APPLICATION FORM/ ADMIT CARD

S. No.

National Talent Search Examination (NTSE)- 2017

(for the students studYing In Class
Science
Read the instructions

Branch,

carefully

Directorate

~~
-- .......... _. __ ._ .._--------_._-

xl

of Education,

Delhi

given on the back and take help of your teacher/

forrn-cum-edrmt

filling up the application

parent

Paste Latest

for

card.

...........

------_

---

----------_

------------------_._---

Date of Exarninetlon.

13 Nov. 2016 at 10.00 AM

Name of Examination

Centre:

Passport Photo

....... __ ...._-_ ...-

Dot. oj Girth

State Level Roll No, (11 digit

rnrn

CO DC
D.,e

MOnth

YeO'

Nam. oj tho ~tudontldo not wri'. Mj,./ M.,t.rj

l.

llbl Ma'ner', N~me Ido not ri'e M./O,./Ptof. ~".I

ll~) f~the", N".

~ Idono, write M,.jOr.{Pcof. etc.)

ITIIIIIITI
l. !>e.

I DDL,-,-_I:::::::JLL"-,--'-- --1-'-ClI.JID

4..e.;" wnid> ",.d"n'

rn

." de.

[TIU]
Rural

M.le

6. OI.~blllly S'~'u.
"f C.ndKl~'~ [

5. C~>t. C.Uec<>fY
"' <tuMn'
lotta'" nnifi""'el

t~'"cenific~'el

V
ally '~I

rn
sc

Urbon

I TI

ITJ~

lo Vi,lon Bind

1. Po".1 .dd . far COllupondence [do not writ! lother', or yOurn~mel

[[llJ]
8,No""e and add! of th. School/ institutl,>"

whkh 'tudvlng

I"

ITIIIIIJ

serecue

In Cia X

PIN Code

rr=cco

!I TW" 01in"itution In whl<h "udylng in Cl" ~

[IJ
II.

Gov!.

Medium of e min.,ion., ,he .te level.

Write n for En,. and lS fa, Hindi

D
D

is.

Molh.,.', Educa,lon

'"

No. of Brother>

21.

Poren,.1 Annu,lln(Qme lin R.I

o::::J

Up'" 1.00.000/.
11.

[!]

loc.ol800V

is

o::::J

OJ

No.

I~

P,ivate

CD

11.NO. offomilv

Occupoti"n

01Sist."

zu

IT]

CD

Z,OO.OOI
to 3,00.000

1,00.001 '0 4.00,000

[!]

lJ. F.ther',
Educati""

U,b.n

U.

f.,Ile'-'
Occupation

member> li";n& in the hau.e

At what no. i. th~ .tude"t

omon~ hi,/h., broth."

[IJ

4.00.001 to 5.00.000

.nd ,i"."

OJ

Mo,. ,hon 5.00,000

ITIIIJJJ[[I]

ITIIIJJJ[[I]

ITIIIIIIJ

whid> the 'ochoal i, loc.ted

[!] Auul

Il. Option lorl"",u.go T".

Wd,. 01 fo. Enl. & Ollor Hindi

16, Mothd,

1.00.001 to z.co.ooo

Telephone

60.t.Aloed

10. .<un

Mobile Princip.l

Studen. Ph"ne IRe<idonco/ Mb.)

To be filled by the Head of School/Institution

Certified that:
(1)
MisS/Master

~I

secured

% marks in

ls a regular student of the School/ Institution and he/she has

from class IX 10 X. He/She has

the Class IX annual examinanon i e when she/he promoted

(2(

secured
" " .... marks out of " ...." ....,,' (candidale mu~t fulfill the criteria announced by State/UTI.
The School where the student was studying is Govt./local Bodv/Gcvr. Aided! Public School.

(3(

Miss/ Master
records maintained

(4(

belong> to Scheduled Caste/ Scheduled Tribe category as per the

in the School/ institution.

otherwise FORM WILL BE REJECTED,)

The particulars given by his/her in the Application

{lor

SC/STjPH/VC/Low

vision/Hearing/

Ortho

must attach

form have beer! verified and found in order.

Dale

Signature of Principal/Head

Signature of the Student

(see in~tructions overleaf)

of School (with Office Seal)

certificare

INSTRUCTIONS

for the STUDENTS

for FILLING-UP

the APPLICAITIONLADMIT

CARD and the OMR SHEET

Coding Plan
Read instructions

carefully

Important:

before

filling

up the Application-cum-Admit

Submit

the application-cum-Admit

original

& ~ readable

Card and the OMR Sheet

(2 copies]

Card in Duplicate

and proforma-A

oI~f,'

in:t~lC~oPies

-1

Xerox), .

1. Use only Blue or Black - Ball Point Pen. WRITE IN CAPITAL LmERS. Do not mark or write outside the boxes.
2. Leave one box blank between two words. Limit your name and address within the space provided for it. Please see example
given below.

3. Cross (X) only one of the appropriate

boxes in item no. 3,4,5,6,9,10

& 6 attachment

and 21. For Serial No.5

of certificate

is

must.

4. Please write code number in items nos. 11,12,13,14, 15 & 16 as given below:(a). Code Nos for Education.

[. Doctoral

Graduation

Upto

(bl Code Nos. for Occupation:

work ~ Clerical & related
worker
S.lncomplete

Transport
or defective

6. Students

Primary ~

Professional

Professional,

& labourer

applications-cum-admit

can not scratch/alter/change

blade/tearing/wearing

or in any other

Primary

@].

Secondary

Sr. Secondary

MCA, MBA etc.]

Medicine,

worker@,

Farmer, Fisherman

Roll Number,

Graduation

(not classified as earlier occupation)

Post

Any other~.
executive

and Managerial

& related worker ~ Production

0. Not Employed

& related

~,

cards will be rejected.

an incorrect

answer

once marked

on OMR Sheet,

by using white

fluid/

eraser/

form,

7. Students have to retain Question Booklet after exam.

8. Students must reach the examination centre at least half an hour before the commencement
the seat that bears his/her

@I,

& related worker ~ Administrative

Technical

work@. Sales/Service

operators

Upper

Degree(Engineering,

of the examination

and occupy

it is also advised to Visit the exam centre one day before the examination.

9. DO NOT take the calculator, mathematical table, cell phone or any other kin/! of ready reckoner in the examination hall.
10. The examination will be conducted in three sessions on the same day.
11, You have to take the examination in THREE PARTS: part-j: is confined to the Mental Ability Test (MAT) consisting of SO
compulsory questions, part-u: of Language (English or Hindi) SO questions, Part-Ill: Scholastic Aptitude Test (SAT) consisting of
100 compulsory questions from eight subjects (Physics, Chemistry, Biology, Mathematics,
History, Geography, Civics &
Economics)

12. Time for Part-I is 45 minutes, for Part-H is 45 minutes and for
13. Each question carries 1 (one) mark.
14. All questions in the booklets are objective type. For each
correct. Your task is to find out the correct answer and mark your
15. Record your answer using the blue/black ball point pen. You
the circle (.

on the serial number

of the correct

alternative.

Part-III is 90 minutes.
question

FOUR possible

answers

are given, but only one is

choice in the Answer Sheet (OMR) only in correct way.

have to indicate

your answer on the OMR Sheet by darkening

No cutting/erasing/rubbing

is allowed

on the OMR Sheet in any

form.

16. During the examination follow the instructions of the invigilator strictly.
17. Hand over your OMR Sheet duly filled on both sides to the invigilator before you leave the Examination Hall.
18. Write your Name, Roll Number, Category and School as given in the Application-cum-Admit
Card on the OMR Sheet and on
the cover page of the Question

Booklet in the space provided

as per example given below.

19. The Exam lncharge should ensure that students fill in correct information
candidate

should

SC/ST/PH!VC/Low

fill

correct/true

vision/Low

information

about

Hearlng/Orthopedlc/Hllno

caste/disability

categories,

otherwise

in all, specifically
category
application

and

in Casle/ Disability category. The

also

enclosed

certificate

forms will be rejected,

e.g.

1. NAME

SHE

2. ROLL NUMBER

, ,

3. CATEGORY
(MUch copyet Ce,,;fic.tel

, ,

lQ)IlQ) ,lQ) lQ),lQ)

IlQ) lQ)IlQ)
~
-05
Q) IQ) ,Q) Q) IQ) Q) IQ) Q)
2 IQ
IW
W IW IW W IW W IW

r-w-

1\lJ OJ 1<1

OJ

1\lJ 1<1

Il') l')Il') 0) 10) ~

IW
1 W W IW W
1<.' @ s
I'"

1(;)

I~

10

0 10

1\lJ
, I~
3

I'" I'"
'" '" '"

@
@
I@
I@
-'! 'e! -'! I"
"
"

JJ

1<1

JJ

10

JJ

1<2) <2) 1<2) , <2) <2) 1<2)

(;)

1(;)

4. SCHOOL

I eovt.

se
General

'\lJ

se

(;)

ST

(6)

Physically

Handicapped

Visually Challenged

<2) 1<2) <2)

Govt.

Govt. Aided

NDMC/MCD

for

S4\c....
1st STAGE - National Talent Search Examination (NTSE - for Class X Students)
GNCT of Delhi, Directorate of Education, Delhi
SCIENCE BRANCH
Behind lady Shri Ram College, lajpat

(To be submitted in triplicate on A4 Size Paper)

alongwith

Moblle( Exam tncharge):

CATEGORY CERTIFICATE & DUPLICATE COPY of Application-cum-Admit

II

Name & Address of the School

SOhOOliD

ZONEI-':'-':"-_- _-.I

Name of Candidate

Father's Name

in Class-IX

Area(RURAL/URBAN)C====j

Whether

(2015-16). Min. 60%

SC/ST/Phy.

for Gen. & 55% for

cnan. (Attach

o.

c.

Card

MObil,1I

T'I.SOhOOIc=J

DlSnC=:j

% of Marks
S.No.

- 2016-17

WELL TYPED ANO PROPERLY SIGNED with MARKS ONLY in % (percentage)

Type of School (GOVT./AIDED/NDMC/MCD):

PROFORMA-"A"

Nagar-IV, New Delhi-24

Summary cum Attendance Sheet

List of Students for NTSExamination
Submit this Proforma,

2017

Signature of the Student

Roll No.

at the time of submission

(to be filled in by Sdence

of Application

Branch)

c.

Signature of the
Student
Examination

225170
225170
225170
225170
225170
225170
225170
225170
225170
225170
To be filled in by the Centre Supdt.

Total Number of Students

Boys
Sen

Girls:

--

SC
__ ST
-- PH --

G,o

--

Note: Do not leave any column blank, if the student is absent, write ABST with Red Pen

5(

-- ST-- PH --

Sign. of HoS

Total Number of Students:

Seal of School

Sign. of Teacher Incharge

Present

Absent

Mob:
Note: Please attach attested copy of SC/ST/PH(VC/Low
Certificate of the student issued by the competent
SI.No. on it as in Proforma"A"

Vision/Hearing/Ortho

authority

and put the same

Forms will be rejected without

Certificates.

Name & Sign. of

lnvigllators

Name & Sign. of Centre Supdt.

with Seal

at
Hall