Page: 1

STATE COUNCIL OF EDUCATIONAL RESEARCH AND TRAINING (SCERT),KERALA

STATE LEVEL NATIONAL TALENT SEARCH EXAMINATION 2010 - 11
APPLICATION FORM Space for the photograph
(passport size)
Read the instructions given in pages 5, 6 and 7 before filling in the application
Class in which the candidate is studying:

Application fee (To be filled by candidate) The photograph should be endorsed by

(Pupils of SC/ ST/ BPL* category are exempted from paying examination fee) the Head of the Institution
AMOUNT DD NUMBER DATE OF DD NAME OF BANK

Educational District
(To be filled by candidate)

Name of the Centre Centre Code

(To be filled by candidate) (Refer page 7) (To be filled by candidate)

Class Code State Code Year Centre Code Serial Number

State Level 11 digit Roll No. 1 4 2 1 1 Code for Class VIII 1
(To be filled by the candidate) (To be filled by the office)

1 Name of the candidate

2 Father’s name
(Do not write Mr/Dr/Prof)
3 Date of birth 4 Sex 5 Area to which candidate resides 6 Caste category of candidate

Day Month Year Male Female Rural Urban General SC ST

7 Residential postal address for correspondence (Do not write father’s name or your name)

Pin

8 Name and address of the Institution in which studying (Class VIII) CBSE ICSE State Syllabus

Telephone (School) Pin

9 Type of Institution in which studying at Class VIII (Refer page 6 ) 10 Disability status of Candidates
Govt. Local Body Private Aided Private Unaided Orthopedic Low vision Blind
Hearing None
11 Area in which the school is located Rural Urban (Physically challenged candidates must
produce a medical certificate. Refer page 5.)
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 members living in the house

18 Number of brothers 19 Number of sisters 20 At what number is the candidate among

his/her brothers and sisters

21 Parental annual income 1 2 3 4 5 6

(Up to 50,000) (50,001 to 100,000) (100,001 to 1,50,000) (1,50,001 to 2,00,000) (2,00,001 to 2,50,000) (More than 2,50,000)

22 Two contact 1 23 e-mail

Phone Nos. Address
2
STD Code Phone Number
(* BPL category pupils should attach proof along with the application form) (PTO)
 Page: 2
DECLARATIONS

1. I declare that the entries made in the form are correct to the best of my knowledge.

Date Signature of the Applicant

2. I .............................................................................................................. parent/ guardian of ..............................................................

studying in class ........... in ................................................................................................................................................... school
in the year 2010-’11 hereby declare that my annual income from all sources is (please write in figures and
words) Rs. ....................................................................................................................................................

Date Signature
Name of Parent/ Guardian

3. I certify that the candidate is studying in class VIII of this school and that he/she obtained ......... grade or ...........%
of marks in non language subjects put together in the annual examination of class VII in the year 2009-’10

Signature
Name of the Principal/ Headmaster
Date with Seal

SC/ ST Certificate
(to be filled for SC/ ST candidates only)
Master/ Miss ............................................................................ belongs to .............................................
(scheduled caste/ scheduled tribe) category as per the records maintained in the Institution.

Date : Signature of the Headmaster

with Seal

(If the SC/ ST Certificate is not duly filled in and without the signature of the
Head of the Institution, the candidate will be considered as general category.)

BPL Certificate
(to be filled for BPL candidates only)

Master/ Miss ............................................................................ belongs to BPL category and the xerox

copy of the certificate to prove he/she belongs to BPL category is attached herewith.

Date : Signature of the Headmaster

with Seal
(PTO)
 Page: 3
STATE COUNCIL OF EDUCATIONAL RESEARCH AND TRAINING (SCERT),KERALA
STATE LEVEL NATIONAL TALENT SEARCH EXAMINATION 2010-’11
Affix passport size
Photograph here

ADMISSION CARD
Master/ Miss .................................................................................................................................
(to be attested by the
S/o / D/o Sri. ................................................................................................................................. Head of the School
School Seal)
of (school) .................................................................................................................................
of (Educational District) ................................................................................................................. is permitted to appear for
(To be filled by candidate)
the above said examination.

Full Postal Address of Candidate (To be filled by candidate)

_______________________________________________________________________________________________
_______________________________________________________________________________________________
She/ He is alloted Roll Number:

(To be filled by office)

Date of examination 2 1 1 1 2 0 1 0 from 9.00am to 1.30pm

Venue of Examination (To be filled by candidate) (Refer Page 7)

Signature of the Candidate

Pin Code

Attested by the Head of the School

with Office Seal
Signature of the Candidate
at the time of issue of this card

Signature of the Chief Superintendent

of the Centre of Examination with
Seal and Date

Scrutinized by
(Office Seal) Office Seal
Signature of Liaison Officer
State Level NTS Examination
SCERT

Signature of the Invigilator MAT:

at the examination centre
SAT :

(PTO)
 Page: 4
1 Make sure that the admission card is not detached from the application form. Admission cards will be
sent to the chief superintendent of the examination centre after allotting the Roll Numbers. Candidate
can collect the Admission Card from the chief superintendent of the examination centre at least a week
before the examination. Admission Card will not be sent to you from this office.

2 Reach the examination centre alteast 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 two sessions on the same day.

5 You will have to take the examination in TWO PARTS:

(i) PART I: Part I is confined to Mental Ability Test (MAT) consisting of 90 compulsory questions.
9 am to 10.30 am All candidates except disabled candidates
9 am to 11 am Disabled candidates only

(ii) PART II: Part II is confined to Scholastic Aptitude Test (SAT) consisting of 90 compulsory questions
from Social Science, General Science and Mathematics.

11.30 am to 01.00 pm All candidates except disabled candidates

11.30 am to 01.30 pm Disabled candidates only

6 Time for Part I is 90 minutes and for Part II is 90 minutes.

7 Each question carries 1 (one) mark.

8 Write your Roll Number, as given in the Admission 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 questions FOUR possible answers are
given but only one is correct. Your task is to find out the correct answer and mark your choice in
the Answer Sheet as per the instructions given in the question booklet as well as on the answer
sheet.

11 During the Examination follow the instructions of the Invigilator strictly.

12 Hand over your question booklet and Answer sheet to the invigilator before you leave the
Examination Hall.

(PTO)
 Page: 5
INSTRUCTIONS TO CANDIDATES
Read the instructions carefully before filling up the application form.
You may seek the help from your teacher/ parent for filling the application form.
(1) Do not send this ‘Instructions to candidates’ along with your application form.
(2) Only students studying in class VIII in the year 2010-’11 are eligible to apply.
(3) Use only blue or black point pen. WRITE IN CAPITAL LETTERS.
(4) Leave one box blank between two words. Limit your name and address within the boxes.
(5) Cross (X) only one of the appropriate boxes in item nos. 4,5,6,9,10,11 and 21.
(6) Please write code number in item nos. 12,13,14,15,16 and centre code as given over leaf.
Example for writing Name and Address
Father’s name P K S WA R O O P
Postal Address 1 4 5 / 6 MOUNT R O A D
CHE N NAI Pin 6 0 0 0 1 5
(7) The application should be accompanied by
(1) Two photographs - one on the application form and the other on the Admission Card both duly attested.
(2) The original DD for Rs.100 in favour of the Director SCERT drawn on or before 31.Aug.2010
payable at SBT Service Branch, Thiruvananthapuram. (SC/ST/BPL categories are exempted from
fees)
(3) Physically challenged candidates must produce a medical certificate from the competent authority stating
that the candidate suffers from 40% or more disability as per the PWD Act 1995.
LIAISONOFFICER
(8) The application may be sent by post to the following address
NTS EXAMINATION, SCERT, POOJAPPURA
It may be deposited in the box kept at SCERT for the purpose. THIRUVANANTHAPURAM - 695012
(9) Last date of receipt of applications in SCERT is 31.Aug.2010
Date of Examination 2 1 1 1 2 0 1 0 from 9 am to 01.00 pm.
(10) Date of issue of Admission card.
You are directed to collect your Admission Card in person from the Headmaster/ Chief Superintendent of the examination centre,
you have noted in your application form, on any working days between 15-11-2010 and 20-11-2010 during office hours,
producing the identification certificate given below.
Admission card will not be sent to your home address or your school address.
Do not send the identification certificate along with your application form.
No further communication will be sent to you about the venue, date of examination and date of issue of admission card. It is the
responsibility of the candidate to collect the admission card from the centre of the examination between 15.11.2010 and
20.11.2010.
(11) It is the responsibility of the candidate and the Principal of the school to deposit the filled in form with the Liaison Officer SCERT
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.
(Give the identifcation certificate, duly filled in, to the Headmaster/ Chief Superintendent of the examination
centre you have noted in your application form at the time of issue of the admission card)
Cut here
Identification Certificate
(To be obtained from the head of the school in which the candidate is studying)
Name of the candidate
Caste Category
Date of birth Class
Day Month Year General SC ST
Name of the School
studying

Certified that the above candidate has applied for the State Level NTS Examination 2010. The admit
card may be issued to the candidate whose signature is attested.

Place: Signature of the Signature of the Headmaster

Date: Candidate with Seal

(PTO)
 Page: 6
CODING PLAN
Medium of Code Education of Father or Mother Code
Examination Upto Primary 1
English 13 Upper Primary 2
Secondary 3
Kannada 16 Senior Secondary 4
Graduation 5
Malayalam 18 Postgraduation 6
Doctoral 7
Professional degree (Eng., Med, MCA, MBA, etc.) 8
Tamil 21
Any other 9
Father’s/ Mother’s Occupation (Refer to item 13&16)
Occupation Code
Professional, Technical and related worker 1
Administrative, Executive and Managerial Worker 2
Clerical and Related worker 3
Sales/ Service Worker 4
Farmer, Fisherman and Related Worker 5
Production and Related Worker, Transport 6
Operators and Labourer Worker not classified by the above occupations 7
Not employed 8
Type of School/ Instituion
Government A government school is that which is run by the State Government or Central Government
or Public Sector Undertaking or an autonomous organisation 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 Contonment Board.
Private Aided Private Aided School is that which is run by an individual or a private organisation and
receives grant from govenment.
Private Unaided Private Unaided school is that which is managed by an individual or a private organisation and
does not receive any grant either from government or local body

(PTO)
 Page: 7

CENTRE CODES
Educational Centre Centre of Educational Centre Centre of
District Code No. Examination District Code No. Examination
Kasaragode 11 Government High School, Kothamangalam 51 Govt. Girls H.S.S, Perumbavoor
Kasargod
Aluva 52 Govt. H.S.S, Chengamanad
Kanjhangad 12 Govt. High School Kanhangadu
53 MAHS Nedumbassery
Kannur 13 Govt. Girls V.H.S.S,
Payyambalam, Kannoor Muvattupuzha 54 Govt. H.S.S, Sivankunnu
14 Govt. HSS, Pallikunnu Thodupuzha 55 Govt. H.S.S, Thodupuzha
15 CHM High School, Ilayavoor Kattappana 56 Govt. Tribal H.S, Kattappana
Thalassery 16 B.E.M.P High School, Thalassery Kottayam 57 M.T. Seminary H.S, Kottayam
17 Govt. Brannan HSS, Thalassery 58 CMS College HSS, Kottayam.
Vadakara 18 Govt. V.H.S.S, Payyoli 59 Govt. Model HS, Kottayam
19 JNM GHSS Puduppanam, Kanjirappally 61 Pettah Govt. H.S, Kanjirappally,
Kozhikode Kottayam
Kozhikkode 21 Govt. Vocational HSS, Pala 62 Govt. H.S.S, Pala.P.O., Kottayam
Nadakkavu, Kozhikkode Kaduthuruthy 63 Vaikom Govt. Girls HSS, Vaikom
22 Govt. Model HSS, Kozhikode Kottayam
Thamarassery 23 Govt. VHSS Thamarassery Alappuzha 64 Govt. Mohammeden Girls H.S,
Alappuzha
24 GHSS, Koduvally
65 Govt. Model GHS, Alappuzha
Wayanad 25 Govt. Sarvajona V.H.S.S, Sulthan
Batheri Cherthala 66 Cherthala South Govt. High
School
26 Govt. HSS. Moolankavu
Mavelikkara 67 Govt. H.S.S for Girls Mavelikara
Tirur 27 Govt. Girls V.H.S.S , Tirur,
Puthiyangadi, Malappuram 68 Govt. Boys HS, Mavelikara
28 Govt. Boys HSS, Tirur Kuttanad 69 Govt. High School, Thekkekara,
Alappuzha
Malappuram 29 Govt H.S.S for Boys, Malappuram
Down Hill, Malappuram Pathanamthitta 71 Govt. H.S.S & VHSS,
Pathanamthitta
31 Govt. Girls HSS Malappuram
72 Catholicate School,
Wandoor 32 VMC Govt. HSS Wandoor Pathanamthitta, Pathanamthitta
Thrissur 33 Govt. Model H.S.S For Boys, Thiruvalla 73 Govt. Model Girls H.S, Thiruvalla,
Thrissur Pathanamthitta
34 Govt. V.H.S.S For Girls, Thrissur Kollam 74 Govt. HS West Kollam
35 St. Thomas College HSS, Thrissur 75 Govt. Model BHSS, Kollam,
Irinjalakkuda 36 Govt. V.H.S.S for Girls, Thevaly
Irinjalakkuda 76 Govt. Model HSS for Girls Kollam
37 Govt. Model Boys HSS, Punalur 77 Govt. H.S.S, Punalur
Irinjalakuda
Kottarakkara 78 Govt. VHS & BHS, Kottarakkara
38 SN HSS Irinjalakuda
79 Govt. VHSS & HSS for Girls
Chavakkad 39 Govt. V.H.S.S, Pazhanji Kottarakkara
41 HS Pengamukku Attingal 81 Govt. Boys H.S.S, Attingal
Ottappalam 42 Govt. H.S.S, Vadankurisi 82 Govt. GHS, Attingal
43 Govt. HS Pattambi 83 Govt. HSS Venjaramood
Palakkad 44 P.M.G.H.S.S, Palakkad Thiruvanantha 84 Govt. V.H.S.S & HSS for Girls
45 Govt. Moyans Girls HS, Palakkad puram Manacaud
46 Govt. HSS, Big Bazar, Palakkad. 85 Govt. Model BHSS, Thycaud
Ernakulam 47 St.Alberts H.S.S, Ernakulam 86 GHS, Chala,
48 SRVGHSS, Ernakulam Thiruvananthapuram
49 Govt. Girls HSS Ernakulam Neyyattinkara 87 Govt. Boys H.S.S, Neyyattinkara
88 Govt. Girls H.S.S, Neyyattinkara
Lakshadweep 89 Govt. H.S, Kavarathi