personal fitness form - RD Rajpal Public School

Please send filled form to:
“THE PRINCIPAL,
R.D. RAJPAL SCHOOL,
SECTOR-9, DWARKA, NEW DELHI”

PERSONAL FITNESS FORM
To be filled and signed by the applicant and submitted with the application form.
If selected for the post, then applicant needs to submit Medical certificate from a recognised medical
practitioner.
1. NAME ____________________________________________________________________
Last First Middle
2. HEIGHT ___________________________cms
3. WEIGHT ___________________________kgs
4. VISION
LEFT EYE ______________________ RIGHT EYE ________________________
5. HEARING
LEFT EAR ______________________ RIGHT EAR _________________________
6. BLOOD PRESSURE ________________________________ ON DATE _______________
7. DO YOU HAVE DIABETES? (Tick) YES / NO
8. PERSONAL IDENTIFICATION 1 ______________________________________________
PERSONAL IDENTIFICATION 2 ______________________________________________
9. MAJOR ILLNESS(ES) IN THE PAST OR PRESENT, IF ANY
___________________________________________________________________________
___________________________________________________________________________
DECLARATION
I hereby certify that the particulars furnished above are correct to the best of my knowledge and belief. I have not concealed any
information likely to impair my fitness for employment. If it is revealed later that I have given false details or concealed information, my
services shall be liable to termination without any notice or compensation.
DATE
PLACE SIGNATURE OF APPLICANT

PLEASE UNDERTAKE THE FOLLOWING
NOTE:
� Please submit typed material.
� We are interested in your own thoughts, rather than textual or schooled responses.
� Please do undertake this exercise by yourself, in a frank, honest and forthright manner.
� Your responses will be treated with utmost confidentiality.
� Remember, there are no right or wrong answers.
1. Please write in autobiographical form, your responses to the following. Limit yourself to no
more than one appropriately titled paragraph on each.
a) Your views about your parents. (Max. 50 words)
b) Your views on your brothers / sisters. (Max. 50 words)
c) Significant events in your childhood. (Max. 50 words)
d) Your experiences at school as a child. (Max. 50 words)
e) Teachers you liked / did not like. (Max. 50 words)
f) Your capabilities as a student. (Max. 50 words)
g) Your own successes and failures. (Max. 100 words)
h) Your own strengths and weaknesses. (Max. 100 words)
i) Your view of what you expect to be five years from now. (Max. 50 words)
j) Your personal philosophy of life. (Max. 50 words)
k) Any thing else which you think has been of significance to you, to date. (Max. 50 words)
2. Describe your view of an ideal child, in the age group of 4 years to 8 years. (Max. 100 words)
3. Comment on the most fulfilling and satisfying experiences that you have had in your career as a
teacher. (Max. 150 words)