Application Form (For Abroad Students only) National Talent Search Examination-2018 For the Students Studying Abroad in Class X) Read the instruction carefully given on the next page before filing the application form. Space for the ‘You may take the help rom your teacher/parent or filling up the application form, Photograph [Passport Date of amination 13° may, 2018 size and Black & white) Name & address ofthe agency for conducting NTS Examination: NCERT Name ofthe Country The Photograph (were the candidate is studying In clas X asa regular stuent) should be Name ofthe examination centre in India (State/Chy) endorsed by the {where candidate tkely to appear in exam) Head of the 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./Pro [E Jesfeay 3. Mother's Name (Do not write Mr/Dr/Prof) 4 Sm SAreatowhichcanddnesresdes 6. Caste category ofeandidate 7. Disability satus TE [2 etal. és 1A AE 1a Fede al Ui Tan SET Reterovera tor deatsofcodth ee Please enclose a copy of the relevant certificate in support of information at Sr.No.6 87) Postal adress ofthe candidate for corespondence (Do no writs father’s or your name) Pin cate 9. Nan sd aes ote Steavastae wc tg 10 Type he natn a wich thing Chas X Gov ern oy TT Attn wih soa sed 1] oom [E] oats [CG] rrimenies — CZ] rive Unided — EZ] nurs E] tn |2Metumof evans) ate sat Level |] —] ya he NCERT Level 13.Faterstneton [] raters Oxpaion 1SMoter'swcaion [] 16. t's Occupation [ —] 17. No of fil meer ling in sh house 18.8 oftotes [] 90. ofsistes 20.At what, te candies among hisher bothers and sisters 21. Past naa! none 1 2 3 4 5 Upo2,00,000. 2.000119 3,00000 300001 105.0000 $00,001 19.00.00 More than 1000000 22. Tlepbone STD Code Phone 23. Ball aes £24 Mote Number (Do ot kav this column Bak) Tote fd y the Hed ofthe stun Gareted Omer Cen tat (i) Masri so 8a egulr stadt ofthis ScooVnstition and hele has ued ‘és inh clases aman, ey when bese was promoted om cts Xo Clase He She hasseS rns ovto.. 2) The pantculars given by him/her in the application from have been verified and found in order. G) MasteriMiss css belongs to Scheduled Caste/Scheduled Tribe category as per the records maintained in the Institution (to be filled for SC/ST candidates ony). Date oe Signature ofthe Headmaster’ Headmistress/Gazetted Otticer With seal vo (See Instructions Overleat) Signature of the candidateCoding Plan Read instruetion carefully before filing up the Application Form. ‘Use only Ble or Black Ball Point pen, WRITE IN CAPITAL LETTERS, Do not mak or write outside the boxes, Leave oe box blank between to words. Limit your name and/or ares within the space provided fer it Please sce example given Below ‘Cross only one of the appropriie boxes in items nos. 4 5,6, 7,10, end 21 Please write Code mmber mn items nos 12, 13,14, 15 and i ae given vere. Its the responsibility of the candidate andthe principal of the school to deposit dhe filed inform with the state concemed Officer before the last dats No ‘equst for condoning delsy in submission wil be entrained whether itis duc to the fault of the Cini or the HeadmusterPincpl of hier insitaion 6. Incomplete o defensive applications are ible tobe reeted, 7. 4% for Physically Challenged Group of Students, with benchmark disabilities of which, one per cent each shall be reserved for persons with benchmark disabilities under clauses (a), (b) and (¢) and one per cent for persons with benchmark disabilities under elauses (4) and (e) namely: (@) blindness and low vision; (©) deaf and hard of hear (©) locomotor disability including cerebral palsy, leprosy cured, dwarfism, acid attack vietims and muscular dystrophy (@) autism, intellectual disability, specifi learning. © le disabilities from amongst persons under clauses (a) to (d) including deaf- blindness in the posts identified for Example for writing Name and Address. FathersName [OT | [| 6] U] P]TIA Postal Address: do not try to write complete address in one line. Break it appropriately a shown below: TET TS [OUTS A] RO AT D Region | State0T Cade clule|wl wali Pe ‘North | Arunachal Pradesh [11 East Assam 7 Medium of Examination | Education of Father or Mather Manipur B (Refer to item 12) (Refer to item Nos 13 & 15) “Meghalaya 14 Medium of Code | Edveation Code Mizoram 5 Examination Nagaland 16 Assamese Ti_| No Formal Education i Sikkim 17 12__| Upto primary z Tiare ie 13 _| Upper primary 3 Eat A& Niland [9 14] Secondary a ‘Bihar 20 15 | Senior secondary 3 Tarkan 21 16 | Graduation 6 Orissa 2 Marathi 17 _| Post graduation 7 Tea Bagh 5 Malayalam 18 Doctoral = North | Chandigarh 2 Ona 19 | Professional degree 9 Dei 35 (Engineering,Law, Tamma& Kashir [25 Medicaine, MCA, BA.et) Taya ir Punjab 20 | Timasial Pradesh [28 Tamil 2 Panes 3 Teluge 2 aaa a [rau B ‘Unar Prades) 31 Urarahand 3 Far Maan E f c (refer to item Nos 14 & 16) banal Coat ae oe Daman & Dia [34 Fosiaml 7 DEN Fiaveli 3s oo 3 x 5 i 7 Caja 7 a Ta 3 Mhadiya Padeah 38 Fedral Tea = — x Spare 7 heme : Soati | Andi Pradesh} 20 Kamat a “Type of ScheoW/institutions (refer to item Ne.10) Kerela p2 GOVERNMENT A Gowen wl at wich isn bythe Site a Gove or Poe Sacer mine Atewemt ond m Organization completely financed by the Government Pome LOCAL BODY ‘A Local Body School is that which is run by Panchayati Raj ‘Tamil Nadu a ‘ta nies uh Zi Pacha Telangana % Cynon, Mata “Conmite, Netfed Ae — - Commie nd Crone ard PRIVATE AIDED A pate add seo tht wich ie by an india or 0 privy ofgnization and reeves at fom PRIVATEUNAIDED Pate Unido Sool is thet wbih is mined by 22 individual ora rae ezasiation a oes st ie a gr om government al bay