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JBNSTS REGN. NO. :................. |
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1300 Rajdanga Main Road, Kasba, Kolkata 700 107,
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APPLICATION FORM FOR DoNER-JBNSTS SENIOR TALENT SEARCH TEST
Eligibility for Application : Students who have passed 10 + 2 examination in this year from any Institution from the North Eastern States namely Assam, Arunachal Pradesh, Manipur, Meghalaya , Mizoram, Nagaland, Tripura and Sikkim under any Board and are studying Basic Sciences (Hons) / Medical Sc. / Engineering in any of those states only are eligible. Pass course and diploma course students are not eligible and the test will be taken on Physics, Chemistry, Mathematics and Biology.
DIRECTIONS
Read the form carefully before filling in
details. Incomplete applications will be rejected.
In case of change of residential address before test,
notify immediately.
Along
with the
completely filled
in Application form the following should
be sent to JBNSTS Office, 1300 Rajdanga Main Road, Kasba, Kolkata - 700
107
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i) Two recent passport size photographs attested by the Principal/Head of the Department of your College/Institute/University is required. One copy to be pasted in the Application form and another to be sent with the form. |
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ii) Photocopy of the original marksheet of the H. S. equivalent ( + 2 level) examination, attested by the Principal / Head of the
Department of your
College / Institute / University . |
iii) Bank Draft of Rs. 50/- (non - refundable) payable in favour of Jagadis Bose National Science Talent Search", Kolkata.
as examination fee.
ivi) Self Addressed Stamped Envelope of Rs. 10/- (Envelope Size 20"x12") for sending Admit Card.
LAST DATE FOR RECEIVING APPLICATION FORM AT JBNSTS OFFICE IS September 30, 2008
JBNSTS REG. NO.
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Name ( IN BLOCK LETTERS) :
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Father's Name :
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2A.Guardian's name
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Address for Correspondence: (Notify immediately in case of any change before
examination) |
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Paste Photograph attested by the Principal / Head of the Departnment
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Telephone
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Email (if any)
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Permanent Address :
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Telephone
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Email (if any)
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5. Name and Address of Present Institution : |
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6. Mention Course ( with Honours if
any ) which you are pursuing :
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| 7. Duration of Course : |
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| 8. Where did you obtain information about this test ?Tick ( √ ) the appropriate box. | ||
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NEWSPAPER |
TV/ RADIO |
FAMILY |
FRIENDS |
TEACHERS |
SCHOOL/ COLLEGE |
OTHER ( SPECIFY) |
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9. Examination Passed : |
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EXAMINATION PASSED |
SCHOOL WITH ADDRESS |
YEAR |
BOARD |
% OF MARKS IN EACH SCIENCE SUBJECT |
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i Class X
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SUBJECT PERCENTAGE
a. Phy. Sc. b. Life Sc. ... c. Math d. Others |
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ii Class XII
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SUBJECT PERCENTAGE
a. Ph Sc. b. Chem. ... c. Math d. Biology |
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10. Average percentage of marks considering all Science subjects |
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in the last examination. |
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12. Your favourite subject |
13.
Hobbies |
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DECLARATION
I declare that the entries in this form and its enclosures are to the best of my knowledge and belief, complete and correct.
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Date: Signature of Applicant
Certified that ............................................................................................................. son / daughter of .....................................................
is a student of this college, studying for ................................................................................... (mention course and honours, if any.)
His / her date of birth ( as per school certificate is ..............................................................
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Seal of College / Institute / University Signature of Principal / Head of the Department
