Form: COMPETITIVE SCHOLARSHIP EXAMINATION FOR CLASS V/VIII FOR THE YEAR....200.. APPLICATION FORM (Particulars to be filled in by the candidate in his/her own handwriting) 1. Name in full (IN BLOCK LETTERS).......................... 2. (a) Category of Candidate: Male/Female..... (b) Whether scheduled Caste or Scheduled Tribe............... 3. Date of birth (in figures)............(in words)................ .....................one thousand nine hundred and......... 4. Name of the school where from the candidate is sent up................... ........................... 5. Permanent Address.................................. 6. Name of Father (in block letters)............................ 7. Medium of examination.............. Signature of the candidate (not in block letters) FOR THE HEAD OF THE INSTITUTION I have checked /verified the entries made by the candidate and found them correct according to the records of my school/the documents submitted by the candidate. I certify that he/she has signed the above Application, Admission card and Attendance sheet in my presence. Headmaster Seal ........................................... GOVERNMENT OF MANIPUR ( EXAM. UNIT) EDUCATION DIRECTORATE (S) ADMISSION CARD COMPETITIVE SCHOLARSHIP EXAMINATION FOR CLASS V/VIII Affix FOR THE YEAR 200. Passport size Photograph Attested by the Head of the Institution ROLL NO....... (to be filled in by the Officer-in-charge) (to be filled in by the candidate in his/her own handwriting) Admit (Candidate's name)............................... Son/daughter of Shri.................................. To the Competitive Scholarship Examination, commencing on............. 200... Full Signature of the candidate (not in block letters) Headmaster Officer-in-Charge seal
