APPLICATION FORM

STATE LEVEL NATIONAL TALENT SEARCH EXAMINATION – 2014

(For the students studying in class X)

State Level 12 digit Roll Number

Class X Code State Code Year Centre Code Serial No. (Office to fill) Class Date of Birth

Date Month Year

1. Name of the Candidate (Do not write Miss/Master)

2. Father’s Name (Do not write Mr./Dr./Prof. etc.)

3. Mother’s Name (Do not write Mr./Dr./Prof. etc.)

4. Sex 5. Area in which candidate resides 6. Cast category of candidate 7. Disability status as per PWD act

M / F Rural Urban General SC ST Orthopaedic Hearing Blind Low vision None

Please enclose a copy of the relevant reservation certificate in support of information at sr. No. 6and 7, otherwise they

will be treated as General Candidate.

8. Postal address for correspondence (Do not write father’s or your name)

9. Name and address of the institution in which studying at Class X level

10. Type of the institution in which studying at Class X level (see definition overleaf*) 11. Area in which the School is located

21. Parents annual income

Up to 50,000 50,001 to 1,00,000 1,00,001 to 1,50,000 1,50,001 to 2,00,000 2,00,001 to 2,50,000 2,50,001 to 5,00,000 More than 5,00,000

STD CODE PHONE E-Mail address

To be filled by the Head of the Institution

Certified that: (a) Master / Miss …………………………………………………. Is a regular student of this school / institution and he / she has

secured % marks in the class IX annual examination i.e. when he / she was promoted from IX to X. He / She secured

………………… marks out of …………………(Candidate must fulfil the criteria announced by the state / UT)

(b) The particulars given by him / her in the application form have been verified and found in order.

(c) Master / Miss ………………………………………………… belongs to Scheduled Cast / Scheduled Tribe category as per

record maintained in the Institution. (To be filled for SC / ST candidates only)

………………………………….. …………………………………………..

Date Signature of the Headmaster/Headmistress

With Seal

……………………………………. (See Instruction Overleaf)

Signature of the candidate Phone:

Read the instruction carefully given on the next page before filling the application

You may take the help of your teacher / parent for filling up the application form

Date of examination 17 November 2013 Time – 08:00 A.M. to 11:00 A.M.

(for eligible physically challenged group)

(08:00 A.M. to 12:00 Noon)

Name & Address of the agency: - (for conducting Director Bureau of Psychology U.P.

First level NTS Examination) 2, Lowther Road, Allahabad

(Where the candidate is studying in class X as a regular student)

Name of Examination Centre

(Where the candidate is studying in class X as a Regular student)

*Application fee – Payable to Registrar Departmental Examination, U.P., Allahabad.

Amount D.D. No. Date of D. D. Name of Bank

2 3 1 1 4 10

1 2 1 2 1 2 3 1 2 3 4 5

PIN Code

PIN Code

1 Govt. 2 Local Body 3 Private Aided 4 Private Unaided 1 Rural 2 Urban

12. Medium of examination (a) at the state level (b) at the NCERT Level 13. Father’s education

14. Father’s occupation 15. Mother’s education 16. Mother’s occupation 17. No. of Family member

living in the house

18. Number of brothers 19. Number of sisters 20. At what number is the candidate among his/her brother and sister

1 2 3 4 5 6 7

22. Telephone:

Space for the

Photograph

(Passport size)

The Photograph

should be endorsed

by the Head of the

institution/Gazetted

Officer

CODING PLAN Read Instruction carefully before filling up the Application Form

1. Use only Blue or Black Ball Point Pen. WRITE IN CAPITAL LETTERS. Do not mark or write outside the boxes.

2. Leave one box blank between two words. Limit your name and address within the space provided for it. Please see example

as given below.

3. Cross (X) only one of the appropriate boxes in item nos. 4, 5, 6, 7, 10, 11 and 21.

4. Please write code number in item nos. 12, 13, 14, 15 and 16 as given overleaf.

5. It is the responsibility of the candidate and the principal of the school to deposit the filled form at the concerned examination

centre for the district (see the last page) before the last date. No request for condoning delay in submission will be entertained

whether it is due to the fault of the candidate or the Headmaster / Principal of his/ her institution. 25.09.2013 is Last date of

submission of form.

6. Incomplete or defective applications are liable to be rejected.

Example for writing Name and Address

Father’s Name

Postal address for correspondence (Do not try to write complete address in one line. Break it appropriately as shown below)

2 L O W T H E R R O A D

A L L A H A B A D U P PIN 2 1 1 0 0 1

Medium of Examination

(Refer to item 12)

Medium of Code

Examination

Education of Father or Mother

(Refer to item Nos.13 & 15)

Father’s / Mother’s Occupation

(Refer to item Nos. 14 & 16)

Education Code Occupation Code

13 No formal education 1 Professional, Technical and Related Worker 1

Assamese 11 Up to Primary 2 Administrative, Executive and Managerial Worker 2

Bangla 12 Upper Primary 3

Clerical and Related Worker 3

English 13 Secondary 4

Gujarati 14 Senior Secondary 5 Sales / Service Worker 4

Hindi 15 Graduation 6 Farmer, Fisherman and Related Worker 5

Kannada 16 Postgraduation 7 Production and Related Worker, Transport 6

Marathi 17 Doctoral 8 Operators and Labour Worker

not classified by the above occupations 7

Malayalam 18

Professional degree

(Engineering Medicine,

MCA, MBA, etc.) 9

Not employed 8

Oriya 19

Punjabi 20

Tamil 21

Telugu 22 Region State Code

Urdu 23 North Uttar Pradesh 31

*TYPE OF SCHOOL / INSTITUTION (refer item No.10)

GOVERNMENT: 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.

LOCAL BODY: A Local Body School is that which is run by Panchayati Raj and local body institutions such as Zila

Parishad, Municipal Corporation, Municipal Committee, Notified Area Committee and Cantonment

Board.

PRIVATE AIDED: A private Aided School is that which is run by an individual or private organization and receives grant

from the Government or local body.

PRIVATE UNAIDED: Private Unaided School is that which is managed by an individual or a private organization and does

not receive any grant from Government or local body.

ELIGIBILITY: Student of class X studying in recognised school are eligible to appear for the respective class X stage I

examination conducted by the state /UT in which the school are located. There will be no domicile

restriction.

EXAMINATION Each district of the state has been allotted a examination centre, students are required themselves to

CENTRE submit their application form at the allotted centre of the district after forwarded by the Principal of the

institution where they are studying. List of the examination centre of each district is given on the back of

application form. If number of candidates in any district exceeds from the prescribed limit then additional

centre will be allotted and students will have to make effort themselves to know centre name.

O P S I N G H

STATE LEVEL NATIONAL TALENT SEARCH EXAMINATION – 2014 (For the Students studying in class X)

Name of the State/UT: Uttar Pradesh

(Which will conduct the Examination)

ADMISSION CARD

To be filled in by the applicant

Master / Miss ………………………………………………………………………………………..

S/o /D/o: Sri …………………………………………………………………………………………

Of (school) ………………………………………………………………………………………….

Of (District / Centre) ………………………………………………………………………………..

is permitted to appear for the above said examination.

Full Postal Address:

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

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

……………………………………………………………………. Pin Code ……………………..

She/He is allotted 12 digit Roll number:

Class X Code State Code Year Centre Code Serial No. (to be filled by the office)

Date of Examination: 17 November 2013 Time: 08:00 A.M. to 11:00 A.M.

(For eligible physically challenged group 08:00 A.M. to 12:00 Noon)

Venue of Examination Centre

…………………………………………… Signature of Head of the School

…………………………………………… With office seal

……………………………………………

……………………………………………

Signature of District

Level Officer (Authorised for State Level

NTS Examination

Scrutinized by

(Office Staff)

Office Seal

MAT: …………………………

Signature of Invigilator

Signature of the

At the examination Centre Candidate in the LANGUAGE …………………

presence of Invigilator

SAT …………………………..

2 3 1 1 4

Affix Passport size

Photograph attested

by the Head of the

School / Gazetted

Officer

INSTRUCTIONS TO THE CANDIDATES

(For the Students studying in class X)

1. Make sure that the Admit Card is not detached from the filled in application. Admit card will be sent to the Chief

Superintendent of the examination centre after allotting the roll Number. Candidate can collect the Admit Card

from the Chief Superintendent of the examination centre at least one week before the examination.

2. Reach the Examination Centre at least half an hour before the commencement of the examination; and occupy the

seat that bears your Roll Number.

3. DO NOT take calculator, Mathematical & Physical table or any other kind of ready reckoner to the examination

hall.

4. The examination will be conducted in one session and in two papers.

5. You have to appear in the examination in TWO PARTS:

(i) Part I: Part on e is confined to Mental Ability Test (MAT) consisting of 50 compulsory questions.

(ii) Part II: Part II is confined to Scholastic Aptitude Test (SAT) consisting of 130 compulsory questions.

(a) Question 40 from language comprehensive test(either from English language or from Hindi language)

(b) Questions 90 from Aptitude Test (question 35 from Science, 35 from Social Science, and 20 from

Mathematics).

6. Time for both part, i.e. part I and part II is 180 minutes (three hours) and for eligible physically challenged group

is 240 minutes (four hours)

7. Each question carries 1 (one) mark.

8. Write your Roll Number, as given in the Admit Card, on the Answer Sheet and on the cover page of the Question

Booklet in the space provided.

9. DO NOT write your name in any part of the Question Booklet or the Answer Sheet.

10. All questions in the booklets are objective type. For each question FOUR possible answers are given but only one

is correct.

11. Record your answer using black or blue ball pen. You have to indicate your answer on the answer sheet as

instructions are given on the question paper.

12. During the Examination follow the printed instructions on the question booklet carefully.

13. Handover your Question booklet and Answer sheet to the invigilator before you leave the Examination Hall.

14. Last date of submission of the application form at the Centre is ‘25 September 2013’

15. Students should deposit the filled Application form at only allotted centre of the district, where he/she is

studying. 16. Date and time of Examination of state level is 17 November 2013 from 8:00 A.M. to 11:00 A.M. (For eligible

physically challenged from 8:00 A.M. to 12:00 Noon).

17. State level Roll No. Will be filled as follow:

(i) First one digit for examination code, 2 for class X

(ii) Next 2 digit for state/U.T. code for U.P. is 31

(iii) Next 2 digit for selection year (14)

(iv) Next 4 digit for Centre Code (to be filled by the Office)

(v) Last 3 digit for serial number (001-500-999)

(to be allotted to each candidate at each centre at the time of registration)

18. Centre code and serial number will be filled by Incharge of Examination Centre allotted for the district.

19. Physically challenged candidate studying in any recognised school having disability of 40% and above can appear

in the NTS Examination. It is essential to submit P.H. Certificate in the prescribed form by the three specialists

including the specialist of the concerned disability. The certificate should be counter signed by the CMO

concerned.

*20. Attach Bank Draft of Rs. 50/- for general Candidate & Rs. 30/- for SC/ST Candidate with application form

payable to Registrar Departmental Examination, U.P. Allahabad.

21. It is essential to attach cast certificate (SC/ST) and certificate for physically challenged group. Certificate

should be attested by Gazetted Officer. If the Candidate of SC/ST/Physically challenged group will not

attach the cast /disability certificate with the application form, they will be treated as General candidate .In

this condition candidate will be responsible.

22. The Email address of Bureau of Psychology U.P. Allahabad is: manovigyanshala2@gmail.com.

STATE LEVEL TALENT SEARCH EXAMINATION 2014

UTTAR PRADESH LIST OF EXAMINATION CENTRE AND CODE NUMBER

District Examination Centre Code No. District Examination Centre Code No

*Meerut G.I.C. First Centre 0001 Hardoi G.I.C. 0050

Second Centre 0002 Lakhimpur Kheri G.I.C. 0051

Third Centre 0003 Sitapur G.I.C. 0052

Bulandshahhar G.I.C. 0004 Rai Bareli G.I.C. 0053

*Gautam Budh G.I.C. Noida First Centre 0005 *Gorakhpur Govt. Jubliee I.C. First Centre 0054

Nagar Second Centre 0055

Second Centre 0006 Kushi Nagar T.D.I. College Padrauna 0056

*Ghaziabad G.G.I.C. First Centre 0007 Deoria G.I.C. 0057

Second Centre 0008 Maharajganj Maharajganj I.C. 0058

Hapur Sri. SaraswatiVidylaya I.C. 0009

Bagpat Sri.Yamuna I.C. 0010 Basti G.I.C. 0059

Saharanpur G.I.C. 0011 Sant Kabir Nagar G.G.I.C.

Muzaffa Nagar G.I.C. 0012 Khalilabad 0060

Shamali V.V.I.C.Shamali 0013

Agra G.I.C. 0014 Siddharth Nagar Tilak I.C. Bansi 0061

Manpuri G.I.C. 0015 Azamgarh G.G.I.C. 0062

Etah G.I.C. 0016 Batia G.I.C. 0063

Kasganj G.G.I.C. 0017

Mathura G.I.C. 0018 Mau D.A.V.I. College 0064

Aligarh G.I.C. 0019 Jhansi G.I.C. 0065

Mahamaya Nagar Saraswati Hamirpur G.I.C. 0066

Hathrus I.C.Hathrus 0020 Jalaun (Orai) G.I.C. Orai 0067

Ferozabad S.R.K.I.C. 0021 Lafitpur G.I.C. 0068

Bareilly G.I.C. 0022 Banda G.I.C. 0069

Badaun G.I.C. 0023 Mahoba G. G.I.C. 0070

Pilibhit G.I.C. 0024 Chitrakoot G. G.I.C. Karvi 0071

Shahjahanpur G.I.C. 0025 Faizabad G.I.C. 0072

*Allahabad G.I.C. First Centre 0026 Ambedkar Nagar G. G.I.C. Akbarpur 0073

Second Centre 0027 Sultanpur G.I.C. 0074

Third Centre 0028 Amethi G. G.I.C. Gauriganj 0075

Barabanki G.I.C. 0076

Kaushambi D.I.E.T. Manjhanpur 0029 Gonda G.I.C. 0077

Fatehpur G.I.C. 0030 Balrampur D.A.V.I. College 0078

Pratapgarh G.I.C. 0031 Shravasti Alkchhendra I.C. Bhinaga 0079

*Varanashi G.I.C. First Centre 0032 Bahraich G.I.C. 0080

Second Centre 0033 Moradabad G.I.C. 0081

Sambhal Intermediate College Bahjoi 0082

Third Centre 0034 Rampur Raza G.I.C. 0083

Bijnor G. G.I.C. 0084

Chadauli Nagar Palika I.C. Jyotiba Phule Nagar G.I.C. Amroha 0085

Mugalsarai 0035 *Kanpur Nagar G.I.C. First Centre 0086

Ghazipur G.I.C. 0036 Second Centre 0087

*Jaunpur G.G.I.C. First Centre 0037

Second Centre 0038 Third Centre 0088

Mirzapur G.I.C. 0039 Fourth Centre 0089

Sonbhadra G.I.C. Pipri 0040 Fifth Centre 0090

Sant Ravidas

Nagar (Bhadoli) G.I.C. Gyanpur 0041 Kanpur Dehat G.G.I.C.

*Lucknow Governent Jubilee First Centre 0042 Pukhrayan 0091

I.C.

Second Centre 0043 Farrykhabad G.I.C. 0092

Third Centre 0044 Etawah G.I.C. 0093

Fourth Centre 0045 Kannauj Kanh Kunwar Inter College 0094

Fifth Centre 0046 Auraiya Choudhary Bishambher 0095

Singh Bhartiya

Vidayalaya I.C.

Sixth Centre 0047

Seven Centre 0048

Unnao 0049

*Note: - Number of Participant in Merrut, Gautam Budhanagar, Ghaziabad, Allahabad, Varanasi, Jaunpur, Lucknow, Gorakhpur

and Kanpur Nagar is large. Therefore more than one Centre are required as per requirement, principal of the Government Inter

College mentioned in this list is authorized to allot another centre, after approval from District Inspector of School of the District.