AFFII6AII0N F0M

0|81kk0f lfkkk|k0 Pk00kkNNf8 0lk88X|, X||(X|||

k0k0fN|0 8f88|0k 20112012

4. kame et the 8taeat :
5. Iather's kame :
6. Nether's kame :
7. 8tate et 0em|c||e:
9. 0eaer :
N I
8. 0ate et 8|rth :
0 N N Y Y Y Y 0
0fk 80 080 81
10. 0ategery :
08 Ph
0|staace leara|ag Pregrammes
1
0eposited Rs. :
0u A/C of (course uame) :
Materia| giveu by haud :
Rest materia| (lf auy) : 8y haud 0ispatch
Fee Receipt lo. :_____________ Remarls : ________________________
0ate : _____________ Auth. Sigu : __________
Ier 0tt|ce 0se
1. 0se ea|y 0kP|1kl lf11fk8et fag||sh |aagaage tecemp|ete the kpp||cat|ea Ierm.
3. Paste year receat|y
ta|ea passpert s|te
0e|ear Phetegraph
(3.5cm x 4.5cm|
ke||. ke.
2. 0earse Iee :
kmeaat
00 ke.
8raach
0|ty
0ate
kmeaat
00 ke.
8aa|
0|ty
0ate
00
kt keseaaace's 0eatre
0ash |t epes|te |a |0|0| ( 88| 8aa| ( |
0ehraaa ka|tha| 0era|hapar Natattarpar Varaaas| 8hat|aa
0aagapar c|ty 0wa||er latar kampar 8e|are
0aya hyera|a Naa|apar 8ha|t| kagar (k1P0| 0heaaa|
kete :
Prepese 0eatres
khmea|a' Nam|a|kera|' Ja|par' kew 0e|h|west' 8r| 0aagaaagar 8ha|aeshwar'
Nam|a|kaher|' kaapar 0haa|garh'' kew 0e|h|8eath' 8eag|ara'
Nam|a|1haae' 8||aaer kew 0e|h|kw' 0a|par' k[mer Jehpar
Nam|a|0aar' ke||ata' 0haa|a Pataa' 8haga|par
|aere'' 8hepa|' kgra lac|aew' kew 0e|h|fast' kaach|''
keta' 0awahat| kagpar' ka|par 8h||a|
0eat|rme 0eatres
Memory based | SA Stream-C|ass Xl | S8+2 Stream-C|ass Xll | lo Scho|arship
III-JEE | AIFMI | AIEEE | 0IMFIA8 | kvF | NI8E
l|ve 1est ser|es ter ||1Jff (0|assX|| w||| |e ceaacte at 80s & |0s ea|y.
l|ve 1est 8er|es ter k|fff (0|ass X||(X|| passe| w||| |e ceaacte at 80s ea|y.
' 80s '' |0s
8.ke. 6ourso Namo
1.
2.
3.
0u|iue Test Series
8ooster+C0
C0
fag||sh
l|ve 0a||ae Pesta|
h|a|
13. Ne|am et 8ta|es ( |
14. 1est Nee (k|18 ( N18|
0oo oar (kII} Frogrammo
0lk88 : X| X|| X|| Passe
1|c| re|evaat ( |
1.
2.
5. Scieuce Practica| 8ool
Combo Pacl
(Test Papers 8 Study Materia| for SA Stream)
Test Papers of Last 4 Years (SA Stream)
Test Papers of Last 4 Years (S8 + 2 Stream)
8.No. kvF Mator|a| kI kII
l.A.
3.
4.
Study Materia| (SA Stream) l.A.
8.ke. 6ourso Namo
6.
5.
1.
2.
3.
4.
III-JEE AIEEE AIFMI
Comp|ete Paclage (SMP+AlTS+RP)
A|| ludia Test Series (AlTS) - Live
Study Materia| Paclage - SMP
l.A.
A|| ludia Test Series (AlTS) - Posta|
A|| ludia Test Series (AlTS)-0u|iue (Eug. medium ou|y)
A|| ludia 0peu Test (Al0T)
8.ke. 6ourso Namo III-JEE AIEEE AIFMI
9.
10.
11.
12.
13.
7.
8. Comp|ete Revisiou Paclage(RP) (R8,RM,RR, R-Rec.)
Major Test Series (MTS)
Raul 8ooster
Raul Master
Raul Refiuer
Ready Reclouer
lCERT - 8oard 0uestiou 8aul (808)
l.A.
kvF Frogrammos (Eog||sh Mod|um}
II8AI Frogrammos (Eog||sh Mod|um}
12. 0he|ce et 1est 0eatre ter kk|18 ||1Jff ( | ( k|fff ( |
11.
16. kcaem|c Pertermaace |a |ast passe eat 0|ass :
0|ass Year et Pass|ag 0at kame et the 8chee| 0|ty 8tate 8ear Nar|s (kggregate| kemar|s (|t kay|
18.
Te|. No. :
SD Ccoe}
0
e|epncne Nc.}
17. Preseat|y 8tay|ag at (8chee| kame, kress & 0eatact ke. w|th 810 cee| : _______________________________________________________________________
______________________________________________________________
19. kpp||caat's 0errespeaeace kress (0e aet wr|te year(year Iather's kame| :
0|ty(1ewa(P.0. :
0|str|ct :
8tate :
P|a 0ee :
fma|| :
0eaatry :
Voo||e No. :
0 Te|. No. :
SD Ccoe}
0
e|epncne Nc.}
20. Permaaeat kress (wr|te ea|y |t |t |s |ttereat trem 0errespeaeace kress| :
0|ty(1ewa(P.0. :
0|str|ct :
8tate :
P|a 0ee : 0eaatry :
Voo||e No. :
0 Te|. No. :
SD Ccoe}
0
e|epncne Nc.}
0f0lkkk1|0k
| here|y cert|ty that the |atermat|ea g|vea |a the app||cat|ea term(as we|| as |a a|| ether re|evaat ecameats| |s cemp|ete aa accarate te the |est et my |aew|ege aa |e||et. | aaerstaa aa
agree that m|srepreseatat|ea er em|ss|ea et tacts w||| [ast|ty the ea|a|(caace||at|ea et my am|ss|ea, er expa|s|ea tremthe |ast|tate at aay stage et the acaem|c sess|ea. | have rea aa e
here|y prev|e ceaseat te the '1erms & 0ea|t|eas' aa a|| re|evaat |atermat|ea as meat|eae |a the |atermat|ea 8rechare ter am|ss|ea |a the |ast|tate ter the acaem|c sess|ea 20112012.
Iarther, |t am|tte, | prem|se tea||e |y the ra|es & rega|at|eas aa aerms et |sc|p||ae et the |ast|tate as |eag as | rema|a a reg|sterestaeat et kf80kkk0f.
| a|se ec|are that |e|ag aa eare||e staeat et keseaaace, | w||| |e respeas|||e te |t |a terms et prev||ag re|evaat eta||s et a|| the cempet|t|ve exam|aat|eas (|a the termet trae phetecep|es et
the app||cat|ea term et the re|evaat exam|aat|ea| that | w||| |e appear|ag |a the tatare |y v|rtae et ceach|ag & acaem|c sappert trem the |ast|tate. |t | saccee |a aay et these cempet|t|ve
exam|aat|eas, the |ast|tate w||| have a|| the r|ghts et as|ag my resa|t aa phetegraph |a aay termter |ts grewth strateg|es aa eve|epmeata| p|aas. |a sach a case, |'|| aever ever have aay
8|gaatare et eae et the Pareats(0aar|aa
8|gaatare et the 8taeat
0ate P|ace 0ate P|ace
0eatact ke. :
|t 8|gae |y 0aar|aa, :
wr|te h|s(her kame
ke|at|eash|p :
22. 0hec| l|st
1we 0e|ear Passpert 8|te Phetegraph
Phetecepy et 0|ass X mar|sheet (ter c|assX|, X||(X||| staeats|
Preet et 8che|arsh|p (|t app||ca||e|
21. fmergeacy 1e|.(Ne|. ke. (ether thaa g|vea |e|ew| :
'0|ymp|as 0eaacte |y hem| 8ha|ha 0eatre ter 8c|eace facat|ea (h808f| ter the staeats et 0|ass X| & X||. Pertermaace |a aay ether 0|ymp|a w||| aet |e ceas|ere.
8cho|arsh|p 6r|tor|a Ior 2011-2012 (6|ass kI, kII, kIII passod 8tudoots}
||1Jff 0aa||t|e ( |ateraat|eaa| 0|ymp|a' Nea||st 75
50
25
20
15
10
k1 0rae |a 8c|eace & k2 0rae |a Naths er v|ce versa |a 0|ass X ( X||Nar|s 85 te 89. (P0N| er (P08|
k2 0rae |a 8c|eace & Naths |a 0|ass X ( X||Nar|s 80 te 84 (P0N| er (P08|
0| staeat et keseaaace 0lP0 er P00P (0|assreem| 0|v|s|ea( k18f ( leve| 1| aa||t|e( 0|ymp|a |eve| 1 aa||t|e.
k18f 8che|arsh|p w|aaer(kVPY I|aa| keaa 0aa||t|e(Ner|t he|er (1ep 10| et aay 8ear(|ateraat|eaa| 0|ymp|a' Part|c|pat|ea(1ep 1000 k|k |a
k|fff 2011(k|PN1 8creea|ag 0aa||t|e
k18f (leve|||| 0aa||t|e ( X||Nar|s 90 & a|eve (P0N| er (P08| ( XNar|s 91 & a|eve er k1 0rae (8c. & Naths |a|v|aa||y| (
kay e| staeat et keseaaace 0|assreem (||1Jff 0|v|s|ea|(0|ymp|a |eve| 2 aa||t|e(1ep 10015000 k|k |a k|fff 2011.
8cho|arsh|p 6atogory 8.No.
1.
2.
3.
4.
5.
6.
% 8cho|arsh|p