1. No category

Rs. 250/-
²jZeY
Form No. .........................
JMI-WDAF-2015
JAMIA SCHOOLS
(Senior Secondary Section)
Affix your recent photo
(size 2"x1.5") self attested.
Photograph should be
pasted with gum and not
stapled or pinned.
25X ‹Š5ÔôeY ÔðsZ¯eY
JAMIA MILLIA ISLAMIA
JAMIA NAGAR, NEW DELHI - 110025
2015 – 2016
xg Ã
„ ZpgŠ
Application Form For Class IX / XI Sc. /XI Arts/ XI Com.
Roll No.
™Å
XÐN YŒŠšxg Ãå*
*X ³,
7Ðg¨ ÿ) Zg2Š¬Ðä½xg Ã
(to be allotted by Office)
Read the Prospectus carefully before filling up this Form. Incomplete Form will not be considered.
zgŠ ñZ,
'
„ZpgŠ
Code: eÃ
1.
Application for Class:
2.
Choice of School: Write I for first choice, II for second choice and III for third choice.
(I)
Jamia Sr. Secondary School
(See Class Code at the Back)
X ,Š ßF,
Ðg ±ZÆÏh
+IKZÃ IIIgzZ IIÔ I K
M n!*
~[ NZÆwjZ
wjZ ~g²‘eY
YH
¾
G
3. Category:~æ 54´
wjZrñŠp@+
$±
(III) Jamia Girls Sr. Secondary School wjZ ~g²‘²/
¤eY
(II)
4.
5.
6.
Syed Abid Husain Sr. Secondary School (S/F)
Name of Candidate (in block letters):
( ~szw} ,
(Æ~ ,
môZ )g ZzyZx *
*
x
Father's Name *
* »−Zz:
Mother's Name x *
* »{−Zz:
7.
Name of guardian (if any) x*
*»
„,
6u:
8.
Sex (Male/Female) /
$¸&™è)½ : .......................................
Nationality : è¸ ...........................................
9.
ì m»g ZzyZÐTx *
* »/ß ........................................................................................
10. State to which Candidate belongs
11.
Local Mailing Address (if any)
12.
Permanent Address:
( ì ðÃ/
¤ Z)$
"ÂzâñZ,
'Øò £:
Øx:
..........................................................................
..........................................................................
..........................................................................
..........................................................................
..........................................................................
..................... State
(/ß) :...........................
Pin '''' Phone No ''''''
Pin '''' 'Phone No '''''''
13.
(See Category Code at the Back)
Date of Birth (in words) ( ~V/)öZaõg *
@: .......................................................................................................................
(in figures)~VÎy :
yŠ
Day
Month
14.
Blood Group\z/
¤¤:...................
15.
Last Examination Passed
Year
Institution/Board
ƒHk*
0 Ž yJZ ~
yW
w‚
eg1&{ǽ
·
English
Year
Maths.
Science P.C.B
w‚
Aggregate
gzZ ~dÔ¾Û‚)b‚ ( yZö)À
Grade/% Grade/% Grade/% ( Yß- *
! Grade/%*
~,
môZ
è*
cg
Class VIII (for IX)
Class X (for XI Science)
Class X (for XI Arts / Com.)
* For calculating aggregate grade, please see the Prospectus
16.
17.
Institution last attended { ǽ~
y W :.....................................................................................................................................
Bank Draft No. .......................................... Date ................................ Drawn on Bank ............................. Rs. .................
(only for downloaded forms)
....................................................
Signature of Applicant g ZzyZ \Š
Date õg *
@ .........................
Form No. ......................
FOR TEST CENTRE
2015 – 2016
Affix your recent photo
(size 2"x1.5") self attested.
Photograph should be
pasted with gum and not
stapled or pinned.
JAMIA MILLIA ISLAMIA
JAMIA NAGAR, NEW DELHI - 110025
wzg
Roll No.
1.
(to be allotted by Office)
®)ñZ,
'
„ZpgŠ
Application for Class: )
2.
Choice of School (See admission Schedule before choice)
(I)
Code: eÃ
(See Class Code at the Back)
YH
4
wjZ ~g²‘eY
Jamia Sr. Secondary School
5´
3. Category:~æ¾G
wjZrñŠp@+
$±
(III) Jamia Girls Sr. Secondary School wjZ ~g²‘²¤
/
eY
(II)
(See Category Code at the Back)
Syed Abid Husain Sr. Secondary School (S/F)
( ~szw} (,
Æ~ m,
ôZ )g ZzyZx **
4.
Name of Candidate (in block letters):
5.
Father's Name x **
»−Zz:
6.
Mother's Name
Signature of Applicant
x **
»{−Zz:
g ZzyZ \Š ....................................................
ADMIT CARD
eg »Ö$+
iZ
Form No. ......................
JAMIA MILLIA ISLAMIA
Affix your recent photo
(size 2"x1.5") self attested.
Photograph should be
pasted with gum and not
stapled or pinned.
JAMIA NAGAR, NEW DELHI - 110025
2015-2016
wzg
Roll No.
1.
(to be allotted by Office)
Application for Class: )
®)ñZ,
'
„ ZpgŠ
2.
Choice of School (See admission Schedule before choice)
Code: eÃ
wjZ ~g²‘eY
(I)
Jamia Sr. Secondary School
(II)
Syed Abid Husain Sr. Secondary School (S/F)wjZrñŠp@+
$±
(III)
Jamia Girls Sr. Secondary School wjZ ~g²‘²¤
/
eY
(See Class Code at the Back)
YH
4
5´
3. Category:~æ¾G
(See Category Code at the Back)
( ~szw} (,
Æ~ m,ôZ )g ZzyZx **
4.
Name of Candidate (in block letters):
5.
Father's Name x **
»−Zz:
6.
Mother's Name
x **
»{−Zz:
..........................................
.......................................
Signature of Applicant
Signature of Invigilator
g ZzyZ \Š
ø**
\Š
.........................................
Signature of Applicant g ZzyZ \Š
at the time of Admission Test ‰
Ü zƱ
$gzZ \ŠÆá Zzä™wßzxg Ã
Signature of the Receiving Clerk & Office Stamp .............................................................. Date
õg @*.......................................
DECLARATION
I, hereby, solemnly declare that:
i) The information given in the form is true to the best of my knowledge and belief, and
ii) I have read the rules printed in the School Prospectus and agree to abide by them and accept the changes (if any)
made therein at a later stage.
I, further declare that I am not involved in any criminal case and no such case is pending against me in the court of law.
..............................................
..................................................
6,
„
u&{−Zz&−Zz\Š
õg @*
Signature of Father/Mother/Guardian
g ZzyZ \Š
Date .............................
Signature of Applicant
]*
c Z@0Ðä½xg Ã
GENERAL INSTRUCTIONS FOR FILLING THE APPLICATION FORM
1. Read the instructions given in the prospectus carefully before filling this form.
2. Category code should be given carefully. Incorrect proclamation of the category shall lead to immediate cancellation of
form/admission.
3. Apply separately for each Group (i.e. Science/ Arts/ Commerce) for Class XI.
4. Do not attach original copies of certificate of mark-sheets etc. with the form.
4. CHOICE OF SCHOOL -
ß,
FÅwjZ
- Indicate your preference for school by writing 1, 2, 3 in the boxes.
Write 1 for the first preference and 2 for the second preference and 3 for the last preference of School.
CODE eÃ
5. CLASS k¯
IX
NI
XI Science
ES
XI Arts
EA
XI Commerce
EC
6. CODE eÃ
YH
5 4´
¾
CATEGORY ~æ G
GE
''''
General
M
''''
Muslim
MW
''''-
Muslim Women
MO
''''-
Muslim OBC
MT
''''
Muslim Schedule Tribe
PD
''''
Persons with Disability
KM
''''
Kashmiri Migrant
----------------------------------------------------------------------------------------------------------------------------------------------------------------------
CERTIFICATE
(For Jamia Employee's son/ daughter only)
Certified that Mr. / Mrs. ..............................................................................................................................................................................
(Name of employee)
father/mother of ................................................................................................................ is an employee of Jamia Millia Islamia and
has been working in ....................................................................................................... as .................................................................... on
(Name of candidate)
permanent / probation / temporary /adhoc / contract / daily wages basis since .................................................
.........................................................
Counter Signature
S.O.
(Medical Section, J.M.I
..................................................
Head of the Deptt. / Office / School
Office Stamp
INSTRUCTIONS FOR WRITTEN TEST
]c*
Z@0б
1. The Examination room will open 15 minutes before the commencement of the Test. No candidate will be permitted to
enter the Examination room 15 minutes after the commencement of the Test.
2. Each candidate must show on demand his/her Admit Card during the Test. The invigilators will check and sign the
Admit Card of the candidates to satisfy themselves about the identity of each candidate.
3. Candidates must not take any book or paper except Admit Card, pen or pencil (required for use) during the Test. All
books, notes etc. should be kept outside the Examination room.
4. Calculator is not allowed in the Test.
5. Candidates must keep perfect silence during the Test and must not indulge in any conversation and gesticulation.
6. Violation of any of these instructions or any unfair means or copying will lead to cancellation of the Admission Test of
the candidates on the spot by the Superintendent of Examination Centre. Such candidates may also be debarred from
appearing in any future Test/Examination of this University.
7. Candidates must hand over the Booklets to the invigilator before leaving the Examination room. No page should be torn
off the Booklets.
8. It will be advisable for the candidates to visit their Centre at least a day earlier to know the exact location.
Admission Schedule 2015 - 2016
Class
Date of Entrance Test
Time
IX
24th May, 2015
9:00 – 11:00 a.m.
XI-Science
31st May, 2015
9:00 – 11:00 a.m.
XI-Arts
1st June, 2015
9:00 – 11:00 a.m.
XI-Commerce
2nd June, 2015
9:00 – 11:00 a.m.