Directorate of Government Examinations - Tamil Nadu

State Level National Talent Search Examination (X-STD) (NOV 2017)

FEES : Rs.50/- (Rupees fifty only)
Student Information :
Medium : Tamil English [

Name : ___________________________________________
Affix passport
Sex : Male Female Transgender
size photograph
Date of Birth : _______________________ (DD-MM-YYYY)
Caste : General SC ST OBC OB(Muslim) MBC
Area of Candidate resides : Rural Urban
Disability Status of Candidate : None Orthopaedic Hearing Blind
National ID No. (If Disabled)

School Name & Address:_____________________________________________________

Rural Urban

Phone No : _____________________ Aadhar No.____________________

Residential Address :
Door No. & Street : ______________________________________________________

__________________________________________________
City / Town : ____________________________ Pin code : _______________
District : _____________________________
Parents Details :
Fathers Name : ___________________________ Mothers Name : ___________

Education : ___________________________ Education : ___________

Occupation : ___________________________ Occupation : ___________

Parents Annual Income : No. of Family Members : __________

Up to 2,00,000
2,00,001 t0 3,00,000
3,00,001 to 5,00,000
5,00,001 to 10,00,000
More than 10,00,000
No. of Brothers : __________
No. of Sisters : __________
At what No. is the Candidate among
his / her brother and sisters : __________
Phone No. : _______________________

E-mail ID : _____________________________ Mobile No : ______________________

Students Signature Parents Signature

_______________________ _______________________

The particulars given by the student in the application form have been verified with
school records and found in order

Headmaster / Principal Signature

with School Seal