Government of Andhra Pradesh
Commissionerate of Collegiate Education
Andhra Pradesh, Vijayawada
S.No Personal Information
1 Zone:  
2 College in which the incumbent is now working            
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3  Full Name:    
4 Employee ID
5 Designation:
6 Subject:  
7 Sex  
8 HRA Category as per State Scales for the Present Station
10 Native District  
11 Native Place    
12 Applicant current station
13 Date of Birth(DD/MM/YYYY)    
14 Age as on 01-04-2017:     Years
15 Date of Retirement:(Ex: DD/MM/YYYY)    
16 Period of Service in all Cadres in the present station as on 01-04-2017.

(ex: DD/MM/YYYY)
From :    
To     :  

17 Total service in All Stations in the present Cadre as on        01-04-2017

(ex: DD/MM/YYY)
From :
To    :  

18 Completed No of Years Working Currently in ITDA Area.  
18.b. Whether the Applicant Present Statioin is under ITDA
20 Details of the Disiciplinary Cases if any:
21 Give details of pass % in the concerned subject duly certifying the principal of the College(If teacher is handled more than two papers then average of them should be entered):. For PD, Librarian Choose NA
March/April 2016 :
24  API Score
25 AADPI Score
26 Received State Teacher Award in the year
Reasons for Request for Transfer
a)if the applicant is Single Woman
(applicable only in case of women applicant)
b) Transfer request on Spouse Grounds ( Apply only if not availed the transfer based on Spouse Grounds with in last 8 years)
i) Name of the  spouse :  
ii) Office:   
iii)Place :  
iv) District :
v)spouse working orgav)spouse working organization
v)  whether certificate from the competent authority as mentioned in the guidelines at point no.5(b)(v) has been enclosed.  
c)Transfer request on Physically handicap Grounds    
i)Nature of Physical handicap  
ii) what is the percentage of handicap   %
iii)whether the medical certificate from the Govt. Doctor not below rank of Civil Surgeon submitted?
d) Transfer request on Medical Grounds

i)Nature of the disease
ii)whether the medical certificate issued by the competent authority i.e. District Medical Board/State Medical Board enclosed
e)whether the Applicant is having dependent children with mentally retarded
f)Whether the dependent children suffering from Juvenile Diabetes and children suffering from congenital Heart problems and are under medical treatment    
g) Recommendations of principal with special remarks.
Place of posting requested for
Preference College and Place
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