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APPLICATION FORM (ANDHRA PRADESH)

STATE LEVEL NATIONAL TALENT SEARCH EXAMINATION2015

(For the students studying in ClassX)

State Level 12 digit Roll Number (To be filled by the DEO Office)

X th

Class Code State Code Year Dist Code Centre Code Sl.No. Class Date of Birth of Candidate

2 4 0 1 5 10

1. Name of the candidate (Do not write Miss/Master) Date Month Year

2. Fathers Name (Do not write Mr./Dr./Prof.)

3.Mothers Name (Do not write Mrs./Dr./Prof.)

4. Gender 5.Area of candidate resides 6.Caste category of candidate 7. Disability Status of Candidate

1 2 1 2 1 2 3 1 2 3 4

Male Female Rural Urban General SC ST Ortho Hearing Blind None

(Please enclose a copy of the relevant reservation certificate in support of information at Sr. No.6 & 7)

8. Postal address for correspondence (Do not write fathers or your name)

Pin Code

9. Name and address of the institution in which studying at Class X

Pin Code

10. Type of the institution in which studying Class X (see definition overleaf*) 11.Area in which the school is located

1 Govt 2Local

Body3

Private

Aided4

Private

Unaided1 Rural 2 Urban

12. Medium of examination

(a) at the State Level

(b) at the NCERT

Level

13.Fathers

education

14.Fathers

occupation15. Mothers education 16.Mothers occupation 17.No.of family members living in the

house

18. Number of brothers 19. Number of sisters20. At what number is the candidate

among his/her brother and sister

*21. Language for Language Comprehensive Test at the State Level

22. Parental annual income

1 2 3 4 5

Up to 50,000 50,001 to 1,00,000 1,00,001 to 2,00,000 2,00,001 to 5,00,000 More than 5,00,000

23.Telephone/

Mobile

24. E-Mail address

STD Code Phone

Hall Ticket Number Month Year25.If the candidate already enjoying scholarship of NMMS/NTS,

mention Roll No. and Month & Year of test .

To be filled in by the Head of the Institution

Certified that:

(1) Master / Miss.............................................is a regular student of this School/Institution and he/she has secured...% marks in theclass IX Annual examinations i.e., when he/she was promoted from Class IX to class X. He/She has secured ...........Marks out of 600.

(2) The particulars given by him/her in the application form have been verified and found in order.

(3) Master / Miss.........................................belongs to Scheduled Caste/Scheduled Tribe category as per the records maintained in theInstitution. (caste/disability certificate may be enclosed along with application form in respect of SC/ST and disability candidates)

Signature of the candidate Signature of the Head of the Institution With Seal

Date (See Instructions given on next page)

Read the instructions carefully given on the next page before filling the application form.You may take the help from your teacher/parent for filling up application form.

Date of Examination :02-11-2014(10.00AM to 01.00 PM)

Fee should be paid through CHLLAN ONLY (DDs are not acceptable)

Amount Challan Number & Date Application No,if any

Rs.100/-

Space for the

Photograph

(Passport size)

The Photographshould be endorsed

by the Head of the

Institution

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Coding Plan

Read Instructions carefully before filling up the Application Form

1. Use only Blue or Black Ball Point Pen. WRITE IN CAPITAL LETTERS. Do not mark or write outside the boxes.2. Leave one box blank between two words. Limit your name and / or address within the space provided for it. Please see example as

given below.

3. Cross (X) only one of the appropriate boxes in item nos. 4,5,6,7,10,11 and 22.4. Please write code number in item nos. 12,13,14,15,16 and 21 as given below.

5. It is the responsibility of the candidate and the H.M of the school to submit the filled in Application with the concerned DistrictEducational officer before the last date. No request for condoning delay in submission of application will be entertained whether itis due to the fault of the candidate or the Headmaster / Principal of his/ her institution.

6. Incomplete or defective applications are liable for rejection.7. The students who have selected for NMMS scholarship and studying X class now may also eligible to appear for NTSE

Examination. But such candidates have to forego the further NMMS scholarship, if he/she are selected in NTS Examination.8. Candidates belongs to SC/ST/PH should enclose Caste/Disability certificate along with the application form invariably.

9. Candidates should opt any one language from TELUGU, URDU and ENGLISH for Language Comprehensive Test.

Example for writing Name and AddressFathers Name (Do not write Mr./Dr./Prof.)

B L A Z A R U S

. Postal address for correspondence (Do not try to write complete address in one line. Break it appropriately as shown below)

9 - 5 - 9 0 D E V U N I T H O T A

R O Y P E T N A R S A P U R W . G . D T

A N D H R A P R A D E S H Pin Code 5 3 4 2 7 5

Medium of Examination

(Refer to item 12)Education of Father or Mother

(Refer to item Nos.13 & 15)

Medium of Examination Code EducationCode

English 13 No formal education 01

Hindi 15 Upto Primary 02

Telugu 22 Upper Primary 03

Urdu 23 Secondary 04

*Language Comprehensive Test

(Refer to Item 21)

Senior Secondary 05

Graduation 06

Post Graduation 07

Doctoral 08

Telugu 1 Professional degree (Engineering Medicine,MCA, MBA, etc.)

09Urdu 2

English 3 Any other 10

Fathers / Mothers Occupation

(Refer to item Nos. 14 & 16)

Occupation Code

Professional, Technical and Related Worker 1

Administrative, Executive and Managerial Worker 2

Clerical and Related Worker 3

Sales / Service Worker 4

Farmer, Fisherman and Related Worker 5

Production and Related Worker, Transport 6

Operators and Labour Worker not classified by the above occupations 7

Not employed 8

*TYPE OF SCHOOL / INSTITUTION (refer item No.10)

GOVERNMENT: A Government School is that which is run by the State Government or Central Government or Public sectorUndertaking or an Autonomous Organization completely financed by the Government.

LOCAL BODY: A Local Body School is that which is run by Panchayati Raj and local body institutions such as Zilla Parishad,Municipal Corporation, Municipalities, Notified Area Committee and Cantonment Board.

PRIVATE AIDED: A private Aided School is that which is run by an individual or a private organization and receives grant fromthe Government.

PRIVATE UNAIDED: Private Unaided School is that which is managed by an individual or a private organization and does notreceive any grant from Government.

Instructions to Candidates / Principal of school

before filling up the Application Form forState Level National Talent Search Examination

1. The candidate / Principal of the school must confirm the last date for submission of Application Formfrom the state liaison officer

and Application(s) must be submitted before the last date to the concerned District Educational Officer.

2. The candidate / Principal shall get confirmed the name of examination centre from the DISTRICT EDUCATIONAL OFFICER.

3. Last Date for remittance of examination fee by the candidates / Head Master or Head Mistress: 01-09-2014.

4. Incomplete/ wrongly filled-in application is liable for rejection.

5. The candidate/principal shall submit the filled-in application along with the examination fee of Rs.100/- in the form of

CHALLAN to the following Head of Account: (No Demand Drafts are acceptable)

0202 Education, Sports and Culture

01 General Education

102 Secondary Education

06 Director of Government Examination800 User Charges

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GOVERNMENT OF ANDHRA PRADESH

STATE LEVEL NATIONAL TALENT SEARCH EXAMINATION - 2015

(For the Students Studying in Class X)ADMISSION CARD

To be filled by the candidate only

Master / Miss__________________________________________

(School Seal)

S/o D/o Sri.____________________________________________

of (School)_____________________________________________

of (District )____________________________________________

is permitted to appear for the said examination.

She / He is allotted with the following 12 digit Roll Number:(to be filled by the O/o The District Educational Officer)

Class State Code Year Dist Code Centre Code Sl. No.

2 4 0 1 5

Date of Examination: 02-11-2014 (10:00 AM to 1:00 PM)

Venue of Examination centre

______________________________________

______________________________________

______________________________________

______________________________________

Signature of the Head of the School

With office seal

Scrutinized by

(Office Staff)

Signature of District Educational Officer

with Office Seal

Signature of the Invigilator

at the Examination Centre

Signature of the Candidate

in the Presence of Invigilator

Passport size

photograph

attested by the

Head of theSchool to be

affixed

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INSTRUCTIONS TO THE CANDIDATE

1. Candidate belonging to SC/ST/PH categories should enclose a copy of the Caste/Disabilitycertificate along with the application form, Otherwise they will be treated as GENERAL category.

2. Make sure that the Admit Card is not detached from the filled in application. Candidate can collect

the Admit Card from the District Educational Officers office concerned at least one week before

the examination.

3. Reach the Examination Centre at least half- an- hour before the commencement of the examination;

and occupy the seat which is allotted to your Roll Number.

4. DO NOT take calculator, Mathematical & Physical table, cell phones or any other kind of ready

reckoner to the examination hall.

5. The examination will be conducted between 10:00 AM and 1.00 PM on first Sunday in November

i.e., 02-11-2014.

6. You have to take the examination as follows:

(i) Mental Ability Test (MAT) consisting of 50 compulsory questions for 50 marks.

(ii) Language Comprehensive Test consisting of 40 compulsory questions for 40 marks. This test

will be qualifying in nature and marks will not be added for deciding final merit list of the

candidate.

(iii) Aptitude Test consisting of 90 compulsory questions for 90 marks from eight subjects (History,

Geography, Political Science, Economics, Physics, Chemistry, Biology and Mathematics).

7. Each question carries 1 (one) mark.

8. Write your Roll Number, as given in the Admit Card, on the OMR Answer Sheet and on the cover

page of the Question Booklet in the space provided.

9. DO NOT write your name in any part of the Question Booklet or the OMR Answer Sheet.

10. All questions in the booklets are objective type. For each question FOUR or FIVE possibleanswers are given but only one is correct. Your task is to find out the correct answer and mark your

choice in the OMR Answer Sheet.

11. Please follow the instructions given on the OMR while shading the answers in the OMR answer

sheet.

12. During the Examination follow the instructions of the Invigilator strictly.

13. Handover your OMR answer sheet to the Invigilator before you leave the Examination Hall. Youshall retain your Admission card for your future reference.

14. Postal Address

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

Pin:________________