INDIAN ASSOCIATION OF PHYSICS TEACHERS

NATIONAL STANDARD EXAMINATIONS

2010 - 2011

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

Signature of the
School / College Stamp
Date : _______________ Centre in-charge