1. No category

JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST 2015-16
LATERAL ENTRY – CLASS IX
APPLICATION FORM
Passport
size
photogra
Roll No.
ph of the
individual
attested
(To be left blank. To be filled by the Office of Principal, JNV)
by Head
of the
1.
Name of the Candidate_________________________________________
school
(in block letters)
where
candidate
2.
Father’s name________________________________________________
studying
(in block letters)
in class
3.
Mother’s Name_______________________________________________
VIII
(in block letters)
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 :
…………………………………………………………………………………….
…………………………………………………………………………………….
…………………………………………………………………………………….
Tel :______________/_________________Mobile No.____________________
STD Code
Number
8.
Tick ( √ ) the appropriate Box :
(a)
(c)
9.
(a)
Sex
Boy
Girl
(b) Category Gen.
Marital Status :
SC
Married
ST
OBC
Unmarried
Date of Birth (in figures)
Date
Month
Year
Date of Birth (in words)………………………………………………………
(b)
10.
Identification Mark…………………………………………………………..
Name of the school where candidate was studying his/her class VIII during 2014-2015
:
……………………………………..…………………………………………………
(b)
Whether recognized
(Tick appropriate)
Yes/No
11.
Medium through which candidate 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)
13.
Signature of Candidate (With date)
Certified by the Head of the School where candidate has studied in Class -VIII
during 2014-15 :
This is certified that Master/Ms……………………………………………………
S/o, D/o Shri…..............................................................................................….was
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/Other
is……………………………….
category
and
his/her
caste
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- 2015-16
LATERAL ENTRY – CLASS IX
ADMIT CARD
Day & Date of Examination
Sunday 7th June 2015
Roll No.
Time 10.00 Hrs.
(Candidates to report 30 Minutes before)
Passport size
photograph of
the candidate
Venue : Jawahar Navodaya Vidyalaya
duly attested by
………………………………………….
head of the
………………………………………….
school where
candidate
(1)
Name of the candidate………………………………………………………
studying in Class
(2)
Father’s Name………………………………………………………………
VIII.
(3)
Date of Birth………………………………………………………………..
………………………………………………………………………(Words)
……………………………………….(Figures)
(4)
Category : (Encircle appropriate)
(i)
Boy / Girl
Signature of the candidate in the
presence of HM/Principal of the school
where the candidate is studying in
her/her class VIII during 2014-15.
(ii)
Gen. / SC / ST / OBC
To be left blank for obtaining signature
of the candidate in the presence of
Center Supdt. /Invigilator on the day of
exam.
------------------------------------------------------------------------------------------------------------------------------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, 2015-16.
PRINCIPAL
J.N.V.____________________
Distt. ____________________
State ____________________