APPLICATION FORM FOR PARTICIPATION IN REGIONAL MATHEMATICAL OLYMPIAD

UTTARAKHAND 2014
The form must reach Dr. M.C. Joshi Coordinator (RMO), Department of Mathematics, DSB Campus,
Kumaun University, Nainital-263002 by OCTOBER 30, 2014

Name of Candidate ..
Fathers Name .
Address for Correspondence
Pin Code
Name and address of the college where enrolled in class XI
Pin Code
Details of High School or equivalent examination (Enclose attested copy of Mark sheet):Roll No. .year percentage of marks in Mathematics
Center (Desired*)
Bank DRAFT No./ Cash Receipt No. ** for Rs. 150.00 dated .
Payable to :

Coordinator RMO Uttarakhand, at Nainital.

Signature of Candidate (in full)

Signature & Seal of the Principal

* List of Centers : Pantnagar, Roorkee, Srinagar (Garhwal), Almora, Dehradun, Nainital, Kotdwara, Haldwani and Hardwar
** For those depositing in cash at Nainital.

(Center In charges Copy)

(To be filled by the candidate)

RMO Roll No.

Name .
Fathers Name ..

..
Photograph

College where studying

Signature of the candidate

..
Seal of the
Coordinator

Seal and Signature of the

Principal on the
photograph

ADMIT CARD
Date of the examination December 7, 2014 (From 1 P.M. to 4 P.M.) Sunday.

RMO Roll No.

Name ...
Fathers Name

..

Center (desired) Please write complete address of the centre .

Signature of the candidate ..

Seal of the Coordinator