JBNSTS REGN. NO. :.................
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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 SENIOR TALENT SEARCH TEST
Eligibility for Application : Students who have passed 10 + 2 examination in this year and are studying Basic Sciences (Honours) / Medical Sc. / Engineering in West Bengal 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
i) Two recent passport size photographs attested by the Principal/Head of the Department of your College/Institute/University
and they will be fixed at appropriate places
(in Application form and Admit Card).
ii) Photocopy of the original mark sheet 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. 100/- (non - refundable) payable in favour of
Jagadis Bose National Science
Talent Search",
Kolkata. as examination fee.
iv) 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 23rd August 2008
JBNSTS REG. NO.
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1.
Name ( IN BLOCK LETTERS) :
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2.
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. |
| 11. Language in which you prefer to take the test : |
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English |
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Bengali |
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12. Your favourite subject : |
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13.
Hobbies :
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14. Center for examination : Tick ( √ ) your choice. |
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Kolkata |
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Howrah |
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Darjeeling |
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Berhampur | ||||
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Burdwan |
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Siliguri |
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Kharagpur |
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Durgapur | ||||
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
