(Please do not send this form to the exam office ; it is to be retained at the centre.

INDIAN ASSOCIATION OF PHYSICS TEACHERS

NATIONAL STANDARD EXAMINATIONS
2012 - 2013
Name of the Student : _________________________________________________________
Standard (Class)

: _________________ Date of Birth : _____/_____/_______________

School/College
(in which studying)

: ________________________________________________________
________________________________________________________

Residential Address : ________________________________________________________

___________________________________________________________________________________
_________________________________________________________________________________
Phone No. (with STD) : (

) _________________ (Mob.) _______________________

Appearing for (Please put R for the appropriate examination.):

NSEP

/ NSEC

/ NSEB

/ NSEA

/ NSEJS

Centre No. : __________________ Roll No. : _______________ (Allotted by the Centre in-charge)
(This form is to be retained at the centre.)
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%
(Receipt Cum Admit Card)
Received Rs. _______________ (in words Rs. ______________________________________)
From (Mr. / Ms.) ________________________________________________________________
Centre No. : _________________

Date : _______________

Roll No. : ____________ (Allotted by the Centre in-charge)

School / College Stamp

Signature of the
Centre in-charge