NAVODAYA VIDYALAYA SAMITI

JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST

CLASS VI - 2019
APPLICATION FORM

REGISTRATION NO.: 19110201093

State PUNJAB District BATHINDA

Name of the Candidate GURMAN SINGH
Mother's Name PARAMJEET KAUR Father's Name JAGMOHAN SINGH
Name of the Guardian - Relationship with -
Guardian
Nationality of the INDIAN Date of Birth 24-Aug-2008
Candidate
Present Postal Address VPO-RAMGARH BHUNDER TEHSIL-MOUR, BATHINDA : 151101
Telephone - Mobile No 8872568667
Gender MALE Category GENERAL
Marital Status UNMARRIED Identification Mark MOLE ON LEFT EYE
Medium of Examination ENGLISH
Disablility, if any No

Previous School Details

III Standard Details IV Standard Details V Standard Details

Name of the State PUNJAB PUNJAB PUNJAB
Name of the District BATHINDA BATHINDA BATHINDA
Name of the Block RAMPUIRA PHOOL RAMPUIRA PHOOL RAMPUIRA PHOOL
Name of the Village JODHPUR PAKHAR JODHPUR PAKHAR JODHPUR PAKHAR
Name of the School SBZS SEN.SEC. SCHOOL SBZS SEN. SEC. SCHOOL SBZSP SEN. SEC. SCHOOL
Recognized/Not RECOGNIZED RECOGNIZED RECOGNIZED
Recognized
School Location RURAL RURAL RURAL
Month/Year of Joining April - 2016 April - 2017 April - 2018
Month/Year of Passing March - 2017 March - 2018 -

CERTIFICATE BY CANDIDATE/PARENT/GUARDIAN
Certified that the information given above is true to the best of my knowledge and belief. In case any of the information given
above is found incorrect, I will abide by the decision of the Samiti. I will produce all the certificates at the time of admission.

Signature of the Parent Signature of the Candidate