Form No.

SE(SS)

APPLICATION FORM 2023-24

Name of the Post : SPECIAL EDUCATOR (SS) SELF

ATTESTED
(FILL THE PARTIULARS IN BLOCK LETTERS)
RECENT
1. FULL NAME PHOTOGRAPH
2. FATHER'S NAME

3. DATE OF BIRTH (IN WORDS)

D D M M Y Y Y Y
4. AGE AS ON 5. SEX :
06-01-2024 YEARS MONTHS DAYS MALE FEMALE
6. CRR NUMBER.
(Mandatory)
7. MAILING ADDRESS

PIN :
8. PERMANENT
ADDRESS
PIN :

9. MOBILE NO. 10. EMAIL:

11. Educational & Professional Qualification / Other Board / Max. Marks Max marks Self Marking For Office
University Mark obtained allowed [4][3]x[5] use only
[1] [2] [3] [4] [5] [6] [7]
a. Sr.Sec (XII) 10
b.i Integrated Graduation with B.Ed Special Education with
60
RCI CRR Number.
OR
b.ii Integrated Graduation in any stream with B.Ed (Gen) 30
Certificate / Diploma in Special Education with RCI
30
CRR Number
OR
c Graduation in any stream 20
c.i B.Ed (Special Educaiton) with RCI CRR Number 40
OR
c.ii B.Ed (Genl) 10
Certificate / Diploma in Special Education with RCI CRR
30
Number
d. Post-Graduation 15
e. Computer Knowledge 05
f. Full time Experience @ 0.2. per month No. of months ____________________ 10
Part time Experience @ 0.1 per month No. of months ____________________
TOTAL OUT OF 100 100
12. UNDERTAKING BY THE APPLICANT: (A) My health and family circumstances permit me and I am willing to serve in any Educational
block of this UT. (B) Information given by me are true to the best of my knowledge and I am solely responsible for its accuracy. I am
aware that it is an offence to furnish any false information or to suppress any material information herein for which criminal proceedings
may be launched against me, besides cancellation of my candidature. (C) I have fully understood that this offer is purely on contract
basis and there is no provision for any permanent appointment under Samagra Shiksha / Department of Education and this scheme
does not provide any provision for regular appointment.

Date: Place : Full Signature of Applicant

Candidate should get his/ her application verified by the Committee.

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RECEIPT /ACKNOWLEDGMENT

Received application for SPECIAL EDUCATOR (SS) from Mr./ Ms./ Mrs. __________________________________________________
vide form No _________________________________ with __________ nos. of enclosures.

Date: Office Seal Signature of Receiving Officer

 -2-

ENCLOSURES
Sl. Name of the Enclosures No. of (
𝒇𝒐𝒓 𝒐𝒇𝒇𝒊𝒄𝒆
)
No Enclosures 𝒖𝒔𝒆 𝒐𝒏𝒍𝒚
1 Birth Certificate / Age Proof Certificate (Xth Pass)
2 Mark of Senior Secondary (XII)
3 Pass Certificate – Senior Secondary (XII)
4 Mark sheets of UG for all semesters / Consolidated
5 Provisional/ Degree Certificate of UG
6 Mark sheets of PG for all semesters / Consolidated
7 Provisional/ Degree Certificate of PG
8 Mark sheets of B.Ed. (Spl.Edn)/Diploma in Spl. Edn with RCI CRR Number
9 Degree /Certificate /Diploma in (Spl. Edn) with RCI CRR Number
10 Class XII IT Pass Certificate/ Diploma / Certificate course in Computer
11 Experience certificate from Govt. / Govt. recognised institution counter signed by the
BPOs
12 Appointment orders in support of experience certificate
13 RCI registration certificate (CRR) Provisional/ Permanent
14 Any other relevant documents, if any
Total documents submitted in figure

Signature of Applicant

FOR OFFICE USE ONLY (SCRUTINY TEAM AT STATE / BLOCK PROJECT OFFICE)
(Marks For Academic and Experience – Out of 100 marks)
Member 1 Member 2 Member 3 Vice Chairman
Marks :

Reason for variation in self

marking with candidate :
Name & Designation

Signature

CERTIFICATE
Certified that I have personally verified the submitted documents of the applicant and marks entered in
Final Marks :
the form are as per the marking scheme and the candidate is found eligible.
(out of 100)
Signature of State /Block Project Officer
Chairman, Scrutiny Committee
Name ……………………………………….. SEAL

Signature of State Project Officer Signature of Project Officer

Samagra Shiksha Samagra Shiksha
UT Mission Authority, A & N Islands UT Mission Authority, A & N Islands

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 INSTRUCTIONS TO THE CANDIDATES
1. Samagra Shiksha, UT Mission Authority, Andaman & Nicobar Islands invites applications from the eligible
candidates in the prescribed format for the post of Special Educator (SS) purely on contract basis for the
academic session 2023-24.
2. Vacancy & Qualification and other details:
Details Qualifications Nature of Duty
Vacancy : Essential Qualification:  Developing annual/monthly
03 01. Post-Graduation in any stream. calendar of activities for inclusion.
02. B.Ed. in Special Edn from a RCI  Co-planning of lessons and
Age limit : approved institute and possess a providing tips for teaching
40 years valid RCI CRR number children with disabilities
OR
implementation of IEPs.
Consolidated pay: B.Ed. with recognized qualification
 Arranging for celebrations and
Rs. 45210/- per month (Certificate / Diploma) from an RCI
workshops such as poster
approved institution equivalent to
B.Ed in Special Education and competitions, show casing success
possess a valid RCI CRR number stories and films glorifying abilities
03. Knowledge of Hindi (The candidate children with disabilities for
should have passed Hindi as one of awareness and empowerment.
the language in class 8th or 10th  Working with school council/
standard) SMDC/SMC for inclusive
Desirable Qualification: education, community and parent
01. IT as a vocational subject in Class XII volunteering activites.
or 01 year diploma certificate in  Ascertaining felt needs of
Computer teachers, develop checklist of
02. Teaching Experience in relevant
inclusion, experiential workshops
field in recognized schools.
disability sensitization etiquettes ,
family fair and ‘Inclusion Mela’.
 Teaching the CwSN students for
Senior Secondary Schools and also
provide support to the subject
teachers to tackle the CwSN
students.
Note: B.Ed general with 1 year / 2 year Diploma in Special Education or Post Graduate Professional Diploma in Special
Education (PGPD) (OR) Post Graduate Certificate in Special Education (OR) PG Diploma in Special Education (Mental
Retardation or Multiple disability : Physical and neurological (OR) Locomotors impairment and Cerebral Palsy (OR)
Secondary Level Teacher Training Course in Visual Impairment (OR) Senior Diploma in teaching the Deaf (OR) B.Ed in
Visual Imparement is equivalent to the B.Ed Special Education (OR) any other equivalent qualification approved by RCI.
As per the RCI letter No. 7-91/RCI-2011 dated 11th January, 2012.
3. Issue of Application Form : The application for the post should be filled in the prescribed form, which can be obtained
free of cost from the State Project Office and Block Project Offices / Zonal Offices viz (BPO Little Andaman,
Diglipur, Mayabunder, Rangat, Car Nicobar, Nancowrie, Campbell Bay) on any working days from 09.00 am to
04.30 pm from 28-12-2023. The application forms along with instruction may be downloaded from the departmental
website (https://education.andaman.gov.in/tops/login.aspx).
4. Submission of Application Form : The filled in application form along with photocopy of all certificates in support of
educational qualification, experience and other supporting documents must be self attested and submitted at the
designated places as mentioned in serial number 3 on or before 06-01-2024 by 05.00 pm. The candidate will bring
the original certificates / testimonials for verification while submitting the application. The candidates will submit only
one application form in any one of the designated places as mentioned at serial number 3. Submission of more than
one form from different designated places will lead to cancellation of his / her candidature.
5. The candidates should secure all documents properly and tag them (do not staple), do pagination in all supporting
documents enclosed with application form and indicate the same clearly in the application form and obtain proper
acknowledgement from the Receiving officer with date and seal after verification.
6. All supporting documents should be submitted in chronological order. Qualification mandatory for pursuing further
higher studies should invariably in sequential years.
7. Incomplete & ineligible applications and those without proper supporting documents will be summarily rejected
during submission of application by the State/Block Project Office.
8. The candidates should affix recent passport size photograph on the application form in the space provided for it and
the photo must be self attested by the candidates.
9. Once application is submitted no additional documents/certificates shall be received from the candidates thereafter.
10. The eligibility conditions (qualifications & experience) will be determined as on the closing date of receipt of
application forms i.e. 06-01-2024. The date of birth mentioned in the birth / matriculation certificate shall be taken
into consideration and no other certificate shall be entertained as proof of age.
11. To make the whole process thoroughly transparent the candidate shall himself/ herself do the self-marking in the
application form as per the marking scheme given below and get verified by the Scrutiny Committee at the designated
center.
Qualifications Gradua B.Ed. Compu
Sr. tion B.Ed (Spl.Edn) Post ter
Experi
Sec. (Gen /Diplom Gradua
ence*
(XII) ) a in Spl. tion
Edn
Integrated Graduation with B.Ed in Spl. Edn with RCI
10 60 15 05 10
CRR Number
Integrated Graduation with B.Ed (Genl) Diploma in
10 30 30 15 05 10
Spl. Edn with RCI CRR Number
Graduation with B.Ed. (Spl.Edn.) with RCI CRR Number 10 20 40 15 05 10
Graduation with B.Ed. (Genl.) and Diploma in Spl. Edn
10 20 10 30 15 05 10
with RCI CRR Number.
Mark weightage formula = 𝐌𝐚𝐫𝐤𝐬 𝐨𝐛𝐭𝐚𝐢𝐧𝐞𝐝
× 𝐌𝐚𝐱. 𝐌𝐚𝐫𝐤𝐬 𝐚𝐥𝐥𝐨𝐰𝐞𝐝
𝐌𝐚𝐱𝐢𝐦𝐮𝐦 𝐌𝐚𝐫𝐤𝐬
(upto 2 decimal points only)
* Weightage of experience mark to be calculated for the full time teacher @ 0.2 (point two) marks per month and for
part time teacher @ 0.1 (point one) mark per month for experience in Govt. / Govt. recognised schools in the relevant field
for a maximum of 10 marks. Experience of less than 15 days will be ignored.
12. The selection of candidates for the above post(s) shall be made on the basis of academic marks including experience
to the total of 100.
13. All experience certificates must be supported by the relevant engagement / appointment orders. Experience
certificates which are not supported by appointment orders shall be rejected.
14. Any information/ certificates /documents furnished by any candidate which are found to be false/ wrong or if any
candidate has either wholly or partially suppressed any material information, the candidature of such candidates for
the post shall be rejected/ terminated at any stage of engagement process and even after engagement offer is made.
In addition, as per law penal action shall also be taken against them.
15. If any university has awarded grade points (CGPA) instead of marks, the candidate should submit the conversion table
of grade points into percentage of marks issued by the university concerned failing which, the common criteria/
formula evolved by the department for such conversion shall be applied and shall be final and binding. No further
correspondence shall be entertained in this regard.
16. The Degree / PG Diploma / Diploma certificates should have been issued by recognized university / institution.
17. In relation to determination of equivalent educational qualifications, the decision of the selection committee of the
Samagra Shiksha, UT Mission Authority shall be final.
18. The competent authority shall have right to cancel or postpone the engagement at any time on any administrative
grounds. Samagra Shiksha UT Mission Authority shall not be responsible for any type of losses or damages which may
be suffered due to such cancellation.
19. In any matter not specified above shall be decided by the selection committee of the Samagra Shiksha UT Mission
Authority whose decision shall be final and binding on all those issues.
20. It is in the interest of candidates to ensure that duly filled in applications are submitted at designated place by due
date & time.
21. The selected candidates for contractual engagement should abide with the Contractual Agreement prescribed by the
UT Mission Authority, A & N Islands at the time of engagement.
22. Candidates should fill their correct mobile Number & Email Id for further correspondence regarding any kind of
information.
23. The selected candidates will be posted in any school in Andaman & Nicobar Islands.
24. The number of vacancies indicated above is only tentative. Subject to approval of competent authority, the number of
vacancies may increase or decrease at the time of preparation of panel for engagement and no claims or objection
shall be entertained.
25. The selection for the contract engagement does not entitle the candidate for any REGULAR APPOINTMENT under the
Samagra Shiksha UT Mission Authority /Andaman & Nicobar Administration.
26. All the above engagement under Samagra Shiksha shall stand concluded in the afternoon of 31.03.2024.

State Project Officer