NAVODAYA VIDYALAYA SAMITI JAWAHAR NAVODAYA VIDYALAYA SELECTION TEST LATERAL ENTRY-CLASS IX APPLICATION FORM REGISTRATION NO.

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1 REGISTRATION NO.: Name of the SOHA MONDAL Mother's Name LATIFA MONDAL Father's Name BILLAL MONDAL Name of the - Relationship with - INDIAN Date of Birth 03-Oct-2004 Present Postal Address VILL- HANTRA.P.O-CHHOTO ANDULIA,P.S-CHAPRA.DIST-NADIA.WEST BENGAL : Telephone - Mobile No Gender FEMALE Category GENERAL Marital Status UNMARRIED Identification Mark CUT MARK ON RIGHT EYE BRO VIVEKANANDA ACADEMY TEHATTA-1 BETAI,NADIA 05-Apr Mar-2018

2 REGISTRATION NO.: Name of the TAPOTI SARKAR Mother's Name SIMA SARKAR Father's Name TAPAN SARKAR Name of the TAPAN SARKAR Relationship with DAUGHTER INDIAN Date of Birth 20-Aug-2003 Present Postal Address A-10, 247, DIST- NADIA, WEST BENGAL : Telephone - Mobile No Gender FEMALE Category SC Marital Status UNMARRIED Identification Mark MOLE ON THE NOSE RIGHT SIDE JULIEN DAY SCHOOL. URBAN 13-Apr Mar-2018

3 REGISTRATION NO.: Name of the SUBHADIP SARKAR Mother's Name JUMA SARKAR Father's Name PROHLAD CH SARKAR Name of the PROHLAD CH SARKAR Relationship with FATHER INDIAN Date of Birth 29-May-2004 Present Postal Address VILL SANTINAGAR, PO MADANPUR, PS, DIST NADIA. : Telephone - Mobile No Gender MALE Category SC Marital Status UNMARRIED Identification Mark NA MADANPUR K A VIDYALAYA CHAKDAHA MADANPUR 10-Jan Dec-2017 BENGALI

4 REGISTRATION NO.: Name of the ATIK MONDAL Mother's Name HASNAHANA BIBI Father's Name ABDUL MATIN Name of the - Relationship with - INDIAN Date of Birth 13-Dec-2003 Present Postal Address VILL- JANAKINAGAR, P.O- PLASSEY SUGAR MILL, DISTRICT- NADIA, WEST BENGAL : Telephone - Mobile No Gender MALE Category GENERAL Marital Status UNMARRIED Identification Mark A CUT MARK ON THE FRONT OF THE HEAD VIVEKANANDA ACADEMY TEHATTA-I BETAI 26-Jan Mar-2018

5 REGISTRATION NO.: Name of the PRINCE SHARMA Mother's Name ARATI SHARMA Father's Name HRIDAYANAND SHARMA Name of the - Relationship with - INDIAN Date of Birth 19-Nov-2003 Present Postal Address 222, BAG STATION ROAD, KANCHRAPARA, NORTH 24 PARGANAS : Telephone - Mobile No Gender MALE Category GENERAL Marital Status UNMARRIED Identification Mark AMOL ON THE LEFT UPSER LIP NARAYANA SCHOOLS NADIA URBAN TOWN 07-Feb Mar-2018

6 REGISTRATION NO.: Name of the SUSMITA ROY Mother's Name MITHU ROY Father's Name BIPUL ROY Name of the - Relationship with - INDIAN Date of Birth 10-Oct-2003 Present Postal Address NABAGRAM, PO. - ANANDANAGAR, P.S -, DIST - NADIA : Telephone - Mobile No Gender FEMALE Category SC Marital Status UNMARRIED Identification Mark NA SHIKSHAYATAN URBAN BLOCK - A 06-Jan Dec-2017 BENGALI

7 REGISTRATION NO.: Name of the JAYASREE MONDAL Mother's Name DIPTI MONDAL Father's Name JAGANNATH MONDAL Name of the JAGANNATH MONDAL Relationship with FATHER INDIAN Date of Birth 27-Sep-2003 Present Postal Address VILL-BABLATALA,PO-SANYALCHAR,PS-CHAKDAHA : Telephone - Mobile No Gender FEMALE Category SC Marital Status UNMARRIED Identification Mark MOLE IN BOTH FACE CHARSARATI KENDRIYA HIGH SCHOOL CHAKDAHA 03-Jan Dec-2017 BENGALI

8 REGISTRATION NO.: Name of the SOHINI GOSWAMI Mother's Name MITHU GOSWAMI Father's Name ANJAN GOSWAMI Name of the - Relationship with - INDIAN Date of Birth 23-May-2004 Present Postal Address SNEHA ABASAN, FLAT NO. A3, 142A RANI RASHMONI GHAT ROAD, BAGMORE, P.O KANCHRAPARA, P.S BIZPUR, DIST- 24 PGS NORTH, STATE- WEST BENGAL : Telephone - Mobile No Gender FEMALE Category GENERAL Marital Status UNMARRIED Identification Mark MOLE OVER LEFT CHEEK NARAYANA SCHOOL BRANCH RATH TALA, 06-Mar Mar-2018

9 NAVODAYA VIDYALAYA SAMITI REGISTRATION NO.: State Name of the Mother's Name Name of the WEST BENGAL PRASANT RAY AMITA RAY - Present Postal Address Telephone Gender Marital Status INDIAN Disablility, if any No District NADIA Father's Name Relationship with Date of Birth PARBESH RAY - A-12 UTTAR BHABANIPUR,, NADIA : Mobile No MALE Category UNMARRIED Identification Mark 01-Nov GENERAL CUT MARK ON RIGHT FOREHEAD ORIENTAL PUBLIC SCHOOL URBAN CHAKDAH, NADIA 09-Apr Mar-2018