'II!I! II!

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I GOVERNMENT OF NATIONAL CAPITAL TERRITORY OF DELHI
I,'ill DIRECTORATE OF EDUCATION, SCIENCE & TV BRANCH
I, I !!h , 2ND, FLOOR, OLD GARGI COLLEGE BUILDING, LAJPAT NAGAR-IV,
IlL!," NEW DELHI-lt0024

I,I !nilIli!1
'j!': I:i Ph. No: 26280410& 12;email: sciencebranchrmgmaiLcom

I ',bE,40(131IDDE (Sc,I' NTSE/2017-18/ 7 "-0~0 Dated: :(:{ 18) /7-

l'llillll'l,,: To,
!Iliil:
II
i. II!''I:i,
I"
All the Heads,
Govt.lGovt. Aided! Unaided recoqnized Schools
Delhil New Delhi.
I ", I' "

IiII'I 'iiii'li-:i~~!
: ,
! Subject: Public Information Regarding
1111, I I
IIIII';;I!I 1 First Stage National Talent Search Exam. (NTSE)-2018 (2 Stage to be conducted by
nd

1.
1
1: ,I I NCERT) and National Means-cum-Merit Scholarship Examination NMMS (2017-18).
i-,.1 I')? Junior Science Talent Search Examination JSTS 2017-18 Reg.
ill" 'IIi
II, "I '
i :1 ill:~ I 1 As you are already aware that Science Branch, Directorate of Education, Delhi conducts
the above Scholarship Examinations. The further details of which are as below:
1'" 'i'[
'I ""1'1 C,) NTSE 20 18- Stage rsr Exam illation will be held on 05 11.2017 for the students presently studyin In Class
'Ii X. Under this Scheme there is a provision of reservation 0) SC Category - 15% (1i) ST Category 7.5%and
i" : (iii) Physically & Hearing Challenged candidates 1% each.
,'il III
I11I iii "Cb) National Means-cum-Merit Scholarship (NMMS) 2017-18 Examination will be held on 17.12.2017 for the
III1 : students presently studying in Class VIII. Reservation as per MHRD ! GOI direction/instructions In
;I'
, NMMS Examination, only Govt./Govt.Aided/NDMC School students are eligible.

1'1'1 I cel JSTS Examination 2017-ISwili be held orr 28,01.2018 for the students presently studying in Class -IX.
SCHE[)ULE
1,1,. t,'
1'111 (A) Schedule for NTSE 2018 & NI\11\'1S 2017-18

,
.

! I:' Application-cum-Admit card &

Perfortua 'A' may be downloaded
www.edudel.nic.iu

from Dentt. Website

2 Subrnlssion ol"NTSE/NMMS 23.08.2017 to 011.09.2017
Application -nml-Admit Card&
l'crforma 'A' (Duplicate) duly filled ill
bv I-I,O_Sin the Science Branch
] I{oll No. will be issued from Sc. 23.10.2017 to 31.10.2017
Branch
4 DMe of Exam NTSE on 05.11.20Ii(SlInday) & NMMS
on 17.12.2017 (Sunday)

(B)Schedllle for JSTS 2017-18

, Application-cum-Admit card & www.cdudclnicin

Pcrforma 'A' may be downloaded
n-om DePII. Website
2 Submission 01'J8TS Application 23.08.2017 to 08.09.2017
cum-Admit Card & Performa 'A-
(Duplicate) duly filled in by )-1.0,S ill'
the Science Branch
] Roll No. will be issued 11'0111 Science 15.01.2018 to 25.01.18
Branch
4 uarc or Exam 28.01.2018

,
iI
"
, 'I
 II'
II"1 Ii' j,

Ii' :
Ii
,
i
!
-z-Eligibility Criteria

iI. Nllme lind Date of

the Exam.
Parenlal Annual
Income for the Year
Cmss as on
31.07.2017
-I. of marks for
General Categor)'
% of Marks for
SCfSTfI'H (Certificate
IiII I'. 2016-17 [Certificate is
to be attached at the
required is to be attached at the
time ohubmission of
iI time of submission of application)

'I'I,,
I NTSE 2018
05/11n017
application)
No limit Class X 60"10marks in Class IX
(2016-17)
55% Marks in Class IX
(2016-11)
,!'
n Nrv IMS-2017-18
17/l2n017
Rs. 1.50.0001- Class VIII 55% Marks in Class
VII (2016-17)
50% Marks in Class VII
(2016-17)
'II
I, I" 151'52017-18 No limit Class IX 65% Marks in Class 65% Marks in Class VIII
28/01/2018 VII[(2016-17) (2016-17)
,
ii! 111. ',I.
I
'Ii )
1. I ,j NOTE: (a) All HOS lllfly note that caste category cannot be changed after the Submission of Application forms.
'.1 ,. (b) Percentage of marks should be Calculated as per grading system and not CGIlA.
1:11
(e) Attested photocopy of caste! PH certificate must be attached with application form at the time of
,I.' submission.
11, ; I (d) Application Perfonna should be downloaded from the Website and submitted in triplicate duly

I' I
attested by HOS.

II '
!I
I ' ~I>'''''''
(Madhu Singh)
DDE(Sc.&T.V)

OEAO(l3)/OOE (S<.)I NTSE/20 17-18/7 :<'i?

Copy to :

I.) PS to Director of Edn. Directorate of Education. Old Seen .. Delhi,

I12.) Addl. DE (School & Science), Directorate ofEducmion, Old Sccn., Dclhi
.1 3.) 1\[[ IJIJEs'l)CEdn. Depu.

!I
;14.) lnchurgc. Science Centres No, I,2.3.4 lor wide puhlicity.
,5.) All E,O.s Zones I 1029 with the request 10 ensure the maximum participation
I 6) lncharge. computer Ccf with rho request to upload the Circular . Admhc-cum-Application
Performa "A" 011 the DIe. or Edit. Website as well HS public circulars and I'OI'-Up also
Form.

I,1
~
(Madhu Singh)
DDE(Sc.&T.V)

I'
i{
 I
. SCHOOL LEDER HEAD
11 _
APPLICATION -CUM-ADMIT CARD

JUNIOR SCIENCE TALENT SEARCH EXAMINATION (JSTS)- 2017-18

i to be held on 28.01.2018 (Sunday)
iI (Conducted by Science Branch, Directorate of Education, Delhi)
I

l'
1
ROLL NO. Affix Passport
Size Photograph

Schoo! 1.0 (For All Schools)

I I [
EXAMINATION Attested by HaS

CENTRE>

SCHEDULE OF EXAMINATION:-

Paper- 1
Paper- , General Knowledge
General Science & Mathematics
10.00 AM
to
Answers to be marked in OMR Sheet by Blue!
Black Ball Point Pen. Once marked, students
1.00 PM cannot change the answer."

N.B.: "students can not scratch falter/change out an incorrect answer once marked on OMR sheet by using white
fluid/whitener/blade/tearingjwearing or in any other form.

NAME OF THE STUDENT: CLASS _

FATHER NAME: CONTACT NO's _

SCHOOl NAME & AODRESS: _

PHONE: SCHOOL : MOBILE (PRINCIPAL) _

E.MAll MOBllE (EXAM lNCHARGE) _

BANK OETAllS:-

BANK NAME BANK ADDRESS BRANCH CODE IFSC CODE ACCOUNT NO. AADHAR No. OF
Student

Il) Miss/Master . is a regular student of the School/ Institution and he/she has
secured % marks in the Class a" (VIII) annual eeamtnancn i.e. when she/he promoted from class VIU to IX.
He/She has secured marks out of (candidate must fulfill the criteria announced by State/UTI.
(2) The particulars given by his/her in the Application form have been verified and found in order.

............................. (Prindpal/H.O.S) Certified that the all information given in the form are correct to the best of my knowledge.

SIGNATURE OF H.O.5. _ SIGNATURE OF CANDIDATE _

WITH OFFICE SEAL
 -PROFORMA-"A"
-.--,-------,.-------,----.,----,-,---::--:---:--~---:-.-:-:-----:::----:.,..",---,----,--:-::-::-:-::-:-:--------,
- --
Junior Science Talent Search 'Examination (for Elass IX Students) 2917-18
..
~'b
~~r-------------------~~~~~~~~~~~~~~~~-
--'"
:V
~ --- -- ------ GNCT of Delhi, Directorate of Education, Delhi
sue
SCIENCE BRANCH (To be submitted in triplicate on A4 Paper)
"c.,;- Behind Ladv Shri Ram College, lajpat Nagar-IV, New Delhi-24
\'>
Summary cum Attendance Sheet
list of Students for JSTSE Examination - 2017-18
NOTE: Submit this Proforma, WELL TYPED AND PROPERLY SIGNED with MARKS ONLY in % (percentage)

Name & Address of the School I II

ISChOOl1D TeI.SChOOf~ MObileOfHOS~

Tvpe of schooIIGOVT./AIDED/NDMC/K.V/FO~ROCO,CSOSC~H"OOOOlC,,--- ----- -~Z~O~N~EI====== olsn.C===j Area(RURAL/URBAN)C====j

% of Marks in Class-
Signature of the Student Roll No. Signature of the
VIII 12.017-18).
S.No. Name of Candidate and Student 1.0. Father's Name Date of Birth at the time of submission (to be filled in by Science Student at
(Minimum 65% of Application Branch) Examination Hall

/
/

To be filled in by the Head of School To be filled in by the Centre Supdt.

Total No. of Students: ~Do not leave any column blank, if the student is absent, write ASST with Red Pen
Certified that above students have passed VIII Class
in the year 2016-17 with atleast 65% marks. Total Number of Students:
--- Present ___ Absent

Name and Sign. of Teacher Incharge: Name & Sign. of Invigilators

Name & Sign. of HoS 1
Mob: With Seal of School Name & Sign. of Centre Supdt_
2 with Seal
 APPLICATION cum ADMIT CARD S.NO. _

National Means-cum-Ment Sc hoars

I h'P Examlnatton (NMMS) 2018
,
, (for the students studying in ClassVIII)
Science Branch, Directorate of Education, Delhi
l' Paste Latest
Read the instructions carefully gillen on the back side before filling the application form. Please take
help trom your teacher/ parent for filling up the application form. Passport Photo

Date of Examination; 17 DECEMBER. 2018 at 10.00 AM Attested by: HoS

Name of Examination Centre:

I
I
I scnccltu
(torall5d>ool,)
ITIJIII] StudentID LL..L...L--'.--'_LLL..L...L--'

Date of Birt~hI;:t:::JD
State Lel/el Roll No. (12 digits)
325180 DODO!1
O~le Month Year

1. Name of the Student (do not write Mi'" Ma'ler)

.,, 2. Father's Name (do not write Mr,/Or.jProl. ~!c.1

--,
3.Molher's Name (do not write Mr./Dr./Prof. ~t~.1
--, I
4. Se. 5. Area Inwhich .,dent r~,;de. ~. Caste Catecoryof student 7. DI.abllitySl~tU' of candidate (attach certificate)
I.ttach certific.te) Vl,uollyImp.ired
CD
Mol.
CD Fem"le
CD
Ru,,1
CD
U,ban CD CDsc CDsr CD CD [Drum ITl
'"
Gen. Oflnop.ol, H rlnl lOwvl,lon "lind Dumb & IlNF

8. Postal address for correspondence (do not write father's or your namel
r:::r::.r
I I:::o:::III:IC1 I I I I I I I [II 1=o:::ITI l=r I
I I I I I I I I I I I I I I I I I I I I I I I I I I I "N DI=I1
=IO~
9.Name and addre~s of the Sthool/ Institution in which studying in Class VIII

!;chooliD ITII=rr::IJ PIN Code o=r::::IIIJ ZONE

10. 8ank Det"ils

BANKNAME BANKADDRESS BRANCHCODE IFSCCODE ACCOUNTNO. MOHAll No. of Student

11. Parent,,1 Annual income

o::::J
Upto R.SO.OOO/
CD
R SO.00110 1.00.000/
o::::J
R. 1,00,000 to 1,50,000/'

o::rr:rr:rrm
12. Telephone

I ITIIJTIIJ Phone School Mobile Principal Student Phone (Residence! Mb.]

To be filled by the Head of school! Institution

Certified that:
(1) Mis.s/Master Is a regular student of the School/institution and he/she has secured
.........% marks in the Class VII annual examination i.e. when she/he promoted from class VII to crass VIII. He/She has
secured marks out of (candidate must fulfill the criteria announced by State/UT).
[2) The parent income (Husband & Wife both) from all source does not exceed Rs,l,SO.OOO/ and they are also provide
Income Certificate from Employer/Tehsildor of the District/Area.
I 13) The School where the student was studying is Govt./Local Bcdv/Gcvt. Aided/ Public School.
" (4) Miss/ Master ............................. belongs to Scheduled Caste/ Scheduled Tribe category as per the
records maintained in the School! Instttution.ttor SC/ST/PH/VC/Low vision/Hearing! Ortho must attach certificate
otherwise FORM WILL BE TREATED AS GENERAL)
(S) The particulars given by his/her in the Application form have been verified and found in order.
(Principal/H.O.S) Certified that the all information given in the form are ccrrect 10 the best of my knowledge.
1..............................

Date Signature of Principal/Head of School

(with Office Seal)

Signature of the Student (see instructions overleaf)

 = -c,_ -----
.-
.--.~ ._.~_~-=- - ..-National--Means~cum~Merit-S$:holar:'stlip (NMMS --tOJ Class Vllr-Students)-2U17-18 .PROFORMA-"A" "---'--
.-----_-_-+--.~(;)~~O";~-:1==-:::::::-=-
=========~-(j~N~eT~~o~t-~D~e~lh~i~;-~D~ir~e~ct~o~r~a!:te!::-~o.!:f-~E~du~~ca~t~io~n:!!,::!D~e~l~h!;;i
=:;.==-::::========1'-----
~. SCIENCE BRANCH (To be submitted in triplicate on A4 Size Paper)
~~ Behind lady Shri Ram College,Lajpat Nagar-IV, New Delhi-24

" Summary cum Attendance Sheet

list of Students for NMMS Examination 2017 18

Name & Address of the School I 15(h00110 II TeI.SChOOIC] MobileNo.of HOS~

Typeof SchoolGOVT.!
AIDED/NDMC"".------ --- ---Cz;-;o"N""1 :::::::::: orsrr, t..:==:..=j Area (RURAL/URBAN) ~

Whether
% of Marks in Class- certlflcate
Signature of the Student Roll No. Signature 01 the
VII (2017-18). Min. atte ched for
S.No. Name of Candidate and Student 1.0. Father's Name at the time of submission (to be filled in by Science Student at
55% for Gen. & 50% category
of Application 8ranch) Examination Hall
for Res. cat. SC/ST/Phy.
Chall.

32518
32518
32518
32518
32518
32518
32518
32518
32518
32518
Certified that the parental Income of the student listed above is less than To be filled in by the Centre Supdt.
Rs.1,50,OOO/- p-a- from all sources duri urin8 2016-17 & proof of the same is Note; Do not leave any column blank, if the student is absent, write Ab with Red Pen
kept in school office records. The parent income (Husband & Wife both) from all source
does not exceed Rs.l,SO,OOO/- and they are also provide
Employer/Tehsildar of the District/Area. And submitted
Income Certificate
the same with performa
from
"A"
Total Number of Students:
- Present
-- Absent
--
Name & Sign. of Invigilatofs
Sign. of Teacher Incharge: 1
Name & Sign. of Centre Supdt.
Mob: Name & Sign. of HoS 2 with Seal
Seal of School
 , iJ \.,

I , "
<
i; I
)1 Ii
I I 'I I 1, APPLICATION FORM
I i
National Talent Search EJ<amination fNTSE - 2017(1 'r th" <t(j<i~nt<stud_WR in Class 10' l

!ll ,
'J' Read the instruction carefully given on the next page before filling the application lorm. You may take the help from Spa.oelor !he
your teacher/parent for filling up the application form. Phologr.>ph {P''''lJOrt

I
!
, Date of Examination: 05-11-2017 'Il~ and Black &

: :1
Office of the Deputy Director Education (Science & T.V_ Branch), Whl'~)
, 2"floo<, old Gargi coll~ge 8uilding: Lajpat Nagar-IV,NEW OEtHIlloo24
The Photograph
'I Name of barnlnatlon Centre
Ij <hould ""'_0<-=1 by
,
I
the f4ead of the
Inrutution/Galened
I I

I State level Roll No. III digi",

I
,I

rn rn ffiIJ
Stilte code Year Centre Code Serial No.{Offke to filiI Date of Birth

[ITS] ~ CillIJ [[IJ

II : I
I
l'
1. Name of the Student (do no! write Mi~,/ Ma.ter)
Date Month Vear

',1
:i
,, ,,
II" 2 Father', Name (do not write Mr.jDr./Prof. etc.)

:i I I~ ,-!
I
3, Mothcr's Name (Do not write Mr./Dr./Prof)
II.I!
I
I.
I I"
II 4. Sex S. Ar in which student resides 6_ caste Category of student 7. Disability status

II
I,
I ,.
,I~
~
~
ITl OJ
Male Female
ITlOJRural Urban
ITlITlOJ
Gen. SC ST
[i]
Refer overleaf
[i]
for details
[i] [i]
of code.
IT]
None

I (Please "Mlase a copy of the relevant certilicate in support of information at Sr.No.6 & 7)
8. Po,tal add " for corre'pondence (do nOi write falher" or your name)
,,!

PINDTIIJ

9.Nalne ilnd add " 01 the Scl>ool/ inslitution in which udying in Class x level

I.
ITJIIIJ
I !II i: I PIN Code

111
II
10. tvce of institution in which nudyln~ In Class X 11. Area in which the School is located
[2J 0 [TI
'1

I I i Govt. locnl Body ~ Govt. Aided ~ Private Rural IJJ Urban

II I'll 12. Medium olex"minotion

1
(nl ~tthe SIn!" level. (bl at the NCERT level 13. Path r's Education 14. Father's Occupation

c::::r::::J
',II'ill.,il 15. Mother's Education 110 16. Mother's Occupation
o 17.No. of family members living In the house
o
~':I 18. No. of Brothers D 19. No. 01 Sisters D 20. AI whal no. Is Ihe ,tudent among his/her brothe~ and sisters
o
I I I 21. Parental

[TI
Annual income (in Rs.,

[TI IT] [:I:J CD

Upto 2,00,000/- 2,00,001103,00,000 3,00,001 to 5,00,000 5,00,001 to 10,00,000 More than 10,00,000

zz. Telephone No_ with 510 code 23. lmail address

I I I I
24. Mobile no.
I I I I IDo not leave this column blank)
To be flied by the Head of institution/Gillillted Officer
Certified that:
(1) Master/Miss. -. is a regular student of the School! In'litulion and he/she has securPd " marks in
the Cia" IX annual examination t.e. when she/he promoted from class IX to X. He/She has secured marks oul of ..
(2) The particular given bV him/her in the application from have been veri~ed and found in order.
(3) Master! Miss. belongs to Scheduled Castel Scheduled Tribe category as per the records maintained

I (4)
in the institution,
The particulars
(10 be filled for SC/ST candidates
given by his/her in the Application
only)
form have been verified and found in order,

II: I [(ate .. Signature

seal
of HCodmastcr/Hcadmistressess/Gazctted Officer with

I' Signature of the Candidate ..

I, (see instructions overleaf)

!
I,

t
 II>
I

I Coding Plan

II,
; I
Read instruction carefully filling up the Application Form.
1.
2.
Use only etce or Black Point pen. WRITE IN CAPITALLEITERS. Do not mark or write outside the boxes.
Leave one box blank between two words. Limit vour name and/or address within the space provided for it. Please see example as given

I
below.
i , 3. [ross(xl onlv one of the ~ppropria!e boxes in items nos. 4,5,6,7.10,11 and 21.
i 4. Please writ~ code number in 'terns numbers 12.13.14.15 and 16 as given overleaf.
I
"

S. It is the responsibility of the candid"l" "nd the principii I01 the school to deposit the fill~d in torm with the state concerned Officer before the
I: last date. No request fOI condoning delay in submission will be entertained whether it is due to the f~ull of the Candidate or the
I,
Headmaster/Principal of his/her institution
I 6. Incomplete or defensive apphcations are liable to be rejected.
4% for Physiealtv Challenged Group of Students. with ben.t:hmark disabilities of whiCh. One per cent each shall be reserved for persons with
beBChmark disabilities under creoses la).lb) and Ie) and one percent for persons with benchmar1c disabilities under claus", (d) ilnd (e) namely:
(a) Blindness and low vision:
(b) Deaf and hard of hearing;
(e) locomotor disability including cerebral palsy. leprosy cured. dwarfism, acid attack vklims and muscular dystrophy;
(d) lIu\,sm. intellectual disability. specific learning disability and mental iliness;
Ie) Multiple disabilities from amongst persons under clauses (a) to (d) including deaf - blindness in the posts identified for each disabilities"

Illl, I
I ,
I
~.ample for writing Name and Address.
father's Name
j
10 I I p I I G I u I PiT IA I

I ' i ,I I 5 I /
Postal Address' do not try to write complete address in one line Break it appropriately as shown below:-

-
I
I 6 I 1M 10 IU IN ! T I I RiO I A I 0 I
I Ic I" If I ,I I I I PIN I I I I I I I

-,-
IN

. ..
A
I'
~

-
)< ef\IT

I, Medium 01 Examination
{Refer to item 12)
fducation of Father or Mother IRl'fer to
uem Nos 13 & 13
""" ..." "",;"",
"
Med,umof Code Education Code "
""
Moftlpu,

,
Examination M ~.I

"
Assamese t No Formal Education MI,oram

,
i
N I ~
"
Bangia
" Up to primary
"
!lkklm

fn~lish B Upper prima"" 3 [,,'

Til"""
A & N 1.I,.d. "

w~_
"

-
ao
"is
Gujarati Secondary

"
thO/kII>nd
Hindi Senior secor>dary 5
"

i
Kannada

Marathi
rs

"ta
Graduation

Post graduation
6

r ~.
Oo...-.:J~'"

Jam"",&IC.a.run11
"
"
"
"
Malayalam Doctoral 8 H.",.n. "
'"as
Hlmach,l Pr.desh
Qriya 19 Professional degree 9 Pu"j.b

, {Engineering. LoW.Medkain, ROI",h.n so

MCA, SA, etc)
Punjab! 20
Un" Orod h
U rall",,<1
"'n

--"
W,"
Tamil
"
00"."1,&>1.
"
"as
o. .n& Oio

"
Telugu
O&N"'~

Urdu 23
__ raPno:l"'" "
Father's /Mother's occupation Irefer to item Nos 14 &16) "
Occupation Code
Mo """''''
"
""
Sou,_ .tId",. P,od
Professional i Kom""
Executive and Managerial z
"
~.ral.
Clerical
Business ,
3 l.O~.h.ow"o
"

..-
Pondl,h.,,",
, Agriculture, fishery 5 l.m,1 N>du

. Production and Transport
Op(!rators and labourers
6
r
fol.nl''
"
,
,
Not employed 8

Type of School/lnslltutlons Ire fer to item NO.IO)

" GOVERNMENT A Government school is that which is run by the State Government or Public Sector undertaking or an Autonomous Organization
completely financed bv the Government
I lOCAL BOOY A Local Body School,s that which is run by Panchoyati Raj And local body institutions such as zua Parlchad, municipal Corporation
r Municipal Committee and C~ntonment Board.
t ~RIVATI:AIDED II povate aided schoOl is that which is run by an individual ot"0 private organization and receives gron\ from government or local

!! PRIVATEUNAIDED
body.
Private Unaided School is that which is managed by an individual Or a private organization and does not receive any grant from
Government or local body.
----- - - - - ..-
_-_ - . 'C'_ - . . . . .. .c. .. - - - --- - ~
--
------
--~-.--~~-
.
--.-----
..-
- -- .- -
-- - ..... - . o. "'.::.-- _____ -BtSTAGF- National-Talent-Search Examinaticfn~{NTSE---for Class-X"Stuoents} 201B --;:~~-
- -
-_PROfORMA"A N
.

-
-

- - __~N<:r-of=OeltirDirectorate-oJ:E:dll.Catron, D'el ~ --_.-

--- - -.~~--
-()">'
.'> - -
",,<,;' SCIENCE BRANCH (To be submitted in triplicate on A-4 Size Paper)
Behind lady Shri Ram College, lajpat Nagar-IV, New Oelhi-24
~
Summary cum Attendance Sheet
List of Students for NTS Examlna'tion - 2017-18
Submit this Proforma, WELL TYPED AND PROPERLY SIGNED with MARKS ONLY in % [percentage] alongwith ATIESTED CATEGORY CERTIFICATE ISSUEDBY THE COMPETENT AUTHORITY AND
PUT THE SAME AT SERIAL NO. PROFORMA "AU ( CANDIDATEWilL BE TREATED AS GENERAL WITHOUT CERTIFICATE.)

Name & Address of the Scheel I ISChoellO II Tel.SCheele=] Mobile No.of Hosil
Type of School (GOVT./AIDED/NDMC/K~.V~/=FO=R=C='=S=SC=H=O=O=l-.-
---- -'Z=O=N""I====== OISTT.t=::===j Area (RURALIURBAN)C:===j

Whether
% of Marks in Class-IX Certificate Signature of the Student Rol! No. Signature of the
(2017-18). Min. 60% attached for
S.No. Name of Candidate and Student I.D. Father's Name at the time of submission (to be filled in by Science Student at
for Gen. & 55% for category of Application Branch) Examination Hall
Res. Cat. SCjSTjPhy.

225180
225180
225180
225180
225180
225180
225180
225180
225180
225180
Total Number of Students To be filled in by the Centre Supdt.
Boys Girls: Note: Do not leave any column blank, if the student Is absent, write ABSTwith Red Pen
Gen. -- SC-- ST -- PH -- Gee -- SC-- ST__ PH --

Sign. of Teacher Incharge

Total Number of Students: Present
--- Absent ___
Name & Sign. of Invigilators
Mob: 1
Name &Slgn. of HaS Name & Sign. of Centre Supdt.
, With Seal of School 2 with Seal