Jawahar Navodaya Vidyalay
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1 Jawahar Navodaya Vidyalaya (Ministry of Human Resource Development) Deptt. of School Education & Literacy, Government of India Rewar, Nawada (Bihar) Ref.No.J.N.V Date To.... Sub:-Intimation regarding provisional admission of applicant in class-vi at Jawahar Navodaya Vidyalaya,Rewar,Nawada during the session Sir, With pleasure I wish to inform you that Central Board of secondary Education, had conducted Entrance Examination on for Jawahar Navodaya Vidyalaya and on the basis of select list your son/daughter /Master/Km.Roll.No has been selected provisionally for admission in class VI in this Vidyalaya. He/She is only entitled to take admission after fulfillment of prescribed conditions, In this connection you need to attend Principal s Office with student on We are enclosing some prescribed formats with letter and the applicant must fill up these formats with the help of Headmaster of that school from where he/she has passed 5 th class and submit the same. Admission form must be accompanied with the signature of Guardian & countersigned by the Headmaster. The following documents should be submitted: 1. Admission booklet should be fully filled up sent by the Vidyalaya through registered post. 2. Class V passed T.C counter signed by D.E.O. 3. Report card of class 3 rd.4 th & 5 th counter signed by B.E.E.O. 4. Cast Certificate counter signed by S.D.O. 5. Residential Certificate counter signed by S.D.O. 6. Income Certificate counter signed by C.O/B.D.O. 7. Rural /Urban certificate counter signed by Tehsildar/B.E.E.O to show that school is located in rural/urban area. 8. Affidavit in the prescribed format. 9. Four Passport size photographs of student and two each guardian. 10. Photocopy of Aadhar Card. 11. Blood group certificate issued by pathologist. 12. Medical checkup facility provided by Vidyalaya Doctor on reporting day in the Vidyalaya campus only. In the case of disable, disability certificate issued by the competent authority. 13. General and OBC male students have to pay Rs.200/- per month as Navodaya Vikas Nidhi from class-ix onwards. They will be exempted from fee if they have a BPL(Blow Poverty Line) certificate signed by District Magistrate. The candidature can be rejected,if you will not be present in the Vidyalaya on the fixed date, along with the desired documents. Principal Jawahar Navodaya Vidyalay
2 (To be filled in by the Parent/Guardian of the Candidate with the help of the Headmaster/mistress of the School from where the candidate passed Class V Examination) 1.Name of the Candidate:. Aadhar Number:.. PHOTO OF STUDENT 2. Sex 3. (a) Category Male Female TG Gen OBC Sc ST (b) Caste 4.Date of Birth :. Date Month Year In words : 5. Father s Name : 6. Mother s Name : 7. Name of the Guardian and relationship with him/her, if applicable :. 8. School(s) from where the candidate passed Class III, IV and V. CLASSES III IV V (A) (i) Month & Year of Joining (B) (C) (D) (E) (F) (ii) Month & Year of Passing (i) Name of the School (ii) Is It a recognized school? (YES/NO) Name of the Village or Town in which the school is located. Name of the Block Name of the District Location of the School Indicate RURAL/URBAN (Separate certificate is to be obtained if the candidate had studied classes III, IV & V in different schools)
3 CERTIFICATE (BY PARENT/GUARDIAN OF THE CONCERNED CANDIDATE) 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. Entries verified, certified and found correct. Signature of PARENT/GUARDIAN Signature of the HEADMASTER/HEADMISTRESS Name : Desgn.: School Seal : NOTE FOR THE HEAD OF THE SCHOOL: Dear Sir/Madam, The above mentioned information is required for admission of the candidate in the Jawahar Navodaya Vidyalaya, District Nawada. You are therefore requested kindly to check and verify personally all the entries from the school records and issue the certificate given below:- CERTIFICATE BY THE HEAD OF THE SCHOOL Principal JNV Rewar,Nawada 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 Shool in Class on (date) and passed Class on (date). Signature of the Head of Institution Date : last studied with School Sea
4 UNDERTAKING BY THE PARENT/ GUARDIAN Certified that the information given in the application form for admission into Class VI in Jawahar Navodaya Vidyalaya, District: Nawada for the academic year 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 my original application entries. Address of parent/guardian: Signature of the parent/guardian Name: H.No: Street Village Mandal/Block Pin Code: STD Code: Phone No Mobile No: UNDERTAKING I, (Father/ Mother/ Guardian) of Kumari/Master who got selected for admission into Class VI in Jawahar NavodayaVidyalaya,.District hereby give an undertaking that I am ready to pay Rs (Rupees Twohundred only) per month or revised amount or as charged by the Navodaya Vidyalaya Samiti, Noida from Class IX to XII. Signature of the parent/guardian Note: This is not applicable to SC/ST categories and all girl students and the parents whose income is below poverty line.
5 UNDERTAKING FOR MIGRATION (TO BE FILLED BY PARENT IN PRESENCE OF PRINCIPAL, JNV) I, Father/Mother/Guardian of Kumari/Master who got selected for admission in Class VI in JNV, District hereby give an undertaking that I understand that, for promotion of National Integration and as per the scheme at JNVs, 30% of the students of class IX from one JNV have to migrate to another JNV from non- Hindi speaking area to Hindi speaking area and vice-versa and I agree to abide by the rules of NVS in this regard. Signature of the parent/guardian Full name: Address: Mobile No: Land line with STD code:
6 JAWAHAR NAVODAYA VIDYALAYA: DISTRICT: MEDICAL FITNESS CERTIFICATE 01. Name of the candidate : 02. Father s name : 03. Address : 04. Date of birth 05. Height 06. Weight 07. Abdomen 08. Chest 09. Vision LEFT RIGHT 10 Ears 11. Throat 12. Locomotor system 13. State of vaccination 14. Skin 15 Blood Group 16 Dental Hygiene 17. Remarks of Medical Officer : Recommended/not recommended for admission/recommended to C.M.O for Verification if any. PHOTO OF THE STUDENT CIVIL SURGEON
7 DISABILITY CERTIFICATE If the candidate is selected under disabled quota he/she should bring the certificate issued by the competent authority. COMMUNITY CERTIFICATE Community certificate in the prescribed format from the competent authority is to be submitted by the candidate, wherever necessary. RURAL CERTIFICATE (To be issued by the Revenue Officer of concerned Block) This is to certify that Master/Kumari Son/daughter of Shri studied classes III, IV & V In (Name of the school) of block and the school is located in the village which belongs to RURAL AREA of District;,State:. (Signature of the Revenue Officer) Block: District. Office Seal: Dated:
8 RESIDENCE CERTIFICATE (To be furnished by the parents of the qualified children at the time of admission to JNVs) As per Jawahar Navodaya Vidyalaya, District, State letter No: dated: my ward Master/Kumari has qualified the entrance exam for admission to Class VI at JNV, District, State during the session I am residing along with my ward mentioned above at the following address: 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. Signature of the parent Full name: Address: *Applicable for the students who seek admission through the studies in NIO
9 C E R T I F I C A T E (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 VI IN JNVS THROUGH JNVST) This is to certify that the above information furnished by Shri/Smt Father/Mother of Master/Kumari a candidate for admission to class VI in JNV, District has been verified from the records and is found to be correct. *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.
10 Jawahar Navodaya Vidyalaya (Ministry of Human Resource Development) Deptt. of School Education & Literacy, Government of India Rewar, Nawada (Bihar) AFFIDAVIT (An affidavit to be furnished by parents on Rs Stamp Paper Duty attested by notary at the time of admission to Class VI in JNVs through JNVST) I..Age.Years, father/mother of Mast./Kumari.Distt..solemnly declare and affirm as under: (a) My ward is a student of.(name and complete address of the institution) located in.which is a rural area in District. He/She has passed class V from this institution during the session.. (b) My ward is residing with me at following address which is located in the..rural area of District. (c) He/She has appeared first time in JNVST for class VI, Prior to the year 2017 he/she has not appeared in the entrance examination JNVST from any district. (d) The documents/certificate submitted by me is insupport of the candidature of my ward are correct in my knowledge. If in later stage it is found incorrect/ fake,i will be directly responsible for the same. (e) During his/her early childhood all the vaccination has been given to my ward and he/she is not suffering with any type of disease. Verified on this the..the..20. at that the contents of above affidavit are true to best of my knowledge and belief and based on record and believed by me tome true. Signature (Deponent) Place Date.. Name:
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