Navodaya Vidyalaya Samiti

NOTICE

Provisional Select list of candidates for admission to Class VI for the session
2023-24 through Jawahar Navodaya Vidyalaya Selection Test has been
released. The parents/guardians of provisionally selected candidates may
take the following steps for admission to Jawahar Navodaya Vidyalaya:

1. Formats for submission of details of the candidate may be downloaded.

2. Filled in formats are to be submitted to the Principal of JNV concerned
in person.
3. All the following documents, as notified by NVS are to be submitted at
the time of admission for verification:-
• Proof for date of birth -The copy of Birth Certificate issued by
competent Government Authority concerned.
• Passing Certificate of class V from the district concerned.
• For candidates seeking admission under rural quota, the parents
will also have to submit a certificate from the competent authority
to the effect that the child had studied class III, IV & V in an
Institution/ School located in a rural area.
• Residence Certificate: The valid residential proof (as notified Govt.
of India) of the parent of the same District where the JNV is
located & candidate has studied class V shall be furnished.
• Aadhar Card of the candidate: As per section 7 of Aadhaar act,
2016, the provisionally selected candidate has to submit the copy
of by considering benefits of Navodaya Vidyalaya Scheme.
• Certificate by the Head Master of the school regarding study
details.
• Medical fitness certificate.
• Undertaking by the parent/guardian to pay Vidyalaya Vikas Nidhi
every month as per norms of NVS (All students of classes VI to
VIII, SC, ST, Girls, Divyang students & wards of BPL parents are
exempted from VVN).
• Disability certificate (if applicable)
• Category/community certificate (SC/ST) if applicable.
 • Category/community certificate OBC, as per central list if
applicable. (Format Attached)
Note: - The TC from parent school after the verification of documents and
confirmation of admission by the respective JNV is to be submitted after getting
counter signature of District Education Authorities (DEO/BEO etc.)

After verification of documents submitted, JNVs will confirm the admission,

if the candidate is found eligible as per NVS norms.

It is informed that admission will be given to the provisionally selected

candidates, only after due verification of the documents followed by confirmation
by JNV concerned. Parents are advised NOT to take TC from the previous school
until the admission is confirmed by the JNV. Now the process of admission in
JNVs is highly transparent and activities are visible to all. Admission to JNVs is
done free of cost. No fee is to be paid to school authority for admission to
Class- VI. The parents/candidates are required to approach directly the
Principal of the JNV concerned in case of any issue. In case of any difficulty,
an email may be sent to respective Regional Office addressed to the Deputy
Commissioner.
 PERSONAL INFORMATION FORM
(To be filled in by the Parent/Guardian of the Candidate with the help of the
Headmaster/Headmistress of the School from where the candidate passed
Class V Examination)

1. Name of the Candidate:___________________________

Aadhar Number:
PHOTO
of student
2. Sex Male Female TG

3. (a) Category
Gen OBC SC ST

(b) Caste

4. Date of Birth
Date Month Year

Date of Birth in Words

5. Father’s Name
6. Mother’s Name

7. Name of the Guardian and

relationship with him/her, if applicable:

8. School(s) from where the candidate passed Class III, IV and V.

CLASSES
Particulars
III IV V

(A) (i) Month & Year of Joining

(ii) Month & Year of Passing

(B) (i) Name of the School

(ii) Is It a recognized school? (YES/NO)

(C) Name of the Village or Town in which

school is located.

(D) Name of the Block

(E) Name of the District

(F) Location of the School Indicate

RURAL/URBAN

(Separate certificate is to be obtained if the candidate had studied classes III, IV & V in
different schools)
 CERTIFICATE

(BY PARENT/GUARDIAN OF THE CANDIDATE CONCERNED)

Certified that the information given above is true to the best of my knowledge and
belief. In case, any part of information furnished by me is found incorrect, the
admission of my child/ward may be cancelled at any stage of selection/study in
JNV. I am ready to produce the relevant certificates issued by Competent
Authorities as and when asked for.

Signature of PARENT/GUARDIAN

Entries verified, certified and found correct.

Signature of the HEADMASTER/HEADMISTRESS

Name:

School Seal
Desgn.:

(NOTE FOR THE HEAD OF THE SCHOOL: - Following Certificate is required to be

issued in respect of candidate selected for admission in JNV in the respective
district).

CERTIFICATE BY THE HEAD OF THE SCHOOL

Certified that the information given in pages 1 & 2 is found correct as per our
school records. It is also certified that Master/Kumari
was admitted in this School in Class on
(date) and passed Class on
(date).

Signature of the Head of Institution

last studied with School Seal

Date:
 UNDERTAKING BY THE PARENT/ GUARDIAN

Certified that the information given in the application form for admission into Class
VI in Jawahar Navodaya Vidyalaya, District: for the academic year
2023-24 for my ward is true to the best of my knowledge and belief. In case any part
of the information furnished by me is found incorrect, admission of my ward may be
cancelled at any time. I am ready to produce relevant certificates issued by the
competent authority to your office when asked in support of entries in my original
application.

Signature of the Parent/Guardian

Address of parent/guardian:

Name
Street
Village
Mandal/Block

Pin Code:

STD Code: Phone No

Mobile No:

UNDERTAKING *

, (Father/Mother/Guardian) of Kumari/Master
who got selected for admission into Class VI in Jawahar Navodaya Vidyalaya,
..................District hereby give an undertaking that I am ready to pay Navodaya Vikas
Nidhi from Class-IX to XII every month as per norms of Navodaya Vidyalaya Samiti.

Signature of the parent/Guardian

* Note: This is not applicable to SC/ST/ Divyang students, all girl students and the wards of
parents whose Income is below poverty line (BPL).
 UNDERTAKING FOR MIGRATION
(TO BE FILLED BY PARENT IN PRESENCE OF PRINCIPAL, JNV)

( Father/Mother/Guardian) of Kumari / Master

who got selected for admission in Class VI in JNV,

District hereby give an undertaking that I understand that, for promotion

of National Integration and as per the scheme at JNVs, 30% of the students of class IX

from one JNV have to migrate to another JNV from non-Hindi speaking area to Hindi

speaking area and vice-versa and I agree to abide by the rules of NVS in this regard.

Signature of the parent/guardian

Full Name:

Address:

Mobile No:

Land line with STD code:

 MEDICAL FITNESS CERTIFICATE

JAWAHAR NAVODAYA VIDYALAYA

DISTRICT:

01. Name of candidate

02. Father’s Name

03. Address

04. Date of birth

05. Height

06. Weight

07. Abdomen

08. Chest

09. Vision LEFT RIGHT

10 Ears

11. Throat

12. Locomotor System

13. State of vaccination

14. Skin

15 Blood Group

16 Dental Hygiene

17. Remarks of Medical Officer : Recommended/not recommended for

admission/Recommended to C.M.O for
Verification if any.

PHOTO OF THE
STUDENT

CIVIL SURGEON
 MEDICAL ANTECEDENTS

UNDERTAKING

We, Shri (father) & Smt. (mother),

the parents of Master/Miss , do hereby declare
that our ward doesn’t suffer from any of the medical ailments listed below.

1. Head Injuries
2. Puo- Intermittent
3. CHD- Congerfital Heart Disease
4. AA — Acute appendicitis
5. Epilepsy — Convulsions (Injury, Fever)
6. Blood Disorders (Sickle cell Anemeia, Haemophillia)
7. Communicable Diseases (TB, Hepatitis A & B)
8. Skin Disease.

We further declare that our ward Master/Miss doesn’t have any previous
medical history which required/still requires prolonged or intermittent periods of medical
confinement either in a hospital/nursing home or in our house.

Certified that the information furnished above is true to the best of our knowledge. Any willful
suppression or false information on the medical antecedents revealed later, would make the
admission of our ward invalid and liable for actions as deemed fit by the Vidyalaya and
Navodaya Vidyalaya Samiti.

PLACE: FATHER’S SIGNATURE

DATE: NAME:

MOTHER’S SIGNATURE:

NAME:

ADDRESS:
 DISABILITY CERTIFICATE

If the candidate is selected under disabled quota he/she should bring the certificate
issued by the competent authority.

CATEGORY/COMMUNITY CERTIFICATE (SC/ST)

Category certificate in the prescribed format from the competent authority is to be

submitted by the candidate, wherever necessary.

CATEGORY/COMMUNITY CERTIFICATE (OBC)

OBC certificate is to be submitted only as per Central List.

DATE OF BIRTH CERTIFICATE

The copy of Birth Certificate issued by Government Authority concerned is to be

submitted by the provisionally selected candidate.

RURAL AREA CERTIFICATE

(To be issued by the Revenue Officer of concerned Block)
This is to certify that Master/Kumari Son/Daughter of
Shri studied classes III,IV & V in (Name of the
school)of block and the school is located in the village which
belongs to rural area of District; State:

(Signature of the Revenue Officer)

Block:
District.

Office Seal:

Dated:
 RESIDENCE CERTIFICATE

(To be furnished by the parents of the qualified children at the time

of admission to JNVs)

As per Jawahar Navodaya Vidyalaya, District State

letter No: dated: my ward Master/ Kumari
has qualified the entrance exam for admission to
Class VI at JNV, District ,State for the session
2023-24.

I am residing along with my ward mentioned above at the following address:

Village:
Town:
District:
State:
Pin Code:

It is certified that the information furnished by me is true and no fact has

been concealed.

Signature of the parent

Full name:
Address:

Copy of a certificate to prove the residence in the district like Aadhar Card of the same district,
Residence Certificate issued by the competent authority is to be attached

CER TI FI C ATE

(TO BE FILLED UP BY THE DISTRICT AUTHORITIES AND ISSUED UNDER THE SIGNATURE OF
TEHSILDAR TO THE PARENTS OF THE CHILD SELECTED FOR ADMISSION TO CLASS VI IN
JNVS THROUGH JNVST)

This is to certify that the above information furnished by Shri/Smt

Father/Mother of Master/Kumari a candidate
for admission to class VI in JNV, District has been verified from the records
and is found to be correct.

The area where residence is located falls under (Rural/Urban) area of the district

Signature of Tehsildar
(With Seal)