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 1Instructions for the Candidates/Principal of SchoolsFor Filling up the Application Form ForState Level National TalentSearch Examination, 2011ANDIndian Students Studying Abroad for NTSE, 2011(For the Students Studying in Class VIII)General Instruction1. Use Legal (8.5“ x 14”) size paper for taking print.

 Instructions for Filling up the Application Form for State Level National TalentSearch Examination2. This application form is meant for the students appearing at the State Level NTSexamination conducted by each State/ UT.3. The candidate/Principal of the school must confirm thelast date for submissionof Application Form and where to submit it from the State/ UT liaison officer.Noapplication should be sent to NCERT.4. The candidate/Principal must deposit the

application fee, if any, prescribed bystate/union territory with the application form.5. The candidate/ Principal should leave the4-digit Center  code blank to be filled bythe liaison officer/ concerned district officer/ Center Superintendent.6. Incomplete/wrongly filled in application forms are liable to be rejected.7. Applicants are requested to refer/consult the application form published by the States/ UTs for caste category reservation. Someoptions of Caste Category (like OBC, Other 1and Other 2), given in the formare applicable for the State/ UT only. No reservation willbe given against these categories by the NCERT in the national level examination. 

8. NCERT is not responsible, if any other item, which is not given in the commonapplication form, has been included by the State/UT.Instructions for Indian Students Studying Abroad9.

 TheIndian Students Studying Abroadshould fill the relevant items of theapplication forms and should forwardto NCERTalong withclass VII mark sheetlatest by

March 31, 2011for consideration.10. Please mention the name of State/ UT, where the candidate wants to appear in thenational level NTS examination, in the covering letter.

 2APPLICATION FORMSTATE LEVEL NATIONAL TALENT SEARCH EXAMINATION, 2011 ANDINDIAN STUDENTS STUDYING ABROAD FOR NTSE, 2011(For the Students Studying in Class VIII)Read the instruction carefully given on the next page before filling the application form. You may take the helpfrom your teacher/ parent for filling up the application form. -Date of Examination :- Name & address of the Agency :for conducting First Level NTSExamination- Name of the State/UT :(where the candidate is studying in class VIII as a regular student)- Name of the Examination Center * :(where the candidate is studying in class VIII or likely to appear in Exam)

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- Application fee, if any(write NIL if there is no fee) Amount DD Number Date of DD Name of Bank Application No., if anyState Level 12 digit Roll Number Class VIII CodeState Code Year Center Code Serial No. (Office to fill)Class

Date of birth1. Name of the Candidate (Do not write Miss/ Master)2. Father’s Name (Do not write Mr./ Dr./ Prof.) 7. Postal address for correspondence (Do not write father’s or your name)8. Name and address of the institution in which studying at Class VIII level9. Type of the institution in which studying at

Class VIII level (see definition overleaf*)11. Medium of examination (a) at theState level14. Mother’s education17. 

Number of brothers20. Parental annualincomeUp to 50,000 50,001 to 100,000 100,001 to 1,50,000 1,50,001 to 2,00,000 2,00,001 to 2,50,000 2,50,001 to 5,00,000 More than 5,00,00021. Telephone:STD Code Phone 22. E-mail addressTo be filled in by the Head of the Institution/ Gazetted Officer Certified that:(1) Master/Miss. ………………………………………………… is a regular student of this School/Institution and he/she has secured%marks in the class VII annualexamination i.e. when he/she was promoted from Class VII to class VIII. He/ She has secured ………………… marks outof ……………….(Candidate must fulfill the criteria announced by State/UT)(2) The particulars given by him/her in the application from have been verified and found in order.(3) Master/Miss …………………………………………….. belongs to Scheduled Caste/Scheduled Tribe category as per therecords maintained in the Institution. (to be filled for SC/STcandidates only)………………………………….. ………………………………………………………Date Signature of the Headmaster/Headmistress/Gazetted Officer With Seal

…………………………………………………………..(See Instructions overleaf)Signature of the candidateSpace for thePhotograph(Passport size )The Photograph shouldbe endorsed by theHead of the Institution/ GazettedOfficer 123 456

1 1Pin CodePin CodeDateMonth Year 123. SexMale Female124. Area to which candidate residesRural Urban1 2 35. Caste category of candidateGeneralSCST1 2 3 4 12Govt.LocalBodyPrivateAidedPrivateUnaidedRural Urban10. Area in which the school is located(b) at theNCERT Level 

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12. Father’s education 13. Father’s occupation 15. Mother’s occupation18. Number of sisters16. No. of family members living in thehouse19. At what number is the candidateamong his/her 

brother and sisters1085

1 2 36. Disability Status as per PWD actOrthopedicHearin LowVision4NoneBlind74 5 6OBCOth 1Oth 2

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 3145/

6 MO U NT R O ADCoding PlanRead

 Instructions carefully before filling up the Application Form1. Use only Blue or Black Ball Point Pen. WRITE IN CAPITAL LETTERS. Do not mark or write outside the boxes.2. Leave one box blank between two words.Limit your name and/or address within the space provided for it. Please see example as given below.3. Cross (x) only one of the appropriate boxes in item nos. 4, 5, 6, 9, 10 and 20.4. Please write code number in item nos. 11, 12, 13, 14 and 15 as given overleaf.5. It is the responsibility of the candidate and The Principal of the school to deposit the filled in form with the State concernedOfficer before the last date. No requestfor condoning delay in submission will be entertained whether it is due to the fault

of the Candidate or the Headmaster/Principal of his/her institution.6. Incomplete or defective applications are liable to be rejected.Example for writing Name and AddressPostal Address: Do not try to write complete address in one line. Break it appropriately as shown below.*TYPE OF SCHOOL/INSTITUTION(Refer to item No. 9)GOVERNMENTA Government School is that which is run by the State Government orCentral Government or Public Sector Undertaking or anAutonomousOrganization completely financed by the Government.LOCAL BODYA Local Body School is that which is run by Panchayati Raj andlocalbody institutions such as Zila Parishad, Municipal Corporation, MunicipalCommittee, Notified Area Committee and Cantonment Board.PRIVATEAIDEDA Private Aided School is that which is run by an individual or a privateorganization and receives grant from government or local body.PRIVATEUNAIDEDPrivate Unaided School is that which is managed by an individual or aprivate organization and does not receive any grant either fromgovernment or local body.Region State/UTCodeNorth-EastArunachalPradesh11Assam 12Manipur 13Meghalaya 14Mizoram 15Nagaland 16Sikkim 17Tripura 18

EastA and NIslands19Bihar 20Jharkhand 21Orissa 22West Bengal 23NorthChandigarh 24Delhi 25Jammu andKashmir26Haryana 27HimachalPradesh28Punjab 29Rajasthan 30UttarPradesh31Uttaranchal 32WestChhattisgarh 33Daman andDiu34D and NHaveli35Goa 36Gujarat 37MadhyaPradesh38Maharashtra 39SouthAndhraPradesh40Karnataka 41Kerela 42Lakshadweep43Pondicherry 44Tamil Nadu 45Abroad46Medium of Examination(Refer to item 11)Education of Father or Mother (Refer to item Nos. 12 & 14)Medium of ExaminationCodeEducation CodeAssamese 11 Up to Primary 1Bangla 12 Upper Primary 2English 13 Secondary 3Gujarati 14 Senior Secondary 4Hindi 15 Gr aduation 5Kannada 16 Post graduation 6Marathi 17 Doctoral 7Malayalam 18 Professional degree (Engineering,Medicine, MCA, MBA,etc.)8Oriya 19 Any Other 9Punjabi 20Tamil 21Telugu 22Urdu 23Father’s/Mother’s Occupation (Refer to item Nos. 13 & 15)Occupation CodeProfessional, Technical and Related Worker 1Administrative, Executive and Managerial Worker 2Clerical and Related Worker 3Sales / ServiceWorker 4Farmer, Fisherman and Related Worker 5Production and Related Worker, Transport 6Operators and Labourer Worker notclassified by the aboveoccupations7Not employed 8Father’s Name:O P GUPT ACHE N NAI600 0 15PIN

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