NAVODAYA VIDYALAYA SAMITI

JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST

CLASS VI - 2019
APPLICATION FORM

REGISTRATION NO.: 34040401487

Application is Considered under URBAN Category

State UTTARAKHAND District HARIDWAR

Name of the Candidate RISHABH PATEL
Mother's Name SUNITA PATEL Father's Name MAHENDRA PATEL
Name of the Guardian - Relationship with -
Guardian
Nationality of the INDIAN Date of Birth 07-Jan-2008
Candidate
Present Postal Address H.NO. 6 RAM DHAM COLONY HARIDWAR : 249402
Telephone - Mobile No 9105022007
Gender MALE Category OBC
Marital Status UNMARRIED Identification Mark NA
Medium of Examination ENGLISH
Disablility, if any No

Previous School Details

III Standard Details IV Standard Details V Standard Details

Name of the State UTTARAKHAND UTTARAKHAND UTTARAKHAND
Name of the District HARIDWAR HARIDWAR HARIDWAR
Name of the Block BAHADRABAD BAHADRABAD BAHADRABAD
Name of the Village HARIDWAR HARIDWAR HARIDWAR
Name of the School SATI DHRUV BAL MANDIR SATI DHRUV BAL MANDIR SATI DHRUVA BAL MANDIR
SR SEC SCHOOL SR SEC SCHOOL SR SEC SCHOOL
Recognized/Not RECOGNIZED RECOGNIZED RECOGNIZED
Recognized
School Location URBAN URBAN URBAN
Month/Year of Joining April - 2016 April - 2017 May - 2018
Month/Year of Passing March - 2017 March - 2018 -

CERTIFICATE BY CANDIDATE/PARENT/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. I will produce all the certificates at the time of admission.

Signature of the Parent Signature of the Candidate