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    12 TH

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    Abbas Ali
    1. This document appears to be an application form for admission to the 10th or 12th standard secondary school certificate examination in Madhya Pradesh, India. 2. It requests information such as the applicant's name, father's name, mother's name, gender, caste or tribe, school details, subjects to be examined, contact information and a signature. 3. It also contains fields for information if the applicant has passed a qualifying examination from another board, whether they are a child of an employee or officer of the education board, their annual family income and required documents to be attached.

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    12 TH

    Uploaded by

    Abbas Ali
    27 views2 pages
    1. This document appears to be an application form for admission to the 10th or 12th standard secondary school certificate examination in Madhya Pradesh, India. 2. It requests information such as the applicant's name, father's name, mother's name, gender, caste or tribe, school details, subjects to be examined, contact information and a signature. 3. It also contains fields for information if the applicant has passed a qualifying examination from another board, whether they are a child of an employee or officer of the education board, their annual family income and required documents to be attached.

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    12th

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    1. This document appears to be an application form for admission to the 10th or 12th standard secondary school certificate examination in Madhya Pradesh, India. 2. It requests information such as the applicant's name, father's name, mother's name, gender, caste or tribe, school details, subjects to be examined, contact information and a signature. 3. It also contains fields for information if the applicant has passed a qualifying examination from another board, whether they are a child of an employee or officer of the education board, their annual family income and required documents to be attached.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    27 views2 pages

    12 TH

    Uploaded by

    Abbas Ali
    1. This document appears to be an application form for admission to the 10th or 12th standard secondary school certificate examination in Madhya Pradesh, India. 2. It requests information such as the applicant's name, father's name, mother's name, gender, caste or tribe, school details, subjects to be examined, contact information and a signature. 3. It also contains fields for information if the applicant has passed a qualifying examination from another board, whether they are a child of an employee or officer of the education board, their annual family income and required documents to be attached.

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    © All Rights Reserved
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    of 2

    ek/;fed f'k{kk e.

    My] e/;çns ' k] Hkks i ky


    vkosnu i= gk;j lsd.Mjh lfVZfQdsV ijh{kk 2019
    lacaf/kr dksM uEcj gh [kkus esa Hkfj;s
    1 vkos n d
    dk iz d kj fu;fer&1 Lok/;k;h&2 fu;fer¼12oha Qs y ½&3 Lok/;k;h ¼12oha Qs y ½&4
    Js . kh lq / kkj ¼fu;fer½&5 Js . kh lq / kkj ¼Lok/;k;h ½&6 vfrfjDr fo"k;&11
    ;fn Nk= us=ghu] ewd&cf/kj gS rks mldk izdkj & us = ghu ewd&cf/kj
    e/;iz n s ' k ds ewyfuoklh gk¡@ugh
    D;k vgZdkjh ijh{kk vU; cksMZ ls mRrh.kZ dh gS] ;fn gk¡ rks cksMZ ,oa o"kZ dh tkudkjh vafdr djsaA o"kZ
    jksy uEcj cksMZ dk uke ifj.kke
    Js . kh
    .............................................................................................................................................................................................................................................................................
    3 vkosnd dk iwjk uke FULL NAME OF CANDIDATE

    4 firk dk iwjk uke FULL NAME OF FATHER

    5 ekrk dk iwjk uke FULL NAME OF MOTHER

    2 ftyk dks M fodkl [k.M dks M ‘ ’kkyk@vxz " ks . k la L Fkk dks M ukeka d u dks M

    ftys dk uke fodkl [k.M dk uke


    ek/;e
    fgUnh -1
    10oha dk jks y ua - o"kZ & vaxzsth -2
    mnwZ -3
    ds o y ek/;fed f'k{kk e.My] e-iz - ls vuq Ù kh.kZ ] Js . kh lq / kkj vFkok vfrfjDr fo"k; ds Nk= dk vuq Ø eka d &
    12oha dk jks y ua - o"kZ &
    lacaf/kr dksM ckWDl esa HkjsaA
    7 Hkk "k"kkk ,oa Mk;oflZQkbZM xzqi ds fo"k; ¼fo"k;
    Hkk"k fo"k; dksM lwph vuqlkj gh Hkjs ½ xzqi dksM xzqi uke

    çFke Hkk"kk ¼fof'k"V½ &&&&&&&&&&& çFke fo"k; &&&&&&&&&&&&&&&&&&&&&


    f}rh; Hkk"kk ¼lkekU;½ &&&&&&&&&&& f}rh; fo"k; &&&&&&&&&&&&&&&&&&&&&
    r`rh; fo"k; &&&&&&&&&&&&&&&&&&&&
    vfrfjDr fo"k; &&&&&&&&&&&&&&&&&&&&

    fo'ks"k Vhi %& us=ghu ewd&cf/kj ,oa LikfLVd lsjsfczy ikYlh ¼ekufld :i ls fodykax½ oxZ ds fo|kfFkZ;ksa dks fof'k"V Hkk"kk ls NwV jgsxhA
    fo|kFkhZ fgUnh ¼lkekU;½ vFkok vaxzsth ¼lkekU;½ esa ls dksbZ ,d Hkk"kk dk p;u ¼ikB~;Øekuqlkj½ dj ldrs gSA
    8 i= Ooogkj dk irk &

    House No. : ijh{kkFkhZ dk


    uohure uke]
    Colony : fnukad
    a ;qDr
    fMftVy QksVks
    Town :

    Block :
    District :

    Phone No. : Pin:


    dkye ds vanj Nk= ds gLrk{kj
    Vhi%& Lok/;k;h ijh{kkFkhZ ftuds ikl fdlh Hkh cksMZ }kjk tkjh ukekadu ugha gS rFkk os cksMZ dh ijh{kk esa izFke ckj Lok/;k;h ijh{kkFkhZ ds :i
    esa 'kkfey gks jgs gSa] os xzkg;rk@ukekadu 'kqYd ijh{kk 'kqYd ds lkFk online tek djsaxsA
    9 Nk= dk vU; fooj.k %&

    fya x tkfr
    fcUnq Ø- 11 ls 17 rd ds izdj.kksa esa l{ke vf/kdkjh
    ckyd -1 vuqlwfpr tkfr -1 fiNM+k oxZ-3
    ckfydk }kjk lR;kfir izek.k&i= layXu djuk vko';d gSA
    -2 vuqlwfpr tutkfr-2 lkekU; -4

    10- D;k vki e.My }kjk ekU;rk izkIr f'k{k.k laLFkkvksa ds lsok fuo`Ùk f'k{kdksa ,oa jk"Vªifr }kjk iqjLÑr e/;izns'k ds f'k{kdksa ds iq=@
    iqf=;ksa ds ijh{kkFkhZ gS \ gk¡ ugha

    11- D;k vki e.My ds vf/kdkjh@deZpkfj;ksa ds iq=@iqf=;ka ijh{kkFkhZ gS \ gk¡ ugha

    12- vki e.My }kjk ekU;rk izkIr f'k{k.k laLFkkvksa esa dk;Zjr~ f'k{kd@f'k{kdkvksa dh iq=@iqf=;ka ijh{kkFkhZ gS \ gk¡ ugha

    13- D;k vki ,slh efgyk ijh{kkFkhZ gSA ftuds vfHkHkkodksa dh lHkh lzksrksa ls okf"kZd vk; :- 15]000@& ls vf/kd ugha gS \
    dsoy efgyk ijh{kkFkhZ ds fy, ½ gk¡ ugha
    14- D;k vkids ifjokj dh leLr lzksrkas ls okf"kZd vk; :- 1]00]000@& ¼,d yk[k ½ls vf/kd ugha gS \
    dsoy SC Nk=ksa ds fy, ½ gk¡ ugha
    15- D;k vkids ifjokj ds leLr lzksrkas ls okf"kZd vk; :- 1]08]000@& ¼,d yk[k vkB gtkj ½ls vf/kd ugha gS \
    dsoy ST Nk=ksa ds fy, ½ gk¡ ugha
    16- 'kkyk dh izos'k lwph esa ijh{kkFkhZ dk ljy Øekad ¼dsoy fu;fer ijh{kkFkhZvksa ds fy,½

    17- layXu nLrkost ¼dsoy vgZdkjh ijh{kk vU; cksMZ ls mRrh.kZ Nk=ksa ds fy,½
    ¼v½ LFkkukUrj.k izek.k i=A
    ¼c½ izotZu izek.k&i=A
    ¼c½ d{kk 11oha dh vadlwphA

    18.Bank A/c No. IFSC Code

    19. SSMID Aadhar No.

    ijh{kkFkhZ dh ?kks " k.kk


    esjs }kjk nh xbZ mijksDr tkudkjh lR; gS ;fn blesa fdlh izdkj dh vlR; tkudkjh ikbZ xbZ rks esjk ijh{kk vkosnu ,oa
    ijh{kk ifj.kke dHkh Hkh fujLr fd;k tk ldrk gSA

    ijh{kkFkhZ ds gLrk{kj

    izkpk;Z@vxzs"k.k laLFkk izkpk;Z dk izek.khdj.k


    esSa lacaf/kr nLrkostksa dh tk¡p mijkar izekf.kr djrk gw¡ fd Nk= ijh{kk esa izfo"V gksus gsrq fu/kkZfjr ekin.M iw.kZ
    djrk gSA

    fnukad

    laLFkk Øekad laLFkk dk uke gLrk{kj ineq n z k lfgr

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