DIRECTORATE OF EDUCATION LAKSHADWEEP
NATIONAL MEANS CUM MERIT SCHOLARSHIP EXAMINATION, 2022-23
Application Form
For the Students Studying in Class VIII)
Read the instruction carefully given on the next page before filling the application form. Space for the Photograph
You may take the help from your teacher/parent for filling up the application form. (Passport size)
- Date of Examination:
- Name & address of the agency for conducting NMMS Examination:
- Name of the State/UT
(Where the candidate is studying in class VIII as a regular student): The Photograph should be
- Name of the examination centre: endorsed by the Head of
- Application fee, if any (write NIL if there is no fee): the Institution/Gazetted
State Level 11 digit Roll Number
State Code Year Centre Code Serial No.(Office to fill) Class Date of birth
Date Month Year
1. Name of the candidate (Do not write Miss/Master)
2. Father’s name (Do not write Mr./Dr./Prof)
3. Mother’s Name (Do not write Mrs./Dr./Prof)
4. Sex 5. Area to which candidates resides 6. Caste category of candidate 7. Disability status
Male / Female Rural / Urban General OBC SC ST EWS BLV DH LD AID MD NONE
5. Whether cast certificate is attached?
Yes No Parental income as per the certificate of competent authority:
(Please enclose a copy of the relevant certificate in support of information)
6. Postal address of the candidate for correspondence (Do not write father’s or your name)
. Pin
7. Name and address of the School/Institution in which studying at Class VIII level
Pin
8. Type of the institution in which studying at Class VIII 9. Area in which the school is located
Govt Govt. aided Private aided Private Unaided Rural Urban
10. Medium of examination (a) at the state Level
11. Father’s Occupation 12. Mother’s Occupation
,
13. Mobile No. of student 14. School Phone No.
15. Mobile No. of Principal/HM 16. School E-mail ID
17. Name of Island level coordinator: 18. Mob:
To be filled by the Head of the Institution/Gazetted Officer
Certified that, Master/Miss............................................................................................. is a regular student of this School/Institution in
class VIII and he/she has secured ............. % marks in the class VII annual examination, i. e., when he/she was promoted from class
VII. He/ She has secured ................... marks out of ................. He/ She belongs to ....................Cast as per the records in the school and
his/ her parental income is Rs. ......................... as per the certificate produced and it is below Rs. 3,50,000/-.
The particulars given by him/her in the application form have been verified and found in order.
(Signature of Principal with office seal)
