NAVODAYA

EDUCATIONAL SOCIETY AND WELFARE COMMITTEE

ISO 9001:2008 Certified Society

(Run by Navodaya Shiksha Evam Samaj Kalyan Samiti)

REGISTRATION FORM

Please Affix
Photograph

Note : Please fill all entries in Capital Letters & use only Black/Blue Ball Pen.

Student's Name :

Class

Section

Medium

Hindi

English

Gujarati

Odia

Date Of Birth

Gender

Male

Female

Father's Name

Mother's Name

Residential Address

District

Pincode

Mobile No. 1

Mobile No. 2

School Name & Address

FOR 11th OR 12th CLASS STUDENTS USE ONLY

Stream

Science

Commerce

Arts

Interested Field

Course After 12th

Olympiad Registration

Registration Fee : ₹150

Payment Mode : UPI / QR Code

Olympiad Selection

Mathematics

Science

English

Declaration

I hereby declare that the information provided by me is true and correct to the best of my knowledge. I agree to abide by the rules and regulations of Navodaya Educational Society & Welfare Committee.

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Student Signature

______________________
Parent Signature

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Authorized Signatory

Date