JAHAR NAVODAYA VIDYALAYA SELECTION TEST 2011-12

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					                     JAHAR NAVODAYA VIDYALAYA SELECTION TEST 2011-12
                                LATERAL ENTRY – CLASS IX


                                APPLICATION FORM                                            Passport size
                                                                                         photograph of the
                                                                                         individual attested
ROLL NO                                                                                    by Head of the
(To be left blank . To be filled by the Office of Principal, JNV)                           school where
                                                                                         candidate studying
      1. Name of the Candidates _________________________________________                   in class VIII
         (in block letter)
      2. Father’s name_________________________________________________
         (in block letter)

      3. Mother’s Name________________________________________________
         (in block letter)

      4. Name of the Guardian___________________________________________
         (in case father/Mother is not guardian)

      5. Relationship with Guardian_______________________________________

      6. Nationality of the candidate_______________________________________

      7. Present postal Address: ………………………………………………………..

         …………………………………………………………………………………

         …………………………………………………………………………………

          …………………………………………………………………………………
      8. Tick the appropriate Box.

  (a ) Sex     Boy     Girl      (b) Category Gen         SC        ST     OBC        Rural    Urban



(c)      Marital Status:               Married                      Unmarried


  9. (a) Date of Birth (in figure s)
           Date                  Month                     Year

         Date of Birth ( in words)………………………………………………………………………

      (b) Identification Mark …………………………………………………………………………..
10.     Name of the school where candidate was studying his/her class VIII during 2010-2011:
       …………………………………………………………………………………………………
(b)    Whether recognized                     Yes/No
        (Tick appropriate)
11.     Medium through which candidates is studying in Class-VIII:
            Hindi                             English



12.     CERTIFICATE BY CANDIDATE/GUARDIAN
        Certified that the information given above is true to the best of my knowledge and belief. In case
        any of the information given above is found incorrect, I will abide by the decision of the Samiti.




      Signature of father/Guardian ( With date)                    Signature of Candidate ( With date)

      13.      Certified by the Head of the School where candidate has studied in class-VIII during
               2010-11:
            This is certified that Master/Ms: ………………………………………………
            S/O, D/O Shri…………………………………………………………………..
            studying in the School since ………………………………………………….
                                                         And


            He/she has passed /appeared for his / her Class VIII examination from this school
            As per school record his/ her date of birth is …………………………( in figures)
            …………………………………………………………………………( in words)
            He/She belongs to SC/ST/Others category and his /her caste is …………………..


            This is also certified that entries made by the applicant in the application form are correct as per
            school record.
            Date:…………......................

                                                                          Signature of the Head of School
                                                                                   (with official stamp)
                         JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST 2011-12
                                 LATERAL ENTRY – CLASS IX

                                                     ADMIT CARD

Day & Date of examination
Sunday 8th May 2011                                                                          Roll No.


Time 10.00 hrs.
(Candidates to report 30 Minutes before )                                                         Passport size
                                                                                                  photograph of the
                                                                                                  individual attested
Venue: Jawahar Navodaya Vidyalaya                                                                 by Head of the
……………………………………...                                                                                 school where
……………………………………..                                                                                  candidate studying
                                                                                                  in class VIII
    (1) Name of the Candidate ……………………………………………..
    (2) Father’s Name ……………………………………………………...
    (3) Date of Birth ………………………………………………(Figures)
    ………………………………………………………………….(Words)

    (4) Category : ( Encircle appropriate )
              (i) Boy/Girl                                                                (ii) Gen./SC/ST/OBC

      Signature of the candidate in the presence of                       To be left blank for obtaining signature
      HM/Principal of the school where the                                of the candidate in the presence of center
      candidate is studying in her/his class VIII                         Supdt / Invigilator on the day of exam
      during 2010-11




-------------------------------------------------------------------------------------------------------------------------------

                                              ACKNOWLEDGEMENT
Receipt No._____________________

Received application form from Master/Ms………………………………………………………….. S/o
D/o Sh…………………………………………………Student of ……………………………………
School for admission in Jawahar Navodaya Vidyalaya Selection Test lateral Entry – IX 2011-12.


                                                                                       PRINCIPAL
                                                                                 JNV…………………………….
                                                                                 Dist:……………………………
                                                                                 State……………………………

				
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