JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST 2013-14

LATERAL ENTRY CLASS IX

APPLICATION FORM

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

Roll No.

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

1.

Name of the Candidate_________________________________________

(in block letters)

2.

Fathers name________________________________________________
(in block letters)

3.

Mothers Name_______________________________________________
(in block letters)

4.

Name of the Guardian__________________________________________

(in case Father/Mother is not guardian)

5.

Relationship with Guardian_____________________________________

6.

Nationality of the Candidate____________________________________

7.

Present Postal Address :

.
.
.
Tel :______________/_________________Mobile No.____________________
STD Code
Number

8.

Tick ( ) the appropriate Box :

(a) Sex

(c)

9.

Boy

Girl

(b) Category Gen.

SC

Married

Marital Status :

ST

OBC

Unmarried

(a) Date of Birth (in figures)

Date

(b)

Month

Year

Date of Birth (in words)

Identification Mark..

10.

Name of the school where candidate was studying his/her class VIII during 2012-2013 :
..
(b)

11.

Whether recognized
Yes/No
(Tick appropriate)
Medium through which candidate is studying in Class VIII :
Hindi
English

12.

CERTIFICATE BY CANDIDATE/GUARDIAN
Certified that the information given above is true to the best of my knowledge and belief.
In case any of the information given above is found incorrect, I will abide by the decision
of the Samiti.

Signature of Father / Guardian (With date)

13.

Signature of Candidate (With date)

Certified by the Head of the School where candidate has studied in Class -VIII
during 2012-13 :
This is certified that Master/Ms
S/o, D/o Shri...............................................................................................was
studying in the School since and he/she has passed
/appeared for his/her Class VIII examination from this school.
As per school record his/her date of birth is ...(in figures)
(in words)
He/She
belongs
to
SC/ST/Other
is.

category

and

his/her

caste

This is also certified that entries made by the applicant in the application form are correct
as per school record.
Date :.
Signature of the Head of School
(with official stamp)

JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST- 2013-14

LATERAL ENTRY CLASS IX
ADMIT CARD
Day & Date of Examination
Sunday 23rd June 2013

Roll No.

Time 10.00 Hrs.

(Candidates to report 30 Minutes before)

Venue :

Passport size
photograph of the
candidate duly
attested by head
of the school
where candidate
studying in Class
VIII.

Jawahar Navodaya Vidyalaya

.
.
(1)
(2)
(3)

Name of the candidate

Fathers Name
Date of Birth..
(Words)
.(Figures)

(4)

Category : (Encircle appropriate)

(i) Boy / Girl

Signature of the candidate in the presence of

HM/Principal of the school where the
candidate is studying in her/her class VIII
during 2012-13.

(ii)

Gen. / SC / ST / OBC

To be left blank for obtaining signature of

the candidate in the presence of Center
Supdt. /Invigilator on the day of exam.

------------------------------------------------------------------------------------------------------------------------------ACKNOWLEDGEMENT
Receipt No._______________________
Received application form from Master/Ms.______________________________________S/o
D/o Sh. _____________________________________Student of _______________________
___________________________________________________________School for admission
in Jawahar Navodaya Vidyalaya Selection Test Lateral Entry IX, 2013-14.
PRINCIPAL
J.N.V.____________________
Distt. ____________________
State ____________________