Professional Documents
Culture Documents
Ztuz 1
Ztuz 1
NOTICE
Select list of students for admission to Class IX through Lateral entry Test has
been released. The parents/guardians of selected students may take the
following steps for admission to Jawahar Navodaya Vidyalaya:
After verification, JNVs will confirm the admission, if the candidate is found
eligible as per NVS norms.
It is informed that admission will be given to the selected candidates only after
due verification of the documents. Parents are advised not to take TC from the
previous school until the admission is confirmed by the JNV. Admission to JNVs
is done free of cost. No fee is to be paid to school authority for admission to
Class- IX. The parents/students are required to approach directly the Principal
of the JNV concerned.
Aadhar Number:
PHOTO
of student
2. Sex Male Female TG
3. (a) Category
Gen OBC SC ST
(b) Caste :
4. Date of Birth
Date Month Year
5. Father’s Name : __ _ _ _ _ _ _ _ _ _ _
6. Mother’s Name :
Certified that the information given above is true to the best of my knowledge
and belief. In case, any part of the information furnished by me is found incorrect, the
admission of my child/ward may be cancelled. I am ready to produce the relevant
certificates issued by Competent Authorities as and when asked for.
Signature of PARENT/GUARDIAN
Name :
Certified that the information given above is found correct as per our school
records. It is also certified that Master/Kumari was
admitted in this School in Class on (date) and passed
Class VIII on (date).
Date :
UNDERTAKING BY THE PARENT/ GUARDIAN
Certified that the information given in the application form for admission into
Class IX in Jawahar Navodaya Vidyalaya, District:_________________for the academic
year 2020-21 for my ward is true to the best of my knowledge and belief. In case any
part of the information furnished by me is found incorrect, admission of my ward may
be cancelled at any time. I am ready to produce relevant certificates issued by the
competent authority to your office when asked in support of entries in my original
application
Address of parent/guardian:
Name:
H.No:
Street
Village
Mandal/Block
Pin Code:
Mobile No:
UNDERTAKING
Note: This is not applicable to SC/ST categories and all girl students and the parents
whose Income is below poverty line.
JAWAHAR NAVODAYA VIDYALAYA: DISTRICT:_
___________________________________
___________________________________
___________________________________
05. Height _ __ _ _ _ _ __ _ _ _ __
06. Weight _ __ _ _ _ _ __ _ _ _ __
07. Abdomen _ __ _ _ _ _ __ _ _ _ __
08. Chest _ __ _ _ _ _ __ _ _ _ __
10 Ears _ __ _ _ _ _ __ _ _ _ __
11. Throat _ __ _ _ _ _ __ _ _ _ __
14. Skin _ __ _ _ _ _ __ _ _ _ __
15 Blood Group
16 Dental Hygiene
PHOTO OF THE
STUDENT
_ __ _ _ _ _ __ _ _ _ __
CIVIL SURGEON
MEDICAL ANTECEDENTS
UNDERTAKING
We, Shri. _______________ (father) &Shrimati ________________
(mother), the parents of Master/Miss ________________________ , a
selected 01010102416
____________________ do hereby declare that our ward doesn’t suffer from any of the
medical ailments listed below.
1. Head Injuries
2. Puo- Intermittent
3. CHD- Congenital Heart Disease
4. AA – Acute appendicitis
5. Epliepsy – Convulsions (Injury, Fever)
6. Blood Disorders (Sickle cell Anemeia, Haemophillia)
7. Communicable Diseases (TB, Hepatitis A & B)
8. Skin Disease.
We further declare that our ward Master/Miss ____________ doesn’t have any previous
medical history which required/still requires prolonged or intermittent periods of medical
confinement either in a hospital/nursing home or in our house.
Certified that the information furnished above is true to the best of our knowledge. Any
wilful suppression or false informationon the medical antecedents revealed later, would
make the admission of our ward invalid and liable for actions as deemed fit by the
Vidyalaya and Navodaya Vidyalaya Samiti.
DATE: NAME:
MOTHER’S SIGN:
NAME:
ADDRESS:
DISABILITY CERTIFICATE
CATEGORY/COMMUNITY CERTIFICATE
(OBC/SC/ST)
RURAL CERTIFICATE
Block:
District.
Office Seal:
Dated:
RESIDENCE CERTIFICATE
District
Village:
Town:
District:
State:
Pin Code:
*The area of residence falls under the Rural /Urban area of the district
Certified that the information furnished by me is true and no fact has
been concealed.
Full name:
Address:
*Applicable for the students who seek admission through the studies in NIOS.
CERTIFICATE
(TO BE FILLED UP BY THE DISTRICT AUTHORITIES AND ISSUED UNDER THE SIGNATURE OF
TEHSILDAR TO THE PARENTS OF THE CHILD SELECTED FOR ADMISSION TO CLASS IX IN
JNVS THROUGH LATERAL ENTRY TEST)
*The area where residence is located falls under (Rural/Urban) area of the
district .
Signature of Tehsildar
(With Seal)
*Applicable for the students who seek admission through the studies in NIOS.