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Enrollment Form NSEJS 2019

The document provides an enrollment form for students in classes 8th through 10th who wish to take the 2019 National Standard Examination in Junior Science, with fields to fill out name, class, gender, date of birth, preferred exam language, school details, contact information, and a signature agreeing to the details. It notes an exam fee of Rs. 150 and says students can check their enrollment status online within seven days or with their school.

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Jayant Jain
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225 views2 pages

Enrollment Form NSEJS 2019

The document provides an enrollment form for students in classes 8th through 10th who wish to take the 2019 National Standard Examination in Junior Science, with fields to fill out name, class, gender, date of birth, preferred exam language, school details, contact information, and a signature agreeing to the details. It notes an exam fee of Rs. 150 and says students can check their enrollment status online within seven days or with their school.

Uploaded by

Jayant Jain
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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National Standard Examination in Junior Science - 2019

Student Enrollment Form


NSEJS - 2019
th th th
Students (Born between 01/01/2005 and 31/12/2006) studying in classes 8 , 9 and 10 who wish to appear for the IAPT
Junior Science 2019 Examination are to fill the below given details in BLOCK LETTERS only and hand over the filled enrollment
form to the Centre In charge in the School/Institution.

Name of the Student :


(As per School records)
Class / Standard : ………………………………….............. Gender : (Male / Female)
Father’s/Mother’s Name : .………………………………………………………………………………………………………………………………………….
Date of Birth : D D M M Y Y Y Y
Examination Fee
Language Preferred : English : Hindi :
Rs. 150/-
Note: Select the Language by ticking in either of the block.

STUDENT STUDYING DETAILS (Where the Student is Studying)

Enrolled in : Own School Others School

Name of School : ………………………………………………………………………………………………………………………………………………………..


Address of School : …………….………………………………………………………………………………………………………………………………………..
School District and State : ……………………………………………………………….………………………… Pin Code : ………………………………

STUDENT POSTAL CORRESPONDENCE DETAILS

Residential Address : …………………………………………………………………………………………..…………………………….………………………....


…..……….……………………………………………….………….. City : …………………………………………………………......
District : ……………………………………..…………………….………….. State: ...................................................................
Pin Code : ………………….………………… Mobile No. : ………………..……………………………………………………………………….
E-Mail ID : ……………………………………………………………………………………………………………………………………………………..
Declaration: I hereby declare that the details furnished herein are true to the best of my knowledge.
Date:
Place: (Signature of the Student)

Acknowledgement for Applying for IAPT NSEJS 2019


Mr/Ms : …………………………………………………………………………………… Class: ……………….…….

Applied For NSEJS - 2019 Received Rs: 150 /- Centre No. :……………….

Prof. B. P. Tyagi
Chief Coordinator IAPT Exam. Institution Seal Signature of the Centre In-charge.
15, Block II Rispana Road Dehradun- 248001
Note: Confirm your enrollment status through “Check your Enrollment” within seven working days after submission or else
check with the respective Institution.

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