JAWAHAR NAVODAYA VIDYALAYA - · PDF fileJAWAHAR NAVODAYA VIDYALAYA UDUVALLI POST, ... 20...

JAWAHAR NAVODAYA VIDYALAYA UDUVALLI POST, HIRIYUR TQ , CHITRADURGA DIST

1 Bio Data Signature required Parents, Head Master and concerned Taluk BEO officer ( Bio-data copy

enclosed )

1

2 Acceptance/Willingness Required Parents Signature (Copy Enclosed ) 2

3 Marks Card and the Pass Certificate of Class V Original copy Issued from school

4 Affidavit in original in a Stamp Paper duly attested by the Notary

Matter copy enclosed for reference 3

5 The Residence Certificate in original signed by the Parent and duly attested by the Competent Authority (SDM/Tehsildar)

Matter copy enclosed for reference 4

6 The Medical Fitness Certificate in original-certified, signed and sealed by the Medical Officer

Copy enclosed 5

7 The attested copy of the Birth Certificate issued by the competent Authority

Original copy issued from Authorized officer

8 The Rural Certificate in original issued by the Competent Authority(SDM/Tehsildar/PDO/Panchayat)

Copy enclosed 6

9 The Caste Certificate (Category) in original issued by the Competent Authority (SDM/Tehsildar)

Original copy of issued from Authorized officer

10 The Income Certificate in original issued by the competent Authority (SDM/Tehsildar)

Original copy of issued from Authorized officer

11 Undertaking - Fees Structure Copy enclosed 7

12 Undertaking – (VI Class to XII) Copy enclosed 8

13 Undertaking – (IX Migration) Copy enclosed 9

14 Undertaking - (Mobile Phone & Electronic gadgets)

Copy enclosed 10

15 Declaration – (Damage or loss) Copy enclosed 11

16 Socio – Economic Status Copy enclosed 12

17 School Health Record Copy enclosed 13

18 Application for Admission Copy enclosed 14

19 Student Recent color photos 3 No.

20 Adhar Card -Xerox Copy 2 set Xerox Copy

21 Ration Card (APL or BPL) – Xerox copy Xerox Copy

22 Bhagya Lakshmi yogana card –Xerox copy Xerox Copy

(ALL FORMAT SHOULD BE FILL IN ENGLISH ONLY)

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BIO-DATA FORM

(To be filled by the parent of the candidate with the help of Head Master of the school from where the child has passed Class V Examination) 01. Name of the candidate : ________________________________

02. Sex (Male/Female) : ________________________________

03. (a) Category (GEN/SC/ST/OBC) : ________________________________

04. Date of Birth in figures : ________________________________

In wards: Date:___________________Month:________________Year:______________

05. Father’s Name (In Capital) :______________________________________________

06. Mother’s Name (In Capital) : _____________________________________________

07. Name of the guardian & relationship

With him/her in case father is not the guardian (in Capital)

08. School (s) from where the candidate passed class III and IV and is studying is Class V:

Sl

No.

Particulars CLASSES

III IV V

01 Month & Year of joining

02 Month & Year of passing

03 Name of the School

04 Is it recognized school (Yes/No)

05 Name of the Village or Town

(in which the school is located)

06 Name of the Taluk

07 Name of the District

08 Whether the school is located

In Rural/Urban (Write Rural/Urban)

09 Whether the candidate failed in

class III, IV and V

10 Whether the candidate sat for

JNVST during the previous year

11 SCHOOL DISE CODE

12 STUDENT ID

Signature of the Head Master and Seal

CERTIFICATE

(BY PARENT/GUARDIAN OF THE 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 relevant certificates/issued by competent authorities and when asked for.

Date: / /2017 Signature of the parent/Guardian _______________________________________________________________________________

NOTE FOR HEAD OF THE SCHOOL .

Dear Sir/Madam,

The mentioned information is required for admission of the candidate in the Jawahar Navodaya Vidyalaya. You are therefore requested to kindly check and verify personally all the entries from the school record and issue the certificate given below: Principal

JNV, Chitradurga Dist. _______________________________________________________________________________

CERTIFICATE BY THE HEAD OF THE SCHOOL

Certified that the information given above is true as per school records. It is also certified that

Master/Kumari ________________________________________________________________

S/o D/o._____________________________________________ was admitted in this school in

class__________________ standard on ______________ (date) and passed class

_________________standard on_______________(date).

Signature of the Head Master with seal

Name: ………………………………………………….. Date: / /2017 Designation: Head Master/Head Mistress

Counter Signature by :

Date : Signature of the BEO & Seal (Block Education Officer)

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_______________________________________________________________________________

RURAL AREA CERTIFICATE

(to be certified by an officer not below the rank of Tahasildar).

This is to certify that Kumari/Kumar ___________________________________________

D/o,S/o ______________________________________who had studied in class III,IV, V in the

school (Name of the School) __________________________________________at (Name of the

village) _________________________which comes under rural category as per the 1991 census.

Date : / /2017 Signature of the Tahasildar & Seal Place: (Block Education Officer)

Note :

1 if the candidate has studied in more than one place and is calming rural quota he/she has to produce rural eligibility certificate for all places of study. 2 if below poverty line /Non below poverty line certificate may be issued separately.

AFFIDAVIT

(An affidavit to be furnished by parents on____________Stamp paper duly attested by

Notary at the time of admission to Class VI in JNVs through JNVST)

I_______________ Aged____________Years, Father/Mother of Master/Kumari___________

Resident of Village______________________Post Office_____________________________

Tehsil________________________________District___________________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/URBAN area in District in

State since ____________________________________________________

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/URBAN area of District___________________

Verified on this ________________day of _________________2017 at _________place that

the contents of above affidavit are true to best of my knowledge and belief based on record

and believed by me to be true.

Place:__________________ Signature Name Date:__________________

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RESIDENCE CERTIFICATE

(To be furnished by the parents of the qualified children at the times of admission to JNVs)

As per Jawahar Navodaya Vidyalaya________________________________________

District ________________State _________________Letter No._______________________

Dated ____________________my ward Mast./Kum ______________________has qualified the

entrance exam for admission to Class VI at JNV _________________District___________

State/UT _______________________during the session_______________________.

I am residing along with my ward mentioned above the following address since___________

Village_________________________

Town__________________________

District________________________

State__________________________

Pin Code_______________________

Certified that the information furnished by me is true and no fact has been concealed.

Place: __________________ Signature of Parents

Date: __________________ Full Name and Address

……………………………………………………………………………………………………………………………………………….

CERTIFICATE

(To be filled by the District Authorities and issued under the signature of SDM/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 selected 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 District______________________

Signature SDM/Tehsildar

JAWAHAR NAVODAYA VIDYALAYA, UDUVALLI, CHITRADURGA DIST

MEDICAL FITNESS CERTIFICATE

A) PARTICULARS OF CANDIDATE:

i) Name of the student : ii) Name of the parent / guardian : iii) Permanent Address : iv) Age a) According to the candidate : b) By appearance : v) Sex (Male/Female) : vi) Date of Medical Examination :

B) PHYSICAL EXAMINATION C) SYSTEMIC EXAMINATION i) Height : ………………………… 1. i) Heart : …………………….. ii) Weight : ………………………… ii) Lungs : …………………….. iii) Chest (on full inspiration) 2. ABDOMEN

i)Liver iv) Ovarosis : ……………………….. ii) Splee v) Blood pressure : ……………………….. iii) G.T. Tract vi) Anemia : ……………………….. 3. UROGENITAL TRACT

vii) Oedema : ……………………….. i) Urinary tract viii) Clubbing 4. CARDIVASCULAR NERVOUS SYSTEM

ix) Varicose Vein x) Physical make up 5. CENTRAL NERVOUS SYSTEM xi) Phusical deformities xii) Mental abnormality, if any : …………………….. 6. DYMPHO GRADULARY STSTEM xiii) Hydrocile / Hernia if any: …………………………. xiv) Menshed / Disturbance, if any: ………………… 7. Special sensory system xv) Any congenital abnormality i) Ear : ……………… ii) Nose : ……………… xvi) Blood Test: iii) Throat : ………………

a) W.B.C : ……………………. iv) Oral Cavity : ……………… b) E.S.R : ……………………. c) H.B : ……………………. d) Blood Group : …………………….

Certified that the above particulars are true to the best of my knowledge and belief. Certified that the above student is found physically as well as mentally FIT/UNFIT for admission in JNV, Chitradurga.

Name & Signature of the Parent Signature of the Medical Officer with Seal and Date.

JAWAHAR NAVODAYA VIDYALAYA

UDUVLLI POST, HIRIYUR TQ, CHITRADURGA DIST, KARNATAKA STATE

FEES STRUCTURE

Implementation of recommendation of the expenditure reforms commission regarding collection of fee from the students whose families are above poverty line: The expenditure reforms commission constituted by the HRD, Govt., of India after careful consideration as recommended for charging a monthly fees from the students whose families are above the poverty line. After a great deal of deliberation, it has been decided to initially charge Rs.200.00 per student per month from all he students from IX to XII class excluding SC,ST and Girl students from July 2003. These charges may also gradually be increased to Rs.300.00 per month in due course after undergoing the experience of collection of the fee for Rs.200.00 per month. Since the education at Primary and middle level is free. The fees will be collected only from the students studying in IX class and above. The students whose families are below poverty line as per the certificate of the District Magistrate concerned are exempted from the fee, meaning thereby, all the children whose families are below poverty line, SC,ST and girls students are exempted from the fee. This is aimed at involving a token participation from the families of the students who can economically afford for such payment. This monthly installment of fee may be changed as per Govt., Policy and you are binding to all those changes. The following category of students are exempted from payment of fee.

1. Students belong to SC, ST (Boys and Girls) 2. All the Girls students of the Vidyalaya (General and OBC) 3. Students whose families are below the poverty line on the basis of certificate issued by

the Dist Magistrate concerned pending finalization of detailed guidelines in determining the methodology for below poverty line.

UNDERTAKING I, Shri………………………………………………………….. father of ……………………………………… hereby state that the above contents ready by me and understood. I agree for the above the contents and I will pay the fees fixed by the Samiti to my ward from IX class onwards. Date: Signature of the parent Name:

Signature of the Principal.

U N D E R T A K I N G

This is to certify that:-

(i) I am aware of that education in Jawahar Navodaya Vidyalaya is up to Class XII and my ward admitting in class VI has to study up to Class XII in Jawahar Navodaya Vidyalaya unless otherwise decided by Navodaya vidyalaya Samiti / School Administration.

(ii) And I am aware of that a child once admitted in JNV cannot be withdrawn at the request of his/her parent/guardian before completion of the prescribed study in JNV unless it is proved that the child is suffering from chronic and contagious disease.

I, Shri/Smt………………………………………………………………………………………………… Therefore, do hereby declare that I will not insist the school Administration for insurance of the transfer certificate of my ward before his/her completion of study in JNV for the reasons other than on medical ground as stated at Sl. No. 2 above. In case of my failure to comply with my assurance above, I am bound to pay the entire expenditure incurred upon my ward by NVS right from admission in Class VI to till time of withdrawal and I will abide by the decision of the School Administration/NVS.

Parent Signature:……………………………………………….

Name:…………………………………………………….

Full Address:…………………………………………..

………………………………………………………………

………………………………………………………………

Place: JNV, Uduvalli ..………….……………………………………………….

Date: ………………………………………………………………

UNDERTAKING I, ……………………………………………………………….. Father/Mother/ Guardian of Master/Kumari ………………………………………………………who has been selected for admission to Jawahar navodaya Vidyalaya, Uduvalli, Hiriyur tq., Chitradurga district Karnataka state hereby given the following undertaking:-

1. That I have read the contents of the information bulletion supplied along with the application form for admission to the JNV, Uduvalli, Chitradurga District Karnataka State in respect of my ward and have been explained to me in vernacular and I have understood the same.

2. I have made a declaration in the application form that in the interest of National Integration (Migration) and under the Navodaya Vidyalaya Scheme, students I transferred from one school to another Navodaya vidyalaya on reaching class IX. I hereby undertake and declare that I shall abide by the said conditions of the Navodaya Vidyalaya Scheme and shall have no objection if my Son/Daughter/Ward is transferred from the Navodaya Vidyalaya to which the admission is granted to any Navodaya Vidyalaya in any other linguistic state/Region as provided in the scheme.

I further undertake and declare that I shall abide by the above said condition and if may Ward/Son/Daughter refuses to move to the desired Vidyalaya, He/She will not be allowed to continue to stay in any Navodaya Vidyalaya and his/her studies would be discontinued and I shall withdraw him/her from this Vidyalaya. Date: Name and Signature of the Father/Mother/Guardian. Parent Full Address and Phone No. ………………………………………………………. ………………………………………………………. ………………………………………………………. ……………………………………………………….

UNDERTAKING

(TO BE FURNISHED BY THE PARENT/SCHOLAR DULY SIGNED IN THE PRESENCE OF PRINCIPAL/VP)

I ……………………………………………………………………………………Father/Mother of

Master/Kumari …………………………………………….. student of Class ……………………., JNV,

Chitradurga residing at ………………………………………………………….. do give undertaking

that my ward was not given mobile phone and electronic gadgets for use while he

is studying in the Vidyalaya. If he/she found using mobile phone and electronic

gadgets in the school campus, necessary action as deemed fit as per the guidelines

of NVS may be initiated against my child for whom I have no objection.

(Signature of the Parent) (Signature of the Candidate) Name : Date : Academic year:

JAWAHAR NAVODAYA VIDYALAYA

UDUVALLI, CHITRADURGA

D E C L A R A T I O N

I……………………………………………………………………………………………………………F/O M/O Master/Miss

…………………………………………………………………………….who is being admitted to Class VI in this

Vidyalaya hereby agree that my ward as well as I will abide by all the existing rules and

procedures of this Vidyalaya the rules and procedures that are likely to be introduced in due

course.

Further, I declare that in case my ward causes any damage or loss to the Vidyalaya property, I

shall compensate the same by paying the penalty/fine as may be imposed by the Vidyalaya

authorities.

Name and address of the parent.

………………………………………………………………

………………………………………………………………

………………………………………………………………

………………………………………………………………

Place:

Date:

JAWAHAR NAVODAYA VIDYALAYA UDUVALLI POST, HIRIYUR TQ, CHITRADURGA DIST, KARNATAKA STATE

SOCIO-ECONOMIC STATUS

(Cross the relevant Columns by a tick mark)

1. Name of the Student : ……………………………………………………………………

2. Name of the Father : ……………………………………………………………………

3. Name of the Mother : ……………………………………………………………………

4. Category : General / OBC / SC / ST

5. Name of the Caste : ……………………………………………………………………

6. Caste Certificate NO. : ……………………………………………………………………

7. Selection Category (Area) : Urban /Rural

8. Annual Family Income of : Father: Rs. ____________ (in words)_______________________________

Mother: Rs. ____________ (in words)______________________________

9. Education Qualification of parents:

Qualification Father Mother

Illiterate

Primary

Higher Primary

Secondary Metric

Higher Secondary

Graduate

Post Graduate

Technical/Professional

Any other (Specify)

10. Occupation of Parents:

Occupations Father Mother

Agriculture

Labour

Industrial Worker (Organized Sector)

Self Employed (Give particulars)

Business

Clerical

Technical

Professional

Other (Specify)

----------2----------

11. Family Members : ______________________________________(including parents) 4 or less than 5 / 5 or less than 6 / 7 or less than 8 / 9 or more

No of Sisters: _______________ No of Brothers :______________

12. Any other noteworthy information:

13. Do you belong to Chitradurga Dist ? If so give your address and Phone No.

__________________________________________________________________________

__________________________________________________________________________

_____________________________________Phone No._____________________________

14. If you do not stay in Chitradurga District and if Boy/Girl has studied in Chitradurga

District: give guardian’s address and Phone No.

___________________________________________________________________________

___________________________________________________________________________

_________________________________________ Phone No._________________________

15. Do you do have any relative / Local guardian in Hiriyur ?

If so give their address and phone No.

___________________________________________________________________________

___________________________________________________________________________

_________________________________________ Phone No._________________________

Date: Signature of the Parent: Place: Signature of the Student: Signature of the Principal:

JAWAHAR NAVODAYA VIDYALAYA UDUVALLI POST, HIRIYUR TALUK, CHITRADURGA DIST, KARNATAKA STATE

SCHOOL HEALTH RECORD GENERAL INFORMATION

1. Name of the students

2. Date of Birth

3. Name of the Father’s / Guardian’s

4. Address

5. Phone No. Note: The schools before implementing the Health cards may consult a local registered Medical practitioner.

Attach Photo in

this box

-----------2-----------

BOTH SIDES OF THIS FORM TO BE SUBMITTED AT THE TIME OF ADMISSION Name of the student…………………………………………………………. M/F ……………………… Class ……………date of birth …………………………………… Blood Group …………………….. Father’s Name…………………………………………………………………………………………………… Mother’s Name …………………………………………………………………………………………………

VACCINATIONS

IMMUNIZATION AGE RECOMMENDED

DUE DATE DATE

BCG 0-1 Month

Hepatitis B At Birth 1 Month

6 Months

DTP 2 Months 3 Months

4 Months HB 2 Months

3 Months 4 Months

Oral Polio At births

1 Month 2 Months

3 Months 4 Months

Measles 9 Months

MMR 16 Months Dot + Opv+Hib 18 Months

Typhoid 2 Years Hepatitis (2 Doses) 2 Years

Chicken pox After age 1 year DT- OPA 41/2 Year

BOOSTER DOSES Typhoid (every 3 years)

TT (Every 5 Years) Other Vaccines

Signature of the Father Signature of the Father

-----------3-----------

HEALTH HISTORY ALLERGY TO ANY FOOD, ADHESIVE TAPE, BEE STING

Allergy What happened How Severe Medication taken at the time

Does the child have any problem during physical activity………………………………….. Signature of the Mother Signature of the Father

TO BE CERTIFIED Y A REGISTERED MEDICAL PRACTITIONER Date of physical examination ………………………………….height……………………weight ……………………..B.P………………….. Pulse …………………… vision L ..…………………………… R squint……………………………………Conjunctiva ……….………………………………………….. cornea ………………………….. Ear L …………………………… R ………………………………………..

Clinical Examination Normal Recommendation Head/Neck

Abdomen Surgery

Serious illness

Nails Skin

Summary of current Health condition ………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………….. Fit to participate in age specific physical activity……………………………………………….. Fit to participate in age specific physical activity with precaution ………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………….. Should not participate in competitive sport ………………………………………………………

Name of the doctor Signature of the Doctor

JAWAHAR NAVODAYA VIDYALAYA UDUVALLI POST, HIRIYUR TQ, CHITRADURGA DIST, KARNATAKA STATE

APPLICATION FOR ADMISSION 1. Full Name of Pupil (in Block Letters) : _______________________________

2. Date of Birth (in Christian era) : In figures _______________________

a. In wards __________________________________________________________

3. Age at the time of Admission :________________________________

4. a. Nationality : _____________ b. Region : ________________________

5. Full Name of the : a) Father________________________

b) Mother _______________________

6. Permanent home Address : _______________________________

_______________________________________________________________________

____________________________________________________Pin CodeNo. _________

Phone No.________________________________________

7. Local Address of Guardian if any : _______________________________

8. Occupation of Father : _______________________________

a. Whether a Defense Employee (If so his rank) : _______________________________

b. Whether a Central Govt., Employee : Yes / No

Mention Designation with Department : _______________________________

9. Monthly Income of Father : _______________________________

10. Name of the last School attended : _______________________________

a. Class in which Studying : _______________________________

b. Subject offered : _______________________________

c. Medium of instruction : _______________________________

11. Result of last examination : _______________________________

Percentage of Marks : _______________________________

12. Whether V Std School Recognized School/Unrecognized School: ___________________

13. Class to which Admission is Sought : _______________________________

14. Whether a Transfer Certificate (Yes/No) : _______________________________

15. No and Date of Transfer certificate : _______________________________

16. Mother Tongue : _______________________________

17. a) Whether the Students belong to Scheduled Caste or Scheduled Tribe/OBC (Yes/No): ___________

b) If yes specify the Caste : _______________________________

--------------------2-----------------------

A. I hereby declare that the particulars including the date of birth in respect of my

Son/Daughter Kumar/Master ______________________________Furnished by me in

application from are correct and that I would not demand any change in it in further.

B. I shall abide by the rules of the Vidyalaya.

Date:________________ Signature of the Parent/Guardian

For office use: Please test and report whether the student is fit for admission to Class _____

Subject Name of the

Teacher Fit/Unfit

Signature of the

Teacher

Signature of the

Principal

1. Kannada

2. English

3. Hindi

Admitted to class ____________ Section ________________House ____________________

Name has been entered in class Attendance Register

Date: __________________ Class Teacher________________________

Certified that all the entries been made in all scholar’s Register and the dues have been realized

by class teacher.

His/Her Scholar’s register No. is _________________ Date _____________

Signature of the Office Clerk.

Noted:

Signature of the Class Teacher

Date: PRINCIPAL.

JAWAHAR NAVODAYA VIDYALAYA, UDUVALLI, CHITRADURGA DIST CLASS VI ADMISSIONS-VERIFICATION OF DOCUMENTS

BIO DATA OF CANDIDATE TO BE WRITTEN BY COMMITTEE VERIFIED & FOUND CORRECT/REMARKS, IF ANY,

Roll No with Alpha Code

Name of Candidate

Sex

Date of Birth

Area(Urban/Rural)

Category(Gen/OBC/SC/ST) VERIFIED BY NAME SIGNATURE

Date of Verification OFFICIAL

1

Bio Data of candidate verified and tallied in select list and original application form or not?

A. Duly filled-in-Bio Data form in original submitted or not?

B. Bio Data forms signed and sealed by the Head Master of the school where the candidate studied Class III, IV and V or not?

C. Point(1) to (10) of the Bio Data Form verified and tallied with the details submitted in the original application or not?

D. Whether the child studied Class III, IV & V continuously without any break in studies or not?

2 Acceptance/Willingness in original submitted or not?

3 Whether the Marks Card and the Pass Certificate of Class V submitted or not?

4 Affidavit in original in a Stamp Paper duly attested by the Notary submitted or not?

5 The Residence Certificate in original signed by the Parent and duly attested by the Competent Authority (SDM/Tehsildar) submitted or not?

6 The Medical Fitness Certificate in original-certified, signed and sealed by the Medical Officer submitted or not?

7

The attested copy of the Birth Certificate issued by the competent Authority is submitted or not?

Is the date of Birth of the candidate in the Select List, Application form and bio Data verified with the help of Birth Certificate or not?

8

The Rural Certificate in original issued by the Competent Authority(SDM/Tehsildar/PDO/Panchayat) is submitted or not?

A. Is the candidate eligible to avail Rural Quota or not?

B. If eligible for Rural Quota, the same is verified or not?

9

The Caste Certificate (Category) in original issued by the Competent Authority (SDM/Tehsildar) is submitted or not?

A. The Caste Certificate(Category) in original issued by the Competent Authority (SDM/Tehsildar) is submitted or not?

B. Is the Caste/Category of the candidate verified in Select List/Application form and found correct or not?

10 The Income Certificate in original issued by the competent Authority (SDM/Tehsildar) is submitted or not?

11 Undertaking - Fees Structure is submitted or not?

12 Undertaking – (VI Class to XII) is submitted or not ?

13 Undertaking – (IX Migration) is submitted or not?

14 Undertaking - (Mobile Phone & Electronic gadgets) is submitted or not?

15 Declaration – (Damage or loss) is submitted or not?

16 Socio – Economic Status is submitted or not?

17 School Health Record is submitted or not?

18 Application for Admission is submitted or not?

19 Student Recent 3 color photos are submitted or not?

20 Adhar Card Xerox Copy (Student, Father , Mother)

21 Ration Card (APL or BPL) – Xerox Copy

…………2…………

CERTIFICATION

(1) Certified that the documents in respect of Master/Miss……………………………………………

Roll No……………………….was checked, verified along with the original application form,

select list and the originals submitted by the candidate and found fit for admission. The

candidate is recommended for admission subject to the submission of the following

documents………………………………………………………………………………………………….

.......................................................................................................................................

…………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………

(2) Certified that the documents in respect of Master/Miss……………………………………………

Roll No……………………..was checked, verified and found unfit for admission due to......

…………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………

…………………………………………..

Date…………………………… Signature

Name………………………………………….

Designation………………………………..

FOR OFFICE USE

(1) Date of Admission………………………………………………………………………………………………….

(2) Admitted in Class…………………………………………………………………………………………………..

(3) Allotted to House…………………………………………………………………………………………………..

(4) Name entered in Admission Register Vide Admission No………………………………………

(5) Name entered in Admission Register vide Page No………………………………………………..

IN CHARGE OF JNVST

Countersigned

PRINCIPAL

JAWAHAR NAVODAYA VIDYALAYA, UDUVALLI, HIRIYUR TQ.,

CHITRADURGA DIST.

To,

The House Master,

_______________ House.

Please admit Master/Kumari___________________________ of 6th class to your

house

Thanking you,

Date: I/C JNVST.

______________________________________________________________


CHITRADURGA DIST.

To,

The House Master,

_______________ House.

Please admit Master/Kumari___________________________ of 6th class to your

house.

Thanking you,

Date: I/C JNVST.

JAWAHAR NAVODAYA VIDYALAYA, UDUVALLI,

CHITRADURGA DIST.

Date of Admission:_______________________ Name of the Students:_______________________ The following materials are to be brought while joining Vidyalaya for personal use.

1. Bucket – 1/ §PÉmï -01 Pending Documents

2. Plate /HlzÀ vÀmÉÖ 1. ____________________

3. Mug/ªÀÄUï 2. ____________________

4. Tumbler/¯ÉÆÃl 3. ____________________

5. Bowl/§lÖ®Ä 4. ___________________

6. Torch with cell/PÉÊ ¨Áålj

7. Luggage Box-1/ læAPï

8. Civil Dress Minimum 3 pairs/¢£À ¤vÀå G¥ÀAiÉÆÃV¸ÀÄªÀ §mÉÖ 3 eÉÆvÉ

9. Nail cutter/ £ÉÊ¯ï PÀlgï

10. Thread and Needle/zÁgÀ ªÀÄvÀÄÛ ¸ÀÆf

11. Soap Box/¸ÉÆÃ¥ï ¨ÁPïì

12. Washing Brush/§mÉÖ vÉÆ¼ÉAiÀÄÄªÀ §æµï

13. Undergarment 3 pairs/M¼À GqÀÄ¥ÀÅUÀ¼ÀÄ 3 eÉÆvÉ

14. Slippers/ZÀ¥Àà°

15. Towel -2 Nos/lªÀ¯ï - 2

16. Water Bottle -2 Nos/¤Ãj£À ¨Ál°

17. Sweater and Cap (Woolen)/ ¸Éélgï ªÀÄvÀÄÛ mÉÆÃ¦(¸ÁÌ¥ïð)

18. Umbrella/PÉÆqÉ

19. Half pant for Games Navy blue/DlzÀ GzÉÝÃ±ÀPÁÌV ZÀrØ ¤Ã° §tÚzÀÄÝ

20. Bed Sheet/ ¨Éqï ²Ãmï

21. Mosquito Net/ ¸ÉÆ¼Éî ¥ÀgÀzÉ

22. Tooth Brush, Paste/lÆvï §æ±ï, ¥ÉÃ¸ïÖ

23. Coconut Oil /PÉÆ§âj JuÉÚ

24. Comb/¨ÁZÀtÂUÉ

25. Mirror /PÉÊUÀ£Àßr

26. Shoe polish brush/ ±ÀÆ ¥Á°µÀ §æ±ï

27. Shoe polish/±ÀÆ ¥Á°µÀ

28. Carpet /JAMKHANA

29. 5th Class XEROX Transfer Certificate (always keep with students in school)

30. Caste Certificate (Xerox copy should always keep with students in school)

31. Adhar Card of Student (Xerox copy should always keep with students in school) FINAL ADMISSION INSTRUCTION :

1. To bring original TC during admission. TC should be countersigned by BEO if the school is private aided/unaided.

2. Pending certificate is to be submitted on admission day otherwise after of admission on will be cancelled.

3. Admission is subjected to submission of all certificates.

FORMATS SHOULD BE ARRANGE FOLLOWING ORDER

1 Bio Data the child studied Class III, IV & V 2 Acceptance/Willingness in original 3 Marks Card of Class V





8 The Rural Certificate or zsÀÈrÃPÀgÀt ¥Àv in original issued by the

Competent Authority(SDM/Tehsildar/BEO/PDO/Panchayat)



11 Undertaking - Fees Structure 12 Undertaking – (VI Class to XII) 13 Undertaking – (IX Migration) 14 Undertaking - (Mobile Phone & Electronic gadgets) 15 Declaration – (Damage or loss) 16 Socio – Economic Status 17 School Health Record 18 Application for Admission 19 Student Recent 3 color photos


CHITRADURGA DIST.

To,

Store Keeper JNV Office.

Master/Kumari___________________________ is admitted to class VI

on_______________

Thanking you,

I/C JNVST.

______________________________________________________________


CHITRADURGA DIST.

To,


Master/Kumari___________________________ is admitted to class VI

on_______________

Thanking you,

I/C JNVST.

ALL FORMAT SHOULD BE ARRANGE IN THE FOLLOWING ORDER

1 Bio Data 2 Acceptance/Willingness

3 Marks Card and the Pass Certificate of Class V





8 The Rural Certificate/Drudikarana Patra in original issued by the Competent Authority(BEO/PDO/Panchayat)



11 Undertaking - Fees Structure 12 Undertaking – (VI Class to XII) 13 Undertaking – (IX Migration)

14 Undertaking - (Mobile Phone & Electronic gadgets) 15 Declaration – (Damage or loss) 16 Socio – Economic Status 17 School Health Record

18 Application for Admission 19 Student Recent 3 color photos 20 Aadhar Card -Xerox Copy


CHITRADURGA DIST. To,


Ii is to inform you that Master/Kumari_____________________________S/o

_______________________ is admitted 6th Class to this Vidyalaya for the

year2015-16.

I/C JNVST.

_____________________________________________________________

JAWAHAR NAVODAYA VIDYALAYA, UDUVALLI, HIRIYUR TQ., CHITRADURGA DIST.

To,




year2015-16

I/C JNVST. -

____________________________________________________________

JAWAHAR NAVODAYA VIDYALAYA, UDUVALLI, HIRIYUR TQ., CHITRADURGA DIST.

To,




year2015-16.

I/C JNVST.

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