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You Are Here : Home > Admission > APPLICATION FORM

JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST 2009 APPLICATION FORM


                                                                             APPLICATION FORM

Passport size photograph of the individual attested by Head of the school where candidate studying

Roll No.

 

 

 

 


                            ( To be filled in by the Office of Principal, JNV).

1.

Name of the Candidate (IN BLOCK LETTERS)                                                              

                                          First Name                       Middle Name                                 Surname

Master/ Km.____________________________________________________________________________

                                                                       

2.

Tick the Appropriate Box                                  

Boy  Girl
Gen   SC    ST    OBC      Rural    Urban
a.  Sex    

 

 

b. Category

 

 

 

 

c.

 

 

d Disabled:
Physically Handicapped

 

Visually Impaired

 

Hearing Impaired

 

3.

Date of Birth :   D D   M M       year
In figure

 

 

 

 

 

 

 

In words_____________________________________________________________

  4.  a. Motherís Name (BLOCK LETTERS) ____________________________________________________________
 b. Fatherís Name (BLOCK LETTERS ):____________________________________________________________
 c. Name of the Guardian (In case father/mother is not the guardian) ___________________________________

 d. Relationship with candidate_________________________________________________________________

5.

a.  Present Postal Address ___________________________________________________________________

    _______________________________________________________________PIN Code_________________

b.  Permanent Address  ______________________________________________________________________

     ______________________________________________________________PIN Code _________________

c.  Contact Phone No. with STD code  (a) Landline _____________(b) Mobile________________

6.

Nationality : __________________________         7.  Region  _________________________________

8.

School (s) from where the candidate passed classes III, IV and is studying in class V

Classes

Class III

Class IV

Class V

a)

(1) Name of the School

 

 

(2)Category of School (Recognized/Not)

 

b)

(1) Month and Year of Joining

 

 

 

 

(2) Month of passing class V

                                   

c)

Name of the Village or Town (in which the school is located)

                                   

 

 

d)

Name of the Block

e)

Name of the District

                     

f)

*School Location : Rural/Urban

                   


9.Language (Medium) in which you want to take the selection test ___________________________.

 

* A candidate will be belonging to the Rural Category, if

 

(a) She/he had been studying for all the three academic sessions of classes 3, 4 and 5th each year from the schools located in rural areas of the district. If the candidate has studied for even a single day in Urban School, he/she will be treated as Urban.

 

(b) She/he had studied from Accredited Centres/Institutions of Serva Shiksha Abhiyan/National Institute of Open Schooling and she/he has been residing in a rural area away from the centres in case centres are in Urban area.