APPLICATION FORM STATE LEVEL NATIONAL TALENT SEARCH EXAMINATION 2012 (For the students studying in Class VIII)

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 :20-11-2012 (10.00am to 01.00 pm) Application fee in the form of DD in favour of the SECRETARY TO CGE AP HYD Amount DD Number Date of DD Name of Bank Rs.100/State Level 12 digit Roll Number (To be filled by the DEO Office) VIII th Class Code State Code Year Dist Code Centre Code 1 4 0 1 2 1. Name of the candidate (Do not write Miss/Master) 2. Fathers Name (Do not write Mr./Dr./Prof.) 3. 1 Gender 2 4.Area of candidate resides 1 2 5.Caste category of candidate 1 2 SC 3 ST 6. Disability Status of Candidate 2 3 4 Hearing Blind None Space for the Photograph (Passport size and Black and white) The Photograph should be endorsed by the Head of the Institution

SBH / SBI

Sl.No.

Class 8 Date

Date of Birth Month Year

Male Female Rural Urban General 7. Postal address for correspondence (Do not write fathers or your name)

Ortho

Pin Code 8. Name and address of the institution in which studying at Class VIII

Pin Code 9. Type of the institution in which studying Class VIII (see definition overleaf*) Local Private Private 1 Govt 2 3 4 Body Aided Unaided 11. Medium of examination (a) at the State Level 14. Mothers education 17. Number of brothers 20. Parental annual income 1 Up to 50,000 2 50,001 to 1,00,000 3 1,00,000 to1,50,000 4 1,50,001 to 2,00,000 5 2,00,001 to 2,50,000 6 2,50,000 to 5,00,000 7 More than 5,00,000 (b) at the NCERT Level 15.Mothers occupation 18. Number of sisters 12.Fathers education 10.Area in which the school is located 1 Rural 2 Urban

13.Fathers occupation

16.No.of family members living in the house 19. At what number is the candidate among his/her brother and sister

21.Telephone/ Mobile STD Code Phone

22. E-Mail address

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 the class VII Annual examinations i.e., when he/she was promoted from Class VII to class VIII. 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 the Institution. (to be filled for SC/ST candidate only)

Signature of the candidate Date

Signature of the Headmaster/Headmistress With Seal (See Instructions given below)

1. 2. 3. 4. 5.

6.

Coding Plan Read Instructions carefully before filling up the Application Form Use only Blue or Black Ball Point Pen. WRITE IN CAPITAL LETTERS. Do not mark or write outside the boxes. 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. Cross (x) only one of the appropriate boxes in item nos. 3,4, 5, 6,9,10 and 20. Please write code number in item nos. 11,12,13,14 and 15 as given below. It is the responsibility of the candidate and the H.M of the school to submit the filled in Application with the concerned District Educational officer before the last date. No request for condoning delay in submission of application will be entertained whether it is due to the fault of the candidate or the Headmaster / Principal of his/ her institution. Incomplete or defective applications are liable for rejection.

Example for writing Name and Address Fathers Name (Do not write Mr./Dr./Prof.) B V S S R I N I V A S A R A O . Postal address for correspondence (Do not try to write complete address in one line. Break it appropriately as shown below) 1 / 4 0 2 K A L Y A N I S H A Y H D A E R R A S T A T E S L B N A G A R 5 0 0 0 6 8

A B A D Medium of Examination (Refer to item 11) Medium of Examination English Hindi Telugu Urdu

Pin Code Education of Father or Mother (Refer to item Nos.12 & 14) Code 13 15 22 23 Education

Code 1 2 3 4 5 6 7 8 9

upto Primary Upper Primary Secondary Senior Secondary Graduation Post Graduation Doctoral Professional degree (Engineering Medicine, MCA, MBA, etc.) Any other Fathers / Mothers Occupation (Refer to item Nos. 13 & 15) Occupation

Professional, Technical and Related Worker Administrative, Executive and Managerial Worker Clerical and Related Worker Sales / Service Worker Farmer, Fisherman and Related Worker Production and Related Worker, Transport Operators and Labourer Worker not classified by the above occupations Not employed *TYPE OF SCHOOL / INSTITUTION (refer item No.9) GOVERNMENT: LOCAL BODY: PRIVATE AIDED: PRIVATE UNAIDED:

Code 1 2 3 4 5 6 7 8

A Government School is that which is run by the State Government or Central Government or Public sector Undertaking or an Autonomous Organization completely financed by the Government. 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. A private Aided School is that which is run by an individual or a private organization and receives grant from Government.. Private Unaided School is that which is managed by an individual or a private organization and does not receive any grant from Government. Instructions to Candidates / Principal of school before filling up the Application Form for State Level National Talent Search Examination

1. 2. 3. 4. 5.

The candidate / Principal of the school must confirm the last date for submission of Application Form from the state liaison officer. Applications (s) must be submitted before the last date to the concerned District Educational Officer. The candidate / Principal shall submit the filled in application along with the Examination fee, of Rs.100/- in form of DD drawn in favour of SECRETARY TO CGE AP HYD through SBH / SBI only Last Date for remittance of examination fee by the candidates / Head Master or Head Mistress: 31-08-2011 The candidate / Principal shall get confirmed the name of examination centre from the DISTRICT EDUCATIONAL OFFICER. Incomplete/ wrongly filled in application is liable for rejection.

STATE LEVEL NATIONAL TALENT SEARCH EXAMINATION 2012 (For the Students Studying in Class VIII) ADMISSION CARD To be filled by the candidate only Master / Miss_____________________________

S/o D/o Sri._______________________________

Passport size photograph attested by the Head of the School to be affixed

of (School)_______________________________

of (District )_______________________ (School Seal) She / He is allotted with the following 12 digit Roll Number: (to be filled by the O/o The District Educational Officer) Class 1 State Code 4 0 Year 1 2 Dist Code Centre Code Sl. No.

Date of Examination: 20-11-2011 Venue of Examination centre ________________________________ ________________________________ ________________________________ ________________________________ Scrutinized by (Office Staff) Signature of District Educational with Office Seal Officer Signature of the Head of the School With office seal

Signature of the Invigilator at the Examination Centre

Signature of the Candidate in the Presence of Invigilator

Mat:.. Sat:...

INSTRUCTIONS TO THE CANDIDATE 1. Make sure that the Admit Card is not detached from the filled in application. Admit cards will be sent to the Chief Superintendent of the examinations centre after allotting the Roll Numbers. Candidate can collect the Admit Card from the Chief Superintendent of the examination centre concerned at least one week before the examination. 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. DO NOT take calculator, Mathematical & Physical table / cell phones or any other kind of ready reckoned to the examination hall. The examination will be conduced between 10.am and 1.00 pm on Third Sunday in November i.e., 20-11-2011. You have to take the examination in TWO PARTS: (i) Part I: Part I is confined to Mental Ability Test (MAT) consisting 90 compulsory questions. (ii) Part II: Part II is confined to Scholastic Aptitude Test (SAT) consisting of 90 compulsory questions from seven subjects (History, Geography, Civics, Physics, Chemistry, Biology and Mathematics). 6. 7. 8. 9. 10. Time for Part I is 90 minutes and for Part II is 90 minutes. Each question carries 1 (one) mark. 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. DO NOT write your name in any part of the Question Booklet or the OMR Answer Sheet. All questions in the booklets are objectives type. For each question FOUR or FIVE possible answers 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. Please follow the instructions given on the OMR while shading the answers in the OMR sheet. During the Examination follow the instructions of the Invigilator strictly. Handover your OMR answer sheet to the Invigilator before you leave the Examination Hall. You shall retain your Admission card for your future reference. Full Postal Address of the Candidate: -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Pin Code-----------------

2. 3. 4. 5.

11. 12. 13. 14.