jk"vªh; eqdr fo ky;h f'k{kk lalfkku

Transcription

1 fo k/kue~ loz/kua iz/kkue~ jk"vªh; eqdr fo ky;h f'k{kk lalfkku NATIONAL INSTITUTE OF OPEN SCHOOLING 2016&17 ds izos'k ds fy, vkosnu iqkwez rfkk vkosnu iqkwez Hkjus gsrq vko';d funsz'k Application Form for Admission and Important Instructions for filling the Form Toll Free No. : Website:

2 fo k/kue~ loz/kua iz/kkue~ jk"vªh; eqdr fo ky;h f'k{kk lalfkku National Institute of Open Schooling 2016&17 ds izos'k ds fy, vkosnu iqkwez rfkk vkosnu iqkwez Hkjus gsrq vko';d funsz'k Application Form for Admission and Important Instructions for filling the Form tks f'k{kkfkhz,vkbz (vè;;u ds ekè;e ls vkwu&ykbu izos'k ysuk pkgrs gsa os uhps fn, x, funsz'kksa ds vuqlkj iqkwez esa viuk fooj.k tsls uke] firk dk uke] irk vkfn Hkjdj vkwu&ykbu iathdj.k ds fy, vè;;u dks ns nsa % lkeku; funsz'k % 1. vkosnu iqkwez Hkjus ls igys] bl foojf.kdk esa rkfydk&3 esa nh xbz ^izos'k ;ksx;rkvksa* ds ckjs esa i<+ ysa vksj ;g lqfuf'pr dj ysa fd vki ikb~;øe esa izos'k ysus ds ;ksx; gsaa ugha rks vkids }kjk Hkjk x;k iqkwez jn~n dj fn;k tk,xk o vkids }kjk nh xbz iqhl yksvkbz ugha tk,xha vksj u gh bl laca/ esa dksbz i=kkpkj fd;k tk,xk vksj dksbz lwpuk Hkh ugha nh tk,xha 2. foojf.kdk ds var esa izos'k gsrq,d vkosnu&iqkwez gsa 3. izos'k iqkwez esa ekaxh xbz lwpuk dks dsoy vaxzsth esa gh HkjsaA 4. ewy iqkwez ij glrk{kj djsa vksj ikliksvz vkdkj dk iqksvksxzkiq fpidk, A iqkwez ds lkfk lr;kfir dkxtkr layxu djsa vksj iqksvks izfr;ksa ij yxh iqksvksxzkiqksa dks iz/kukpk;z@leuo;d vfkok jktif=kr vf/dkjh@rglhynkj@ftyk/h'k ls lr;kfir djk, A 5- vki lqfuf'pr dj ysa fd izos'k iqkwez esa nh xbz tkudkfj;k lr; gksaa izos'k iqkwez dk dksbz Hkh dkwye [kkyh u NksM+saA vkidks ewy iqkwez] iqksvksxzkiq vksj glrk{kj djds Bhd ls Hkjdj vlfkk;h izos'k&iqkwez,oa jlhn ds lkfk,vkbz (vè;;u ds anz) ij tek djkuk gsa 6- fy[kkov Li"V gksuh pkfg,a dksbz dkv&nk V gks rks mls lr;kfir djsaa vu; funsz'k % vkidh lanhkz la[;k % ;g vkids {ks=kh; dk;kzy; }kjk fn;k tk;sxka 1- f'k{kkfkhz dk uke % vki viuk uke vaxzsth ds cm+s o.kks± esa fy[ksaa izr;sd o.kz,d vyx dkwye esa fy[kk tk,xk_ tslk fd uhps mnkgj.k esa fn;k x;k gs] ftlesa uke] eè; uke vksj dqy uke ds chp esa,d&,d dkwye [kkyh NksM+k x;k gsa S U S H I L C H A N D E R J O S H I vki viuk uke finys fo ky; ds fjdkmz vfkok cksmz ds izek.ki=k vuqlkj gh fy[ksaa 2 vksj 3-ekrk&firk dk uke % vki vius ekrk vksj firk dk uke vaxzsth ds cm+s o.kks± esa fy[ksa] tslk fd uhps mnkgj.k esa fn;k x;k gsa uke ls igys Jh] Jherh] Jheku vksj Jherht u fy[ksaa K A M A L C H A N D E R J O S H I Learners seeking Online admission through AI (Study Centre)/ may fill the particulars such as Name, Father s Name, Address etc. in the form and give it to Study Centre/ for On-line registration as per instructions given below. General Instructions: 1. Before filling up the application form, please ensure your eligibility for admission as given in Table-3 in the Prospectus. Otherwise the Application Form will be cancelled and the fee paid by you will not be refunded. Neither any intimation will be sent to you, nor any correspondence will be entertained in this regard. 2. One Application Form for admission has been given at the end of this prospectus. 3. Information in the admission form should be filled in English only. 4. Please put your signature and paste a passport size photograph on the original Application Form. Attach the attested documents with Form and get the photographs attested on the photocopies from Principal/Co-ordinator or Gazatted Officer/Tehsildar/District Magistrate. 5. You should ensure that the particulars filled in the Application Form are correct. Don't leave any column blank in the Admission Form. You have to submit original Form, photographs and signatures on the Form for admission at the AI (Study Centre) along with the duly filled in Provisional Admission Letter-cum- Receipt. 6. Writing should be legible. Any cutting should be attested. Other Instructions: Your Reference Number: It will be given by the Regioanl Centre. 1. Name of Candidate: Write your name in block letters, in English. Each letter should be written in a separate column, as per specimen given below, leaving one space between name, middle name and surname. S U S H I L C H A N D E R J O S H I You should mention your name as already recorded in your previous school or Board certificate. 2 and 3. Father s Name and Mother s Name: Write your father s and mother s names in block letters, in English as per specimen given below. Do not write Shri, Smt., Mr. or Mrs. before the name. K A M A L C H A N D E R J O S H I

3 vkids ekrk vksj firk dk uke vkids finys fjdkwmz ls esy [kkrk gksa ;g vkids izek.ki=k esa fy[kk tk;sxka ckn esa blesa dksbz ifjorzu ugha fd;k tk,xka ;fn f'k{kkfkhz izek.ki=k es a ekrk@firk dk uke ugha fy[kokuk pkgrs gsa rks fn, x, dkwye dks [kkyh u NksM+sa] muesa 15 dkwyeksa rd dk fu'kku yxk nsaa 4- vfhkhkkod@lalfkk dk uke % vukfk okys ekeys esa vfhkhkkod@lalfkk dk uke fy[ksaa 5- i=k O;ogkj dk irk % Ñi;k viuk iwjk irk vaxzsth esa cm+s o.kks± esa bzesy vkbzmh] iqksu ua- vksj,l,e,l vyvzl ds fy, eksckby uacj lfgr fy[ksaa Ñi;k izr;kf;r lalfkk ;k dksfpax lsavj dk irk u nsaa 6- tuefrffk % viuh tuefrffk lgh fy[ksaa foojf.kdk dh rkfydk&3 ds vuqlkj tuefrffk ls lacaf/r izek.k i=k dh lr;kfir izfr Hkh layxu djsaa mnkgj.k ds fy, ;fn vkidh tuefrffk 17 vizsy 1986 gs rks mls fueufyf[kr izdkj ls fy[kk tk,xka frffk eghuk o"kz 7. fyax % fn, x, dkwye esa iq#"k ds fy, 1] efgyk ds fy, 2 vksj rhljs tsamj ds fy, 3 fy[ksaa 8. oxz % fn, x, dkwye esa lkeku; ds fy, 1] vuqlwfpr tkfr ds fy, 2] vuqlwfpr tutkfr ds fy, 3] iwoz lsfud ds fy, 4] vksj v{ke ds fy, 5] vkschlh (vu; finm+s oxz) ds fy, 6 fy[ksaa 9. v{kerk % fn, x, dkwye esa gkfk&isj lacaf/r v{kerk ds fy, 1] ns[kus esa v{kerk ds fy, 2] lquus esa v{kerk ds fy, 3] dq"b jksx ls eqdr ds fy, 4] ekufld :i ls vfodflr ds fy, 5] ekufld jksx ls v{kerk ds fy, 6] vusd v{kerk ds fy, 7] eflr"d laca/kh i{kk?kkr ds fy, 8] lh[kus esa v{kerkvksa ds fy, 9] vkwfvle ds fy, 10 vksj ykxw ugha ds fy, 11 fy[ksaa 10. oafpr oxz % fn, x, dkwye esa iqqvikfk ij jgus okys cppksa ds fy, 1] dkexkj cppksa ds fy, 2] xzkeh.k efgyk ds fy, 3] >qxxh esa jgus okyksa ds fy, 4 rfkk ykxw ugha ds fy, 5 fy[ksaa 10d. vukfk % vukfk ds fy, 1] vukfk lalfkku ds fy, 2 vksj ykxw ugha ds fy, 3 fy[ksaa 11. ikb~;øe ftlds fy, vkosnu fd;k gs% fn, x, ckwdl esa ekè;fed ds fy, 1 vksj mpprj ekè;fed ds fy, 2 fy[ksaa 12. vè;;u dk ekè;e % (mpprj ekè;fed) % fn, x, ckwdl esa fgunh ds fy, 1 vaxzsth ds fy, 2, mnwz ds fy, 3, mfm+;k ds fy, 4 vksj caxkyh ds fy, 5, xqtjkrh ekè;e ds fy, 6 fy[ksaa 12 d- (ekè;fed ds fy,) % fn, x, ckwdl esa fganh ekè;e ds fy, 1] vaxzsth ds fy, 2] mnwz ds fy, 3] ejkbh ds fy, 4] rsywxw ds fy, 5] xqtjkrh ds fy, 6] ey;kye ds fy, 7] mfm+;k ds fy, 8] rfey ekè;e ds fy, 9 fy[ksaa 13. ekr`hkk"kk : fganh ds fy, 1] mnwz ds fy, 2] vlfe;k@vlksfe;k ds fy, 3] caxkyh@caxyk ds fy, 4] cksmks ds fy, 5] Mksxjh ds fy, 6] xqtjkrh ds fy, 7] duum+ ds fy, 8] d'ehjh ds fy, 9] dksad.kh ds fy, 10] esffkyh ds fy, 11] ey;kye ds fy, 12] ef.kiqjh ds fy, 13] ejkbh ds fy, 14] usikyh ds fy, 15] mfm+;k ds fy, 16] iatkch ds fy, 17] lalñr Your father s and mother s name should tally with your previous records. This will be recorded in the Certificate. No change will be permitted later on. The students who don't want their father's/mother's name to be printed on the certificate, kindly put cross upto 15 boxes given for father's or mother's name. 4. Guardian's/Institution's Name : Write Guardian's/ Institution's name in case of Orphan. 5. Postal Address : Please write your complete address in block letters in English with Id, telephone number and the mobile number for SMS alerts. Attach proof of residential address. Do not quote AI or any coaching centre for address proof. 6. Date of Birth: Mention your Date of Birth correctly. Attach the attested copies of documents as proof of date of birth as per the Table-3 in the Prospectus. If, for example, your Date of Birth is 17 th April 1986, it should be written as under DATE MONTH YEAR 7. Gender: Write 1 for Male, 2 for Female and 3 for Third Gender in the box provided. 8. Category: Write 1 for General, 2 for SC, 3 for ST, 4 for Ex- Servicemen and 5 for Handicapped, 6 for OBCs (Others Backward Classes) in the box provided. 9. Disability: Write 1 for Locomotor Disability, 2 for Visually Impaired, 3 for Hearing Impaired, 4 for Leprosy Cured, 5 for Mentally Retardation, 6 for Mental Illness, 7 for Multiple Disabilities, 8 for Cerebral Palsy, 9 for Learning Disabilities, 10 for Autism and 11 for Not Applicable, in the box provided. 10. Disadvantaged Group: Write 1 for Street Children, 2 for Working Children, 3 for Rural Women, 4 for Slum Dwellers and 5 for Not applicable, in the box provided. 10a. Orphan Write 1 for Orphan, 2 for Institute for Orphan, 3 for Not Applicable. 11. Course Applied for: Write 1 for Secondary and 2 for Senior Secondary in the box provided. 12. Medium of Study: (For Sr. Secondary): Write 1 for Hindi, 2 for English, 3 for Urdu, 4 for Odia and 5 for Bengali, 6 for Gujarati Medium in the box provided. 12a. (For Secondary): Write 1 for Hindi, 2 for English, 3 for Urdu, 4 for Marathi, 5 for Telugu, 6 for Gujarati, 7 for Malayalam, 8 for Odia, 9 for Tamil Medium in the box provided. 13. Mother Tongue : Write 1 for Hindi, 2 for Urdu, 3 for Assamese/Asomiya, 4 for Bengali/Bangla, 5 for Bodo, 6 for Dogri, 7 for Gujarati, 8 for Kannada, 9 for Kashmiri, 10 for Konkani, 11 for Maithili, 12 for Malayalam, 13 for Manipuri, 14 for Marathi, 15 for Nepali, 16 for Odia, 17

4 a ds fy, 18] lafkkyh ds fy, 19] flaèkh ds fy, 20] rfey ds fy, 21] rsyqxw ds fy, 22 rfkk dksbz vu; Hkk"kk ds fy, 23 fy[ksaa 14. jk"vªh;rk % fn, x, ckwdl esa Hkkjrh; ds fy, 1 vksj fdlh vu; ds fy, 2 fy[ksaa 15. /ez : fganw ds fy, 1] eqflye ds fy, 2] bzlkbz ds fy, 3] fld[k ds fy, 4] tsu ds fy, 5] cks¼ ds fy, 6] ikjlh ds fy, 7- ;gwnh ds fy, 8 fy[ksaa 16. vkidh iwoz ;ksx;rk % fn, x, [kkus esa V, VI, VII, VIII, IX, X, XI, XII rfkk vkxs dh ;ksx;rk fy[ksaa ;fn dksbz iwoz ;ksx;rk ugha gs rks bl [kkus esa N fy[ksaa 17. firk dh 'ksf{kd ;ksx;rk : vf'kf{kr ds fy, 1] izkfkfed rd ds fy, 2] fefmy rd ds fy, 3] ekè;fed rd ds fy, 4] Lukrd ds fy, 5] LukrdksÙkj ds fy, 6 fy[ksaa 18. ekrk dh 'ksf{kd ;ksx;rk : vf'kf{kr ds fy, 1] izkfkfed rd ds fy, 2] fefmy rd ds fy, 3] ekè;fed rd ds fy, 4] Lukrd ds fy, 5] LukrdksÙkj ds fy, 6 fy[ksaa 19. vki dgk jgrs gsa% fn, x, ckwdl esa egkuxj (eaqcbz] dksydkrk] psuubz] fnyyh) ds fy, 1] vu; 'kgjksa ds fy, 2] xzkeh.k ds fy, 3 vksj vèkz xzkeh.k ds fy, 4 fy[ksaa 20. vkidk HkkSxksfyd {ks=k : fn, x, ckwdl esa igkm+h {ks=k ds fy, 1] nwjnjkt+ {ks=k ds fy, 2] ckwmzj {ks=k ds fy, 3] vkfnoklh {ks=k ds fy, 4] Vkiw ds fy, 5] flfdde lfgr mùkjiwohz {ks=k ds fy, 6 rfkk ykxw ugha gksus ij 7 fy[ksaa 21a. jkstxkj ds ckjs esa% fn, x, ckwdl esa jkstxkj izkir ds fy, 1 vksj csjkstxkj ds fy, 2 fy[ksaa 21b. vu; ikb~; lgxkeh fø;k, % fn, x, ckwdl esa yfyr dyk ds fy, 1] vfhku; dyk ds fy, 2] [ksy dwn ds fy, 3 rfkk vu; lkalñfrd fø;kvksa ds fy, 4 HkjsaA 22. okf"kzd ikfjokfjd vk; : 50,000 rd ds fy, 1, 1, 00,000 rd ds fy, 2, 1,50,000 rd ds fy, 3 rfkk 1,50,000 ls vf/d ds fy, 4 fy[ks aa 22a. vkffkzd n`f"v ls finm+ s oxz (bzchlh) % bzchlh ds fy, 1 fy[ks ftudh lhkh lzksrks a ls ikfjokfjd okf"kzd vk; 1-5 yk[k izfr o"kz ls vf/kd ugha gksrh vksj ykxw ugha ds fy, 2 fy[ks aa 23. fo"k; p;u % foojf.kdk dh rkfydk 1 esa fn, x, fo"k;ksa esa ls pquh xbz dksm la[;k fy[ksaa 23a. vkaf'kd vfkok nksgjs ukekadu % gk ds fy, 1 rfkk ugha ds fy, 2 fy[ksaa ;fn vkius ^gk * pquk gs] rks d`i;k uksv djsa fd vki fliqz pkj ;k mlls de fo"k; pqu ldrs gsa vksj blesa Vhvkslh ykxw ugha gksxha 24. nloha cksmz dh ijh{kk dk fooj.k % vxj vki mpprj ekè;fed ikb~;øe esa izos'k ds bpnqd gsa rks fueu tkudkfj;k vo'; nsaa d) ekè;fed ijh{kk mùkh.kz djus dk o"kz] [k) ml cksmz dk jksy uacj] x) ml cksmz dh dksm la[;k] tgk ls vkius ekè;fed ijh{kk ikl dh gs mldk dksm] foojf.kdk esa miyc/ ifjf'k"v&d ls ysaa 25. 'kqyd dk Hkqxrku foojf.kdk dh rkfydk 4 vksj 6 ds vuqlkj izos'k 'kqyd dk Hkqxrku lfpo],uvkbzvks,l ds for Punjabi, 18 for Sanskrit, 19 for Santhali, 20 for Sindhi, 21 for Tamil, 22 for Telugu, 23 for any other language. 14. Nationality: Write 1 for Indian and 2 for any other, in the box provided. 15. Religion : Write 1 for Hindu, 2 for Muslim, 3 for Christian, 4 for Sikh, 5 for Jain, 6 for Budhist, 7 for Parsi, 8 for Jews. 16. Your previous qualification: Write V, VI, VII, VIII, IX, X, XI, XII and above in the column. If you have not gone to the school write N in the box. 17. Father's Educational Qualification : Write 1 for No Education, 2 for upto Primary, 3 for upto Middle, 4 for upto Secondary and 5 for Graduate, 6 for Post Graduate. 18. Mother's Educational Qualification : Write 1 for No Education, 2 for upto Primary, 3 for upto Middle, 4 for upto Secondary and 5 for Graduate, 6 for Post Graduate. 19. Where do you live: Write 1 for Metropolitan City (Mumbai, Kolkata, Chennai, Delhi), 2 for other Cities, 3 for Rural and 4 for Semi-rural in the box provided. 20. Your Geographical Area : Write 1 for Hill Area, 2 for Remote Locality, 3 for Border Area, 4 for Tribal Area, 5 for Island, 6 for North-Eastern Region including Sikkim and 7 for Not Applicable, in the box provided. 21a. Employment : Write 1 for Employed and 2 for Unemployed in the box provided. 21b. Extra Curricular Activities : Write 1 for Fine Arts, 2 for Performing Arts, 3 for Sports and 4 for any other cultural activities in the box provided. 22. Annual family income : Write 1 for upto Rs. 50,000, 2 for upto Rs. 1, 00,000, 3 for upto Rs. 1,50,000 and 4 for Above 1,50, a. Economically Backward Class (EBC) : Write 1 for EBC for those whose family Annual income from all sources does not exceed Rs. 1.5 lakh per year. 2 for Not Applicable. 23. Subject choices: Write code No. of the subjects chosen as per the Table-1 in the Prospectus. 23a. Part or Dual Enrolment: Write 1 for yes or 2 for no. If you have opted for yes, please note that number of subjects will be restricted to 4 or less and no TOC is applicable. 24. Details of X th board examination: If you are seeking admission to the Senior Secondary Course, you should mention the following a) the year when you have passed the Secondary Examination, b) the Roll Number of the Board, c) the code of the Board from where you have passed the Secondary Examination as given in the Appendix-A in the Prospectus. 25. Amount of Fee paid: The admission fee is to be paid as per Table 4 & 6 through Bank draft only in favour of the

5 i{k esa lacaf/r esa ns; csad MªkÝV }kjk fd;k tk,xka dksbz 'kqyd udn tek u djsaa (d) izos'k 'kqyd] ijh{kk 'kqyd] vfrfjdr fo"k; 'kqyd] Vhvkslh 'kqyd rfkk dqy 'kqyd dh jkf'k fy[ksa] ([k) csad MªkÝV la[;k fy[ksa (x) csad MªkÝV dh frffk fy[ksa (?k) csad MªkÝV tkjh djus okys csad dk uke fy[ksa (M-) csad pkyku dh fo'ks"k la[;k fy[ksa 26. D;k vki ØsfMV LFkkukarj.k (Vhvkslh) ds fy, vkosnu dj jgs gsa: gk ds fy, 1 rfkk ugha ds fy, 2 fy[ksaa 27. ØsfMV LFkkukarj.k ls lacaf/r cksmz dk fooj.k% (d) ijh{kk dh ukekadu la[;k fy[ksa ftlds vk/kkj ij ØsfMV LFkkukarj.k pkfg, ([k) fo"k;ksa dks ikl djus dk o"kz fy[ksaa (x) ØsfMV LFkkukarj.k ds fy, cksmz dk dksm foojf.kdk ds ifjf'k"v&d rfkk Hkkx 2.5 vksj 2-6 esa ls fy[ksaa 28. ØsfMV LFkkukarj.k ls lacaf/r fo"k;ksa dk fooj.k% Ñi;k foojf.kdk esa miyc/ rkfydk&1 rfkk Hkkx 2-5 vksj 2-6 ns[ksaa 29. izos'k dh iqf"v u gksus dh flfkfr esa fu;ekuqlkj 'kqyd okil izkir djus ds fy, Ñi;k [kkrk la[;k] csad dk vkbz,iq,llh dksm vksj csad dk uke vksj irk lacaèkh fooj.k nsaa 30. D;k vki,uvkbzvks,l ds ekè;fed ikb~;øe esa izos'k Loizek.ki=k ds vk/kkj ij ysuk pkgrs gsa % gk ds fy, 1 vksj ykxw ugha ds fy, 2 fy[ksaa vko';d lwpuk f'k{kkfkhz ds glrk{kj vksj ekrk&firk@vfhkhkkod ds izfr glrk{kj% f'k{kkfkhz vksj ekrk&firk@vfhkhkkod Ñi;k?kks"k.kk i=k ij fnukad lfgr izos'k ds fy, vkosnu iqkwez ds ihns fn, x, dkwye ij glrk{kj djsaa iqksvks fpidkus ds fy, funsz'k % f'k{kkffkz;ksa dks lykg nh tkrh gs fd fueufyf[kr funsz'kksa dk l[rh ls ikyu djsa % 1- yxk;k x;k iqksvks N% ekg ls iqjkuk ugha gksuk pkfg,a iqksvks ij iqksvks f[kpokus dh frffk o f'k{kkfkhz dk uke fy[kk gksuk pkfg,a 2- iqksvks fpidkus ls igys iqksvks ds ihns f'k{kkfkhz dk uke vksj,uvkbzvks,l iathdj.k la[;k fy[ksaa 3- lqfuf'pr djsa fd iqksvks [kjkc u gqbz gksa 4- f'k{kkfkhz lhkh iqkweks± ij (4 lsa-eh- 3 lsa-eh-) ikliksvz vkdkj dh iqksvks fpidk,aa {ks=kh; dsanz vksj vè;;u dsanz ds fy, fu/kzfjr iqksvksizfr;ks a ij yxk, x, iqksvks fueufyf[kr esa ls fdlh,d ls lr;kfir djok, % (d),uvkbzvks,l vè;;u dsunz ds leuo;d ([k) eku;rk izkir fo ky;@egkfo ky; ds iz/kukpk;z (x) ftyk eftlvªsv (?k) jktif=kr vf/dkjh (M-) rglhynkj Secretary, NIOS payable at the concerned. No fee should be paid through cash. a) Write the amount of admission fee, additional subject fee, TOC fee and total fee paid b) Write Bank Draft No. c) Write date of Bank Draft, d) Write the name of Bank for issuing Bank Draft, e) Write the unique number of Bank Challan 26. Whether you are applying for Transfer of Credit (TOC): Write 1 for Yes and 2 for No. 27. Details for TOC Board: Write a) Enrolment No. of examination for which TOC is required, b) Year of passing the subjects, c) Code of the TOC Board as per Appendix- A and section 2.5 & 2.6 of the Prospectus. 28. Details of TOC subjects: Please see section 2.5 & 2.6 and the Table-1 of the Prospectus. 29. For claiming refund of fee in the event of not confirmation of admission as per policy, please provide details of Account Number, IFSC Code of the Bank and Name and address of the Bank. 30. Whether you wish to get admission in the Secondary Course of NIOS on the basis of Self Certificate : Write 1 for yes and 2 for Not Applicable IMPORTANT NOTE: Signature of the learner and Counter Signature of Parent/Guardian: Learner and Parent/Guardian are requested to sign the Declaration with date as per column provided on back of the Application Form for admission. Instructions for affixing Photograph: Candidates are advised to strictly follow the following instructions: 1. Photograph affixed on the application should not be more than six month old. Thedate on which photograph is made along with Name of candidate should be reflected. 2. Write NIOS registration number and name of the candidate on the back of the photo before it is being affixed. 3. Ensure that photograph is not deshaped. 4. Candidate should affix Passport size (4 cm 3 cm) photographs on all the Forms. Photograph affixed on the photocopies for and the Study Centre should be duly attested by any one of the following: (a) Co-ordinator of NIOS Study Centre (b) Principal of recognised School/College (c) District Magistrate (d) Gazetted Officer (e) Tehsildar

6 fo"k; Codes ekè;fed Examination mpprj ekè;fed Secondary Examination Ø-la- dksm fo"k; S.No. Code Subject Ø-la- dksm S.No. fo"k; CodeSubject fokku,oa izks & Technology lkekftd Science Studies x`g Science euksfokku/psychology Hkkjrh; lalñfr,oa fojklr Indian Culture and Heritage bu fo"k;ksa dh ijh{kk,d gh fnu vksj,d gh le; vk;ksftr dh tk,xha Examination of these subjects will be held on same day and same time MkWVk,aVªh Entry Operations lewg A lewg B Studies x`g Science MkWVk,aVªh Entry Operations lewg C iqlrdky; vksj lwpuk and Information Sciences D jlk;u jktuhfr Science Communication lewg E tho dkuwu dk Introduction to Law lewg F dei;wvj Computer Science i;kzoj.k Environmental Science bu fo"k;ksa dh ijh{kk,d gh fnu vksj,d gh le; vk;ksftr dh tk,xha Examination of these subjects will be held on same day and same time. bu fo"k;ksa dh ijh{kk,d gh fnu vksj,d gh le; vk;ksftr dh tk,xha Examination of these subjects will be held on same day and same time. bu fo"k;ksa dh ijh{kk,d gh fnu vksj,d gh le; vk;ksftr dh tk,xha Examination of these subjects will be held on same day and same time. bu fo"k;ksa dh ijh{kk,d gh fnu vksj,d gh le; vk;ksftr dh tk,xha Examination of these subjects will be held on same day and same time. bu fo"k;ksa dh ijh{kk,d gh fnu vksj,d gh le; vk;ksftr dh tk,xha Examination of these subjects will be held on same day and same time.

7 jk"vªh; eqdr fo ky;h f'k{kk lalfkku,uvkbzvks,l ds ksa dh lwph 1- bykgkckn jk"vªh; eqdr fo ky;h f'k{kk lalfkku mùkj izns'k ] 19/17, dlrwjck xkaèkh ekxz] dpgjh jksm] bykgkckn (mùkj izns'k) iqksu % (dk) ; isqdl % bz&esy% rcallahabad@nios.ac.in 2- csaxyq: jk"vªh; eqdr fo ky;h f'k{kk lalfkku dukzvd funs'kd dk;kzy; (O;kolkf;d f'k{kk) rhljh eafty] ih;wbz Hkou] 18oka ØkWl lsefit jksm] ekys'oje] casxyq: , dukzvd iqksu: iqsdl% , bzesy% rcbengaluru@nios.ac.in 3- Hkksiky jk"vªh; eqdr fo ky;h f'k{kk lalfkku ekul Hkou] ';keyk fgy] Hkksiky&462002] eè; izns'k iqksu% , ; isqdl % bz&esy% rcbhopal@nios.ac.in 4- Hkqcus'oj jk"vªh; eqdr fo ky;h f'k{kk lalfkku {ks=kh; osqunz bz,yvhvkbz] dseil] es=kh fogkj] panz'ks[kj iqj] Hkqous'oj & iqksu% , bz&esy% rcbbsr@nios.ac.in eè; izns'k 5- pamhx<+ jk"vªh; eqdr fo ky;h f'k{kk lalfkku gfj;k.kk (xqm+xkao] iqjhnkckn vksj >Ttj ftyksa dks NksM+dj)] iatkc] teew vksj d'ehj okbz,elh, dkweiysdl lsdvj&11lh] pamhx< vksj pamhx<+ iqksu % (dk) , ; isqdl % bz&esy% rcchandigarh@nios.ac.in; nosrcchd@eth.net 6- psuubz jk"vªh; eqdr fo ky;h f'k{kk lalfkku {ks=kh; osqunz ysmh fofyaxvu dseil] dkejktj lykbz] fvªiyhdsu] psuubz& iqksu% (iQSDl) 044& bz&esy% rcchennai@nios.ac.in 7- nsgjknwu jk"vªh; eqdr fo ky;h f'k{kk lalfkku 69@106] fujatuiqj] vkbzvhvkbz nsgjknwu ds lkeus] nsgnjknwu& iqksu% , iqsdl% bz&esy% rcdehradun@nios.ac.in 8- fnyyh jk"vªh; eqdr fo ky;h f'k{kk lalfkku,&31] balvhv~;w'kuy,fj;k],u-,p-&24] lsdvj&62] uks,mk (m-iz-) iqksu % (dk) , isqdl % , bz&esy% rcdelhi@nios.ac.in 9- /ez'kkyk jk"vªh; eqdr fo ky;h f'k{kk lalfkku nwljk ry] pkewamk dkweiysdl (vk;dj fohkkx ds ikl) njh jksm+] /ez'kkyk] ftyk dkaxm+k] fgekpy izns'k& iqksu %(dk) , bz&esy: rcdharamshala@nios.ac.in 10- xka/huxj jk"vªh; eqdr fo ky;h f'k{kk lalfkku eyvh LVksjh fcfymax] Mh foax] lkroka ry] lsdvj&11] iffkdk vkje ds ikl] xka/huxj , iqksu : iqsdl : bz&esy: rcgandhinagar@nios.ac.in mm+hlk rfeyukmq] ikafmpsjh mùkjk[kam] esjb] ckxir] lgkjuiqj rfkk eqtiq~iqjuxj] eqjknkckn] rfkk ts-ih- uxj (vejksgk) vksj mùkj izns'k ds ftys jk"vªh; jkt/kuh {ks=k fnyyh rfkk blds m-iz-,oa gfj;k.kk ds utnhdh ftys ftuesa 'kkfey gsa xksre cq¼ uxj (uks,mk rfkk xzsvj uks,mk)] xkft+;kckn] xqm+xk o] iqjhnkckn rfkk >TtjA fgekpy izns'k xqtjkr

8 11- xqokgkvh jk"vªh; eqdr fo ky;h f'k{kk lalfkku ukxkysam] v#.kkpy izns'k] vle] ef.kiqj] vle izdk'ku cksmz dk Hkou] es?kky;] fetksje vksj f=kiqjk (vle ekè;fed f'k{kk cksmz ds ikl) izfke ry] ckequh esnku] xqokgkvh (vklke) iqksu % ; isqdl % bz&esy% rcguwahati@nios.ac.in; nosghy1@sancharnet.in 12- gsnjkckn jk"vªh; eqdr fo ky;h f'k{kk lalfkku rsyaxkuk edku ua- 17&26] Jh uxj dkwyksuh] jksm ua- 5] fnylq[k uxj] gsnjkckn iqksu % (dk) ; isqdl % fo'kk[kkiv~vue jk"vªh; eqdr fo ky;h f'k{kk lalfkku] {ks=kh; osqunz vka/z izns'k ik poka ry] ch&cykwd] oh;wmh, dkweiysdl] flfjiqje] fo'kk[kkiv~vue] vka/z izns'k iqksu % (dk) (iqsdl) bz&esy% srcvisakhapatnam@nios.ac.in 14- t;iqj jk"vªh; eqdr fo ky;h f'k{kk lalfkku ] Mh&11&12] :i fogkj dkwyksuh] eksgu ekxz] jktlfkku djksyh xkmzu ds lkeus] U;w lkaxusj jksm] lksmkyk] t;iqj (jktlfkku) & iqksu % (dk) , , (iqsdl) bz&esy% rcjaipur@nios.ac.in mi ] dksvk nwljk ry] 2&ih,&1] fokku uxj esu jksm] dksvk& bz&esy % srckota@nios.ac.in, iqksu % dksph jk"vªh; eqdr fo ky;h f'k{kk lalfkku ] 6oha eafty] dsjy LVsV gkmflax cksmz fcfymax osqjy iukefiyyh uxj] dksph iqksu % (dk) , (T/F) bz&esy% rckochi@nios.ac.in 16- dksydkrk jk"vªh; eqdr fo ky;h f'k{kk lalfkku ] 10@1@,p] Mk;eaM gkjcj jksm] flfdde] if'peh caxky vksj vameku o dksydkrk (if'peh caxky) fudksckj }hilewg iqksu % (dk) ; isqdl % bz&esy% rckolkata@nios.ac.in mi&{ks=kh; lsy iksvz Cys;j iksvz Cys;j funs'kky; esa izks<+ f'k{kk vameku,oa fudksckj iz'kklu f'k{kk lnu vameku,oa fudksckj }hilewg] iksvz Cys;j 17- ivuk jk"vªh; eqdr fo ky;h f'k{kk lalfkku ] fcgkj yfyr Hkou] xzkmam Ýyksj] tokgj yky usg: ekxz] csyh jksm] ivuk ] fcgkj iqksu % (O) , bz&esy% rcpatna@nios.ac.in mi{ks=kh; osqunz% njhkaxk eks- [kku pksd] esu [kku pksd ds ikl] ikslv yky ckx] ftyk njhkaxk& (fcgkj)] iqksu % iq.ks jk"vªh; eqdr fo ky;h f'k{kk lalfkku ] }kjk Hkkjrh; f'k{kk lalfkku] egkjk"vª] xksok] neu vksj nho 128@2 tsih ukbd jksm] Jh fuosqru lkslk;vh (lksykfjl Dyc ds ikl)] dksfk:n] iq.ks (egkjk"vª) iqksu % (dk) , ; isqdl% bz&esy% rcpune@nios.ac.in 19- jkaph jk"vªh; eqdr fo ky;h f'k{kk lalfkku >kj[kam ] Ldwyh f'k{kk] Nk=kkokl ifjlj, vej 'kghn Bkdqj fo'oukfk] 'kkgnso ftyk Ldwy] ftyk Ldwy ifj"kn] jkaph bz&esy% rcranchi@nios.ac.in 20- jk;iqj jk"vªh; eqdr fo ky;h f'k{kk lalfkku ] NÙkhlx<+ ch-vh-vkbz] xzkmam] MkbV ifjlj] 'kadj uxj] jk;iqj , NÙkhlx<+ iqksu: (O) , bz&esy% chhatisgarh@nios.ac.in

9 List of the s of NIOS Name of the Region Address of the Jurisdiction 1. ALLAHABAD National Institute of Open Schooling 19/17, Kasturba Gandhi Marg, Kachahari Road Allahabad (Uttar Pradesh) Ph.: (O) (Fax) rcallahabad@nios.ac.in 2. BENGALURU National Institute of Open Schooling Office of the Director (Vocational Education) 3rd Floor, PUE Bhawan, 18th Cross Sampige Road, Malleswaram, Bengaluru , Karnataka Ph.: Fax: rcbengaluru@nios.ac.in 3. BHOPAL National Institute of Open Schooling Manas Bhawan, Shyamla Hills, Bhopal (M.P.) Ph.: , Fax : rcbhopal@nios.ac.in 4. BHUBANESHWAR National Institute of Open Schooling ELTI Campus Maitrivihar, Chandrashekhar Pur, Bhubaneswar Ph. no : rcbbsr@nios.ac.in Website: htpp://rcbbsr.nios.ac.in 5. CHANDIGARH National Institute of Open Schooling YMCA Complex, Sector-11C, Chandigarh Ph.:(O) , Fax : rcchandigarh@nios.ac.in Uttar Pradesh Karnataka Madhya Pradesh Odisha Haryana (Excluding gurgaon, Faridabad & Jhajjar) Punjab, Jammu & Kashmir and Chandigarh 6. CHENNAI National Institute of Open Schooling Tamil Nadu, Pondicherry Lady Willington Campus, Kamrajar Salai, Triplicane, Chennai , Tamilnadu Ph. no Fax: rcchennai@nios.ac.in 7. DEHRADUN National Institute of Open Schooling Uttrakhand, Meerut, Bagpat 69/106, Niranjanpur, Opp. ITI Dehradun Saharanpur, Muzaffar Nagar, Moradabad Dehradun and J.P. Nagar (Amroha) districts of U.P. Ph.: (O) , ; Fax : rcdehradun@nios.ac.in 8. DELHI National Institute of Open Schooling NCT of Delhi and bordering Distts. of NCT in Uttar Pradesh and Haryana comprising A-31, Institutional Area, NH-24, of Distts. of Gautam Buddh Nagar (Noida Sector-62, NOIDA and Greater Noida), Ghaziabad, Gurgaon Distt. - Gautam Buddha Nagar (U.P.) Faridabad and Jhajjar. Ph: (O) , Fax : rcdelhi@nios.ac.in 9. DHARAMSHALA National Institute of Open Schooling Himachal Pradesh 2nd Floor, Chamunda Complex, (Near Income Tax Office) Dari Road, Dharamshala, Distt. Kangra , Himachal Pradesh, Ph. (O) rcdharamshala@nios.ac.in 10. GANDHI NAGAR National Institute of Open Schooling Gujarat Multi Storied Building, D Wing, 7th Floor, Sector-11, Near Pathikaashram, Gandhinagar , Gujarat Ph.: , Fax: rcgandhinagar@nios.ac.in 11. GUWAHATI National Institute of Open Schooling Building of Assam Publication Board, (Near Assam Board of Secondary Education) Ist Floor, Bamunimaidan, Guwahati (Assam) Ph. (O): , (Fax) rcguwahati@nios.ac.in Nagaland, Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram and Tripura

10 12. HYDERABAD National Institute of Open Schooling House No , Sree Nagar Colony, Rd. No. 5 Dilsukh Nagar, Hyderabad , Telangana Ph.: (O) , Fax : VISAKAPATNAM National Institute of Open Schooling 5th Floor, B Block, VUDA Complex, Siripuram, Visakapatanam, Andhra Pradesh Ph.: , srcvisakhapatnam@nios.ac.in Telangana Andhra Pradesh 14. JAIPUR National Institute of Open Schooling Rajasthan D Roop Vihar Colony, Mohan Marg, Opp. Karoli Garden, New Sanganer Road, Sodala, Jaipur ( Rajasthan) Ph.: (O) , Fax.: rcjaipur@nios.ac.in Sub Kota 2nd Floor, 2-PA-1, Vigyan Nagar Main Road, Kota srckota@nios.ac.in Ph. No KOCHI National Institute of Open Schooling Kerala 6th Floor, Kerala State Housing Board Building, Panampilly Nagar, Kochi Ph.: , (T/F) rckochi@nios.ac.in 16. KOLKATA National Institute of Open Schooling 10/1/H, Diamond Harbour Road, Kolkata (W.B.) Ph.: (O) , Fax : rckolkata@nios.ac.in SUB-REGIONAL CELL PORT BLAIR Adult Education in the Directorate A&N Administration Shiksha Sadan A&N Island, Port Blair Sikkim, West Bengal and Andaman and Nicobar Island Port Blair 17. PATNA National Institute of Open Schooling Bihar Lalit Bhawan, Ground Floor, Jawahar Lal Nehru Marg, Bailey Road, Patna (Bihar) Ph.: (O) , rcpatna@nios.ac.in SUB-REGIONAL CENTRE DARBHANGA Moh- Khan Chowk Near Main Khan Chowk PO Lal Bagh Distt. Darbhanga Phone : PUNE National Institute of Open Schooling C/o Indian Institute of Education Campus, 128/2 JP Naik Road, Sriniketan Society, (Near Solaris Club) Kothrud, Pune (Maharashtra) Ph. (O) , (Fax) rcpune@nios.ac.in Maharashtra, Goa and Daman & Diu 19. RANCHI National Institute of Open Schooling Jharkhand Schooling, Hostel Premises, Amar Shahid Thakur Vishavanath Shahdev Zila School, Zilla School Parishad, Ranchi rcranchi@nios.ac.in 20. RAIPUR National Institute of Open Schooling B.T.I Ground, DIET Campus, Shankar Nagar Ph: (O) , Raipur , Chhatisgarh chhatisgarh@nios.ac.in Chhatisgarh

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13 fo k/kue~ loz/kua iz/kkue~ Provisional Admission Letter-cum-Receipt for 2016 National Institute of Open Schooling A-24/25, Institutional Area, Sector-62, NOIDA , Uttar Pradesh Form No. (To be filled in by the Accredited Institution) Received Application Form from for admission to Secondary/Sr. Secondary on alongwith a fee of Rs. through Bank Draft No. dated. We are happy to inform you that you have been offered provisional admission in the Secondary/Sr.Secondary Course of NIOS in the current academic session i.e., in the following subjects, subject to the confirmation and verfication of your records/documents. Your Reference No. is Please note this number carefully as you have to quote this for communication with your AI (Study Centre)/concerned NIOS Regional Centre. Dated Signature Name of the Official Seal of AI (Study Centre) with AI. Code No. Cancellation of Admission Your admission will be cancelled : if the Admission Form is incomplete, if the fee paid is short, if the supporting documents are not complete, if false documents have been submitted, if required educational qualifications are not fulfilled, if the minimum age criteria is not fulfilled, if incorrect or wrong information is given, if the secondary examination is not passed from a recognised Board. if proof of residential address is not attached. Note: (i) Admission once cancelled will not be re-considered. (ii) If any discrepancy is noticed at any stage of admission even if the Identity Card is issued, the admission will be cancelled and result will not be declared even if appeared in examination.

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