERA A
27. 51015447 NAVJOT RAUR 31.07.1985 FEMALE PGT PHYSICS GOPALPURMS
28. 54006077 SHABNAM SENAPATI 08.09.1992 FEMALE PGT PHYSICS NTPC'KANIHA
29. 53237374 AMIT BAINIWAL 01.02.1994 MALE PGT PHYSICS BOUDH30. 51015849 r\4AN]EET KUMAR 01.09.1986 RILE PGT PHYSICS DEOGARH31. 51015493 BHARAT SAVITA 15 .06.1981 RILE PGT PHYSICS KEONJHAR32. 53001254 POONAM PATEL 26.01.1993 FEMALE PGT PHYSICS PARADIPPORT
33. 53001245 JYOTIRMAYEE 22.03.1987 FEMALE PGT PHYSICS NO. I ,BEHERA BALASORE
34. 51081228 SUNIL KUMAR 01.01. 1991 RILE PGT PHYSICS SINABEDA,NAD
35. 51015892 SANDEEP KUMAR 06.09.1990 MALE PGT PHYSICS KORAPUT36. 52101906 RANJITH D G 16.03 .1992 MALE PGT PHYSICS BONDAMINDA
PGT (CHEMISTRY)37. 18240307 DEEPSHIKHA 17.07.1992 FEMALE PGT CHEMIST GOPALPUR
RY MS38. 18221607 PRIYA DUBE 13 .09.1979 FEMALE PGT CHEMISTRY NO.I, BBSR(ls'SHIFT)
39. 18016296 MANISH KUMAR SONI 23.03.1993 MALE PGT CHEMISTRY BONDAMIND.A
40. 18024176 SARAT CHANDRA DE 28.02.1985 VALE PGT CHEMISTRY NO. I , ANGUL
41. 18920173 ASHOK KUMAR 06.10. 1982 VALE PGT CHEMIST BERHAMPURLAXKAR RY
42. 18346894 POOJA MAHAJAN 22.10.1982 FEMALE PGT CHEMISTRY NO.2, BBSR
43. 18718461 RAJEEV SHARMA 11.06.1982 MALE , GT CHEMISTRY BHAWANIPATNA
44. 18880905 ADESH KUMAR 06.03 . 1995 VALE PGT CHEMISTRY DEOGARH
45. 18237748 GAURAV SHARMA 04.06.1989 MALE PGT CHEMISTRY KANDHMAL
46. 18079375 BALWINDER SINGH 11.05.1989 MALE PGT CHEMISTRY KENDRAPARA
47. 18270175 PARTHIBAN G 18.01.1989 MALE PGT CHEMISTRY PURI
48. 18166747 USHA RANI 05.10.1979 FEMALE PGT CHEMISTRY NTPC'KANIHA
49. 18299460 VANOJ KUMAR 15.08.1990 MALE PGT CHEMISTRY MALKANGIRI
50. 18025081 MUKUND LAL 27.03.1990 RILE POT CHEMISTRY RAYAGADA
Cont'd.......P.3
\qof
51. 18935708 MUKESH SONI 04.02.1988 MALE PGT CHEMISTRY NO.1,BOLANGIR
52. 18205345 SHALU SOLANKI 02.07.1991 FEMALE PGT CHEMISTRY KHURDAROAD
53. 18033379 RAHUL 05.07.1992 VALE PGT CHEMISTRY BOUDH
54. 18408409 JAGDISH CHAND 22.09. 1988 RILE PGT CHEMISTRY KEONJHAR
55. 18350590 VIKAS KUMAR 28.12.1991 MALE PGT CHEMIST SUNABEDASUMAN RY
56. 18434006 JAYALAXMI NAIK 02.07.1994 FEMALE POT CHEMISTRY NO. I , JAJPUR
PGT "ATHS)57. 53219133 GOPAL SINGH RAWAT 07.07.1994 VALE PGT MATHS BARGARH58. 52704768 ASHIF MUJAWAR 28.02.1985 MALE PGT MATHS NO. I ,BARIPADA
59. 52404795 K K BHARTI 22 .04.1991 FEMALE PGT MATHS CHAREATIA,ARC
PGT (COMMERCE)60. 53103905 NEHA TANDON 08.09.1993 FEMALE PGT COMMERCE NO.4, BBSR
61. 53220944 SURENDER SINGH 14.12.1981 RILE PGT COMRERCE BONDAMUNDA
62. 5 3 1 03 1 49 NEHA BAROTRA 03.03.1987 FEMALE PGT COMMERCE KHURDAROAD
PGT (BIOLOGY)63. 53006853 SADHANA MAYBESENAPATI 25.06.1994 FEMALE PGT BIOLOGY ROURKELA
64. 52 I 0449 I GUNDA VENKATASATYANARAYANA 05.03.1986 VALE PGT BIOLOGY VALKANGIRI
PGT (COMP. SC.)65. 53706834 GOLAK BIHARI DHAL 29.06.1993 MALE PGT COMP. SC SAMBALPURNo.I
66. 51043627 ANKITA AWASTHI 27.12. 1989 FEMALE PGT COMP. SC No. I , BBSR(2ndShift)
67. 541 10520 VIVEK VIKRAM SINGH 09.03 . 1990 RILE PGT COMP. SC BHAWANIPATNA
68. 52706240 HARI SHANKAR RAI 05.09.1981 VALE PGT COMP SC BOUDHNO.5,BBSRGAJPATI69. 52107129 SHWETA VERMA 14.09.1993 FEMALE POT COMP. SC70. 51048041 KASHISH GUPTA 27.12.1993 MALE •PGT corm sc71. 51062783 ASHISH KUMAR 07.05.1994 VALE FGT COMP. SC PARADIPPORT
72. 5300406552706668 CHANDRALEKHA 04.07.1977 FEMALE POT COMP. SC NO.1,BALASORE
73. DEEPIKA SHENDE 08.07.1994 FEMALE POT COMP. SC CHARBATIA,ARC
74. 54205980 SHAILENDRA KUMARVERMA 30.06.1988 RILE PGT COMP. SC DEOGARH
75. 52304811 PRIYANKAKALARIKKAL 27.07.1989 FEMALE PGT COMP. SC INS, CHILKA
76. 54205991 SAQUIB ALAM 29.09. 1994 MALE POT COMP. SC NO. I 'BALASORE
77. 53706060 SRINIVASA RAOGANTENAPALLI 30.08.1978 VALE PGT COMP. S DARGARH
78. 51804191 SHEFALIBENGHANTIYA 22 .10.1992 FEMALE POT COMP. SC JAJPUR NO. I
Cont'd.....P.4
\trf"
PRT (MUSIC)79. 43221150 RAJSHREE TANK 02 .10.1993 FEMALE PRT musIC SAMBALPURNO.2
80. 43908938 RICHA SAXENA 25 .10.1993 FEMALE PRT NISIC NO.4, BBSR81. 41094912 SHIVANI 12.03.1994 FEMALE PRT NISIC NO.2, ANGUL82. 44208629 KUMARI SHALINI 17.07.1995 FEMALE PRT MUSIC NO.2,BOLANGIR
83. 43806035 PARAMPARACHATURVEDI 10.08.1992 FEMALE PRT musIC NO. I , JAJPUR
84. 41094259 KARAMVEER SINGH 18.10.1996 RILE PRT NISIC BOUDH85. 41704735 LIKESHWAR PATEL 29.10.1990 RILE PRT qusIC RAIRANGPUR86. 42004160 PRIYA 09.01.1995 FEMALE PRT MUSIC NO.2,
PRIYADARSHINI BARIPADA87. 44005423 AKANKSHA YADAV 01.07.1993 FEMALE PRT NISIC SUNDARGARH
88. 42405683 NARENDRA KUMAR 20.1 I .1992 VALE PRT MUSIC KANDHMAL89. 44208256 SADHANA SONKAR 10.07.1996 FEMALE PRT AVSIC VYASNAGAR,JAJPUR
90. 43220840 PARAS RAM 23.06.1986 RILE PRT NISIC DIGAPAHANDI
91. 41704637 ANIL KUMAR 25.08.1993 RILE PRT MUSIC MALKANGIRITGT (AE)
.92. 44207600 NEHA MISHRA 10.07.1995 FEMALE TGT AE INS, CHILKA93. 44402888 SUBHANKARCHAKRABORTY 05.03.1989 MALE TGT AE BARGARH
94. 41084620 RICHA RAWAT 31.10.1991 FEMALE TGT AE GOPALPURMS
95. 44107627 RAJESH KUMAR 16.07.1986 RILE TGT AE SINDARGARYADAV H
96. 44206967 ANURAG KUMAR 01.07.1989 MALE TGT AE NO.2,KASHYAP BOLANGIR
97. 44107737 NEETU SINGH 25.06.1992 FEMALE TGT AE JHARSUGUDA98. 44207618 SANTOSH KUMAR I I. I I.1990 MALE TGT AE RAIRANGPUR.99. 43907099 SURAJ KUMAR PATEL 15 .07.1993 VALE TGT AE DEOGARHloo. 43102304 RANJIT KAUR 23.09.1988 FEMALE TGT AE NTPC'KANIHA
lot 44207476 MAMTA KARVE 15.06.1989 FEMALE TGT AE PARADIPPORT
TGT ff&HE) ,102. 41703221 ASHWINI KUMAR 19.02.1994 VALE ` TGT P&HE KENDRAPAR
MAJHI A A103. 44500685 ANIRPAN ROY 16.01.1994 VALE TGT P&HE NO.I,BARIPADA
104. 44205469`SOUGAT MUKHERJEE
15 .12.1992 MALE TGT P&HE NoiBBSR (rLShift)
105. 44205038 SHANI SINGH 10.12.1995 MALE TGT P&HE KORAPUT106. 41074464 ARUN 06.05.1992 MALE TGT P&HE NO. I ,CUTACK
107. 4440151 1 BIPLAB PAUL 01.01.1989 MALE TOT P&HE CUTTACKNO.3
108. 44302358 RAHUL MAMGAIN 10.07.1993 MALE TGT P&HE NO.I,BALASORE
109. 43905832 GAGAN SINGH 22.09.1996 RILE TGT P&HE INS, CHILKA110. 41301364 ASHUTOSH SHARMA 05.04.1995 RILE TGT P&HE KHURDAROAD
tll. 44205257 SANTOSH KUMAR 06.05.1986 MALE TOT P&HE PARADIPPORT
Cont'd......P.5
\Qof",
112. 42502073 VISHWAJEET SINGH 29.1 1.1997 RILE TGT P&HE CHARBATIA,
YADAV ARCGOPALPURMS
113. 44004410 ABHISHEK YADAV 25.051987 RILE TGT P&HE
114.115.116 416127394240258342502418 GURDEEP SINGH 27.09.1993 RILE TOT P&RE BOUDH
MANOJ KUMAR SONI 20.06.1992 VALE TGT P&HE NO. I , ANGUL
UTSAV CHAWARE 31. 12.1996 RILE TGT P&HE SONEPUR
117. 43805056 MANINDER ANAND 14.07.1983 VALE TOT P&HE SUNDARGARH
118. 42501978 CHANDAN KUMARPASWAN 10.07.1992 VALE TOT P&HE DHENKANAL
119. 42502165 VILHUKHOTSO 27.04.1993 VALE TGT P&HE BHANJANAGAR
TGTOwET)120. 41093308 RADHESHYAM 22.05.1989 MALE TGT WETWET NO. I ,
MISHRA BALASOREBERHAMPUR
121 41089732 ANURAG SHARMA 01.02.1991 MALE TGT
122 43218935 ALTAF HUSAIN 15.07.1993 RILE TGT VET NO.2'BOLANGIR
123. 42706734 SANTOSH KUMARSHUKLA 16.12.1988 VALE TOT VmeT ASKA
124. 42601955 AMBUJ KUMARDUBEY 21.12.1991 RILE TOT WET BARGARH
125. 41085860 ANJANI NANDAN 16.11.1992 MALE TOT VET BHANJANAGAR
126 41507539 PREETY VATS 22.01.1993 FEMALE TGT WET CHILKA, INS
127. 41089770 BALMIKI SINGH 24.10.1988 RILE TOT VmaT KHURDAROAD
128.129 4340135541093016 RAKSHIT DADHICH 14.09.1991 MALE TOT VVET BOUDH
SATISH KUMAR 05.11.1989 VALE TGT VmeT DEOGARH
130. 42102007 NIRVAY KUMARNIRVAR 01.10.1989 MALE TOT WET HINJILICUT
131 41616899 SHASHANK KUMAR 27.06.1989 MALE TGT WET NO. I , JAJPUR
132. 41507429 HARISH KUMARCHAUHAN 25.10.1992 MALE TGT VET MALKANGIRI
133. 41507530 SUNIL KUMAR 10.10.1993 MALE TGT VET KENDRAPARA
134.135 4108856541091895 DINESH KUMAR 04.06.1990 VALE TOT VAT KHARIAR
MUKUL KUMAR 04.05.1992 MALE TGT VAT NAYAGARH
136. 441 10820 DEVENDRA PRATAPVERMA 10.04.1993 MALE ,, TGT VET RAIRANGPUR
137. 41093679 PR]YANKA MEENA 15.03 .1993 FEMALE TGT WET PARADIPPORT
(LIBRARIAN)138 52504341 APARNA DIXIT 07.11.1989 FEMALE LIBRARIAN CHILKA, INS
139 53238628 I REENA YADAVI I .05 .1990 FEMALE LIBRARIAN NO.2'CUTTACK
140. 54410381 SUDHSHNAKARMAKAR 18.05.1994 FEMALE LIBRARIAN BOUDH
141.142 5200940253807292 RAJNISH RANJAN 31 .12.1986 VALE LIBRARIAN SUNABEDA
ALI RAZA 18.05.1987 RILE LIBRARIAN SONEPUR
143. 54410416 NILADRI SHIT 03.12.1993 RILE LIBRARIAN DHARAMGARH
\ftyft( A.V.L.J. RAO )
DEPUTY COMMISSIONER
Ei
SERVICE AGREEMENT CuM SURETY BOND (To be executed on mom.udiclal
stamp paper worth of Rs. _/- (Rs. (of the value as per rules of theState) oh[y and Rs 1.00 (Rs. One only) Revenue Stamp to be affixed on top left side
of first page.
This contract made on this _ day ofBETWEEN the KVS through the
KVS) having its office at
Two thousand and Nineteen
(designation of the person in
hereafter called the "Employer"
(which term shall unless repugnant to the context mean and include its successors-in-interest and permitted assignees) of the ONE PART; AND,
Shrvsmt./Ku......
Shri.... Resident of. Son/ daughter of
.................... in the tehsil of the ....................................... „ .........
District ................................. „, hereinafter called the "Probationer/employee" (which
term shall unless repugnant to the context mean and include its successors-in-interest
and perm itted assignees) of the SEC O N D PART; AN D ,
Shri/Smt./Ku .... „ ............. „ ............. „ ........ „ . . .
..................... Resident of
............................ „ ..,...... in the tehsil of the
son/daughter of
District ..................................., hereinafter called the .'Surety' (which term shall unless
repugnant to the context mean and include its successors-in-interest and permitted
asslgnees) of the "THIRD PART".
WHEREAS the employer has offered to engage Shrvsmt./Ku+..
............................... as .......
for a period of(post) for on a probation/ training
years, which may be extended and the probationer/employeehas agreed to accept the offer of the employer.
AND WHEREAS Shri/Smt./Ku
Employer as
No.
.... has been selected by the
vide its offer of appointment
dated .......,................... for undergoing
training/probation with a view to utilize his/her service with the Employer after Successful
completion of the training, which offer has been unequivocally accepted by the
probationer;
AND WHEREAS In terms of clause of the Main Terms and Condltions of the
said offer of appointment, the Probationer is required to undergo initial training as
determined by the Employer for a period of twenty-four months, which may be extended
to twelve more months in case of unsatisfactory performance by the Probationer, and to
serve the Employer for a minimum period of 2 years from the date of joining on initial
appointment in KVS.
AND WHEREAS in terms of clause of the Main terms and Conditions of the
said offer of appointment, the Probationer and his Surety are required to execute a
Service Agreement cum Surety Bond on non-judicial stamp paper in favour of the
Employer, undertaking to complete the training and to serve the Employer for a minimum
period of two years failing which the Probationer and the Surety shall be jointly and
severally bound to pay the Employer a sum of Rs.2,00,COO/-(Rupees Two Lakhs only);
AND WHEREAS the Probationer recognizes and accepts that at the time of appointment
as Probationer, except exposure to academic knowledge, he/she has received no formal,
effedive, technical or practical training enabling him/her to become professionally viable
to the Employer;
AND WHEREAS the Probationer is aware that the Employer would be incurring
substantial sums of money and incurring substantial costs, expenses, man hours in the
process of selecting and appointing him/her as Probationer & training him/her thereafter.
il
ANDWHEREASthisserviceagreementcumsuretytondexp€utedwiththeEmployerby
the Probationer along with a Surety to the extent Rs.. 2,00,000 (Rs. Two lakhs only) will
be used for indemnifying the Employer against all such costs as mentioned above by
reason of breach and/or non¢ompliance of any of the terms of this agreement with by
the Probationer;
AND WHEREAS the Probationer also agrees that if he/she commits any breach of any of
the conditions Of this agreement, the Probationer and the Surety shall be jointly and
severally liable to pay to the Employer on demand immediately the above said sum of
Rs. 2,00,000 (Rupees Two lakhs only) from the date of breach of tlie terms of the
contract.
AND WHEREAS in order to secure the Employer against the expen6®8 Incurred by lt on
the training of the Probationer and to ensure due compliance of all tens and conditions
stipulated by the Employer and accepted by the Probationer. it is agreed that the
Probationer Shall be liable to compensate the Employer in the manner and under the
circLimstances enumerated in this agreement;
lN WITNESS WHEREOF THE parties hereto have signed these presents on this date
and year in the presence of the following witnesses:
WITNESSES: (For the Probationer& Surety) Clear Signature :
.. Signature of the Probationer Address.....,.,.I,,,,.,,,,,,.,.............................................................'.................,....,.........
2. Name Signature of the Surety Address .............................
Name. " . . ' ...-...............-..........
Occupation..........„..„....,....... •... PAN NO.
Address........„.............„.........
(Attestation of signatures of Probationer and Surety by Gazetted Officer)
Signature of theProbationer Signature of the Surety Attested Signature & seal of Gazetted OfficerSig nature & seal of Gazetted
For office use only)
WITNESSES: (For the Employer) 1. Accepted.Signature of the
Officer
.. Address
For and on behalf of KVS ..... „ ....... „ ........................... Name ...... „ ...... „ .... „ ...... „„
2. Address„ ....,. „ ................ „.
............. I ..,,,,,,,,,,,,,,,.
AC+:EPTANCE OF OFFER OF APPOINTMENT
appointment to the post ofhereby accept the offer of
No. dated
in Kendriya Vidyalaya
made in your Memoand also the terms and
conditions mentioned therein.
I agree to join duty at the place and on the date indicated therein.
Signature:Name:
Place:
Date:
ToThe Deputy Commissioner,Kendriya Vidyalaya Sangathan,Regional Office, Railway Colony,Mancheswar, Bhubaneswar ~ 751017.
ACCEPTANCE OF OFFER OF APPOINTMENT
appointment to the post ofhereby accept the offer of
No. dated
in Kendriya Vidyalayamade in your Memo
and also the terms andconditions mentioned therein.
I agree to join duty at the place and on the date indicated therein.•/
/`
Si8natu,pe,Name:
Place:
Date:
TO
The Principal,
Kendriya Vidyalaya,
N.fm®fc.,n,#d[;#:L!.T.;founntCwh .®f .R.coa- ttl'
F.Ch .... n.in. .ttd ^d¢ too
8.to of fa!rlh qr Chrfro+ n *r..gx.et a.icht ®v in+...l 'rty.Ptrerqtl.I in-rfe. Of t!d.de lte.lloft
S|gn.tore o`f Cprd!d.trI dri froed)r eniqb p tin I li.`.. .*|mrfu eMgivwh\giv
• c.rdtdr*® for *mpt®`m mt .If I th.. ttwhdrty*`'
-tottth a, oth-ff,:::n=:,a.tr#nrorha#froin#t=L='.
I do rtct. ¢ourld.r tl if. ,. ' 1I.qu.It"Ierb .for ,rtypk}rrmf to pe .' Vfty.Igiv.~~=__ __,=`= Wl.I.I.. ¢d.I.. .Gcoraln. to Wqmr alm..` ct.lqunt.
f .-.,- nd ho\4ho epee.r. .eotltfrofi hertd ti``«nb uno flng., to p}ri.lon ®f th. a.n!etdde.~
8lqom.I. of lf.. €.ndF®utB : iTdr trfon.I:
`,w.in. of tFt. ®Itlopr :i -~
rm-
t.f.
D.utitt.tlon al Offle.I { Th tt`-.fllcor
quf I.tr.`` =~
a" ,a,b,,.-
choule ho Cfvll ,€q!g.qiri or M.Ptcd Otlle.I..q.
i.+ ^preNpix.vii {A\cANDit]ATE's a.TriTEmevT ^ftD Deci^n^TroN
..``
Th. a.ndtdltfo mvor mute ttw .Iettmen< t.qulr.a holew prto.1® tin .Ouq;elo**ttil&.«Ou qfld tryuAt €iafi tfro da¢ .cotarr .fpp.ale.d'ther.te. . Hb .veontton !339col®lly dlT®cted io the wem|ni}{-cO."nSd lttlpr`P€cte.holonr :I .
.1. St.t®7ournema lf` fJtf ;`2. S`.to VOL" .ee eTtd plde. tf blrlh :LL3. {.} tlfr`+. roy .`r.f 'htl.a.thper;..toe.mftt.otqu .mr other fomr,
#.i:€¥®tdrgr...qi#|'dE#ho.'eTe'rm;::m##?torE'u==::•gp,ndldtf® ?
(b)t'B
mAo?,c¥ih::d.#,4fo",f%?,#tutzngulinecewh~`t®-.b.done
Wh.n w.ro Toui. fo.` vac¢fnon .a ?H.v®.you oj .riy ?f |ro`ae n..I r.Iofl®I.-I..in utllte..I lrt!ll coftowlptlm.•orofuie, q®ut. ae.ft'qu.`, to. f ;plt.PV Or tfU.Itltr t
a. I+eve You etlffer®d fibih .mr fom of n.rvoum.ae de.. to a-,iEjas*.rly cth.I coon. }
7. H.in y®v be.f] ®qunfo.d`grl .giv!,nljiifea M.die.I `O{rf¢e.: / M.dfeof r }o.id v.Ilhfo th. lut thte® .v.or., i
•gr¢e-t .prho giv
8. fumith lhe lollowffig p.rtle v I.ro caf`e.mlrty Your I.fully i .
I.tot
(a)
I deol.!® 811 ih® Bt!avli all.w®.a to be, lo `h.. be.` ot my "tol,car,,ct , "I Dl.a sol®mmy glllm ttot+ bey® rot tope!yut . dlaebltfty cenLttcste/p.enelonoo ®ccoiimt o!.ant dlapae oi pther cgivapq. `
caedl¢ae.. €rfunedt. i _.,
•. 3qu.a.. ty rty Prtysldh.Ium ot Ctwll, 8wioe®n `or M®dlcol O!flcw ®f apu.L rquk
Npto :-The ¢.ndldet. w!II be hutd fe.poe.lbl. f®nho rmitrty of. fro dr.4#io!%£fzyii¥::!!##::or¥d:}*a;%,i:#e¥*Onf*"#'.I,ra'i.#
•€?t,tt .
a E a L A a I.T I a "
{!. I 'ebrl / ®I]flmmt / fro4rldutr. er AHdtry :.-,
0.I, I-
APPcOO-VcO
if.`
§T¥tr#£th£:i#fuRErfewl#+OfL=Of_ul#--')i Tin I m` rmqd ``ed in+ hig..md b...no otm ftyno vtr..to fry
ii..¢ Of mr.kmawhdor.I) " I `ho. ecoo~,. \.dprin wh a -rfu tw'4bgivopemryqi ,ef'ftrm fry, Agpfbctfon tor grut Of +xrtylon beeknd
I .armrty -'qfro`ftyut tlt. .tin. dutfwhn 'if. in .giv. I ,vg~iinrf bi.ch-tprul} Of IIi.--emm.aptt mt. mnb tfr b .uN~ .fro`givv' quelptomrf, I ch.« b ftyM. t®'h combed in- .,
8tryrfu. :givm. .oI*ai...' nco mplto.tal..^ppllcobi. .fro th. one ®f cl"ut {.}. {b| ed {e} chfr. -
Of Tvs ,.VIt»"r*®^" `to--ut. TAIImr,. Iarim.< ti..I .-c*Jp"^M ; r*ineir*i '`
to
A,querxit*
mmrtydrty~ `rfu .` -•rd ho ®ve tw. b rm mtl®®t€eei6iiiiijiio.Of
tedpt t. try'qn. qudybed ulJ {ftyi I lull...rty'tfo-tkfro* ct ftry -.,tmitr.I.aertfy,qnd.aAfthtrprithtlty.
uho' I wll'.tr
Sti help in Cud.
a,t. 8
I-Dutcotfro g_
cHAneTth Cant-,tC.ftlfhad 8ict I h.v. l`nowt. 3rgivboutyftyL_v
cO.'d-.Ier ' 'de
Ofqut
-pr'#
ed " to qhe in*rtyqprfu:!dr%j¥LholtJ&..i=#+=qti#EL±tryto+#dywhM~in=|flrN*rty* Giferitenrtyl Kom,ri.i. I Vr.l nco r.I.tod to in..
I,toco :
Dgiv ,_
Com-
®torfu,
` Dqt-
-me
rigiv.,ut
quo¥-,*
an'd-hut iRETrii==-.. a
fp.qdrtdr:iiriE;;-riEi.elm.'pe.ut~utth'drfutrfugivin the lcqumf..Vtequ.w ermwtha .
?quee¥-Ptm=
m'ai
abq-. t•0-
``to i_-_
D'-Oe
8t.rl / 8fgivu } "".I.helped ben unrfutry aeatlnlfl.¥jBeftmmontquftrtram__Brutrty
Pen
to' th
Mgiv W
p quv''Wlth / mrtll.a.ft` .N®iri.nf-. .i`e up /'ho•tournlil.Etod '*m off.st .ten
oa gndgiv` of,r-apatiali fe ..I.oufrowh
a. I+quhe in. .mM.Iginp inm.giv fro Upton pt.th Mffro qm~
EELELEEEiEEEEEEELEEE
q~,`tw. (ie.fl Or ut..trmr t® b.
*qqurfu{ fb.I.ng`l®n ot.
/' /. ,'//
I.'{;
.
2.
ATTgsTATiow Foriifi
-I -.-. : :-.i. - -rJ:'
qucoRAPH'
Nem ln full ('n oopl,a!®tw!t'' .II..ee t' e«y,tpt...®.` {*dfc.f®,(f you 'b.v- '®dd®d, or dtappnd .t 4fiy of qeeJtrt)*rt of'your ham® oF r .
ulfrom®). .
Fre+ept' ..d¢l.il ln full ' {l.I `®.V"!.`.,-:tl.ati. tnt Pfei.lot a.Heiie. «umb.r, Lan.PtF..fpe®adcth..t"n'
Sum7\.M€
a. (,a Jtququ® 7n ft[«®; ,thon& ,tld
ca ®r Hoe.. «urfur,Ldr;/`Stree`|ffoed ` cod Tom'
(tr if-.tl!ftyto*lly tt Tee(dcot of'Pckf.I.nr-lh. nddr®m ln` ,tti.I Cedntrr end the.q.I. of--i:in-n-i-.--_--
4, I]a(trot.I.I.`®f'Pfao.& {vyith.b.I lad ®1 ra*I¢eco.} vftryf® .YOUh.v® .r..|drd-for mare `thin I ,gin.ir®er fit i .ho` givrtT`g ih®, pr.cedlriq''f*® r.',r',
FROM ''a ' . ^._._.':,-ERE.RE
•, ` .I
riiii
8. .<.` {.I i.,q]et+ «.in. h lull wllh• .Itqu` iron.y
• (tl} . b...I.t'pcot.I .a.qri... {If deed ®he I.q .edrwh
.{®) pm`.nor J`Ogiv.ouT®cO
{e} . frof q,.lou`-I?#pdy«ro|#-a.%`£l.i:d..fB"tton
®. ,«eden,,I,y ,,• .,I., f.th'
I. .(b) «giv'e) fry.whpr,'.{d} c*rdftytr• (.I 'Piac.e. elwh
•. Huulnqu'.7. ``. {i} gx.®te.I.Oi.Biwh .
•.(b' p'-n'.qir(o} Ae..t ut.lrloulellon
a.
•`. +,..I..: `.:,, .¥tmjt,try,,
{l} pi.co of'BiTwh, oI.tfmled €iof. fo whleh .twed
` `tb.tr .P_T.¥!=¥ ii-I. to vyhwh
faTr=rfulch(q:
ap?T#rf#¥,,,ii:firfu#d- .nrmi. fe 've..'.`m th. .o.in
• , . I 1` .I.For.a,
a,. ' "uo.lap,ICh.llmrofro •howiro p.rfu::ed CdhedN !tue.1" in.r`.Of `.pe.
fry givl / Coldy,.wm`fyfi.ddMof,, ."-pe q'.
il+-,,-
d`.€eue.tt9rt'wllh.v+.r.-.to3thinot.
•Oun.ct. ,`.ngiv .
'gd, dr' f*-tooIell,lno.. PO,,a.
11. llyou'hrvM`.ny`tlm®tmq
D.®I,g"tfon Ofpdet h,ut ®EulroB,'Ptl®" ®{wO,k
a.
Fron
emu.pgiv.teed.fl.i
T®.
btl.-ct ..th. ottto' ¢ufro-er ..whwh"
Full qrty
frtw#
#'.¢#==.ron?'=fu#q.•`EE§ouRE#ap®,ty,`T
-..
1-`.
:g:,:fF#:[:'pe#i:#un*ou-'®m ?
•1tl...n.iml`fo'',¥.i',t¢ll..putlchu..atth'c..`.idednilch,quho,och+triion•.,- `- , -__,_`_'._- .
lho'rfu,ri gtfun..I,`.nc.,.,C.
is, .. i..«.inde af.the tvy® T.|\|,|S==== -, `-__ -(
per.on. o1. Tour tocoilty a. 'frty'. ___ Lri
+.
-'__._•tlltt.nco. .a wlioii` vau .I. *row"
#.Ttr##T=¥=##im=g=toi#isftr.-##grow.±tyf. oi. ,uit ' condldlf `i
E*," I
p',ch i
• .. IO`..wtiTy .cfBrmchTI
a.rtl.rfu-toiotry.Iona¢dy,.nr`eh-,;o!th.tolthln.!
i..a.act"Otlfo.note.ntr.lt,tq.atr`¢aromrtyuni.2.- .W!onto..al Pa.-ll.in.til a. Sl... Lapl.tw.. .3: ,mar,,a--"_I -_, _
. ,.I..TT„ .-.. ur, I.|I.I.in." a. 8*.le' Lapl.rtyin...... : .-: .a..won.aco«ct sub.Divi.iopa".atotr.quin. ,A4"t.fuii¢"afN.lb®p.TafrolldorGuth.Ihodto~mngtwkl~
.,
aprtl!l.a th.I I thaw 8h.i/§mqurm; . .'`egiv / drhtw .'`ct 8hii
whey,I.dg. .rid
p',.ci.,f .
-n,,,toll,i froJPrfufty,'mtyTi,btry giv
tryonth,.nd
• ,.'.-, `,' .,-. I .,...
~ ,_' .....`- I
..t
I
-
Recommended