Appendix - A

Instructions for filling up the Application Form for Admission

GENERAL INSTRUCTIONS
1. Apply for admission only on the forms available in the Prospectus (or downloaded from the NIOS website).
2. Forms are provided in duplicate. Fill in both the forms giving same particulars. In case of any variation, particulars
filled in the original Form will be treated as final.
3. Ensure your eligibility before filling up the form. You will not get admission in case any of the eligibility criteria is
not fulfilled and fee will be forfeited without any intimation.
4. Fill in the form legibly in CAPITAL letters English or Hindi only. Avoid overwriting.
5. Leave one box blank between parts of Name, Father’s Name, etc. Do not write Mr., Mrs., Shri, Kum., etc.
before any name.
6. Incomplete admission form without supporting documents will be summarily rejected and fee forfeited.
Submit your Application Form and deposit fee only in the AVI/SAIED
where you wish to seek admission, and obtain proper receipt.

SPECIFIC INSTRUCTIONS
PART A of the Form
You need to affix your two recent passport size photographs on each application form. Photograph pasted on left side
of the forms has to be attested by anyone of the following persons:
➤ Coordinator of NIOS AVI/SAIED
➤ Principal of a recognized school/college or institution
➤ District Magistrate
➤ Gazetted Officer
➤ Pradhan, Gram Panchayat
➤ Sarpanch of a Village/ Tehsildar
The photograph on the right side shall not have any mark as it will be scanned for record. It shall also fit in the Box
provided for it.
Sign in the box provide below this place. Don’t sign outside the box.
1. Name of the Candidate : Mention your name as already recorded in your previous school certificate.

V I S H A L C H A N D E N S O D H I

2&3. Father’s and Mother’s Name: Write your father’s and mother’s names in block letters, in English
as per specimen given below. Do not write Shri, Smt., Mr. or Mrs. before the name.
N I H H A L C H A N D E N S O D H I
Your Father's and Mother's name should tally with your previous records. This will be recorded in your
Certificate. No change will be permitted later on.
4a. Postal Address : Provide your complete address with House No., Father’s Name
(if required), Ward No., Village and Post Office, Tehsil, District, State and Pin Code. NIOS will not be
responsible for non-delivery of items/letters/materials if any, to the candidate, due to incomplete
address.

37 ❖ Prospectus 2017 Vocational Education Courses

4b. Permanent Address : Provide your complete address with House No., Father’s Name (if required),
Ward No., Village and Post Office, Tehsil, District, State and Pin Code. NIOS will not be responsible
for non-delivery of items/letters/materials if any, to the candidate, due to incomplete address.
5. Date of Birth : Mention your date of birth correctly in figures only e.g. 05.08.1967 instead of 5th August
1967. Attested copy of certificate as proof of date of birth should be attached with the admission
form.
1 9 0 6 1 9 8 4
DATE MONTH YEAR
6. Gender: Write 1 for Male, 2 for Female and 3 for Third Gender in the box provided.
7. Category: Write 1 for General, 2 for SC, 3 for ST, 4 for Ex-Servicemen and 5 for Handicapped, 6 for
OBCs (Others Backward Classes) in the box provided.
8. Disability: Write 1 for Locomotor Disability, 2 for Visually Impaired, 3 for Hearing Impaired, 4 for Lep-
rosy Cured, 5 for Mentally Retardation, 6 for Mental Illness, 7 for Multiple Disabilities, 8 for Spestic/
Cerebral Palsy, 9 for Learning Disabilities, 10 for Autism and 11 for Not Applicable, in the box provided.
9. Disadvantaged Group: Write 1 for Street Children, 2 for Working Children, 3 for Rural Women, 4 for
Slum Dwellers and 5 for Not applicable, in the box provided.
10. Category of Course Applied for : Provide (a) category of the course. Please tick (P) in the appropriate
box. (b) name of the course and (c) subject code no(s). Refer to Table I on page 4 onwards.
11. Medium of Study: Write 1 for Hindi Medium and 2 for English Medium in the box provided.
12. Nationality: Write 1 for Indian and 2 for any other, in the box provided.
13. Religion : Write 1 for Hindu, 2 for Muslim, 3 for Christian, 4 for Sikh, 5 for Jain, 6 for Budhist, 7 for Parsi,
8 for Jews.
14. Your Previous Qualification, : Please tick (P) in the appropriate box. Attach attested copy of marks
sheet as proof of educational qualifications.
15. Year of Passing X & XII Exam. : Write the name of the Board from where you have passed your
Examination.
16. Amount of Admission Fee Paid : Fill in details of fee remitted. Amount of fee to be remitted is given in
Table I on Pages 4 onwards. Do not pay any extra amount over and above what has been prescribed
by NIOS.

PART B of the Form

17. Fill in this section which will help us develop appropriate strategies for you.
18. Signatures of the Candidate and Counter Signatures of Parent/Guardian (if required) with date be clearly put at
the appropriate place.

National Institute of Open Schooling ❖ 38

ewy izfr
ORIGINAL
Appendix - B
QkeZ la-@FORM NO.

;gka QksVks fpidk,¡ tks fd leUo;d@

jk"Vª h ; eq D r fo|ky;h f'k{kk la L Fkku] uks , Mk ¼m-ç-½ ckWDl ds vkdkj dk f'k{kkFkhZ
ç/kku@ljiap@ç/kkukpk;Z ;k National Institute of Open Schooling, NOIDA (U.P.) dk QksVks ;gk¡ fpidk,¡
jktif=kr
vf/kdkjh }kjk lR;kfir gksA
O;kolkf;d ikB~;Øeksa esa ços'k ds fy, vkosnu QkWeZ-2017 tks lR;kfir u gksA
PASTE PHOTOGRAPH HERE OF THIS Application Form for Admission to Vocational Courses-2017 PASTE HERE
BOX SIZE DULY ATTESTED BY
COORDINATOR/PRINCIPAL/
QkeZ fganh ;k vaxzst+h ds cM+s o.kks± esa HkjsaA dsoy uhys ;k dkys ckWy ikbaV isu dk gh ç;ksx djsaA ,d [kkus esa dsoy PHOTOGRAPH OF
PRADHAN/SARPANCH OR ,d o.kZ fy[ksaA [kkuksa ls ckgj dgha Hkh dqN u fy[ksaA bl QkeZ dh QksVks dkWih dk iz;ksx u djsaA dsoy vjch THE STUDENT OF THE
GAZETTED OFFICER vadksa dk iz;ksx djsa tSls 1, 2, 3... Write in Hindi or English (CAPITALS). Use only Blue/ Black Ball Point Pen. SIZE OF THIS BOX ONLY
Write one letter in one Box. Do not write outside the boxes. DO NOT USE PHOTOCPOY OF THIS FORM . Use Arabic Numericals only DO NOT ATTEST
egÙoiw.kZ % QkWeZ f'k{kkFkhZ }kjk nks izfr;ksa esa Hkjk tk,A 'kqYd rFkk çek.ki=ksa dh lR;kfir QksVks dkWih ds lkFk iwjk QkWeZ Hkjdj vafre frfFk ;k mlls igys ekU;rk çkIr laLFkk esa
tek djsaA QkWeZ v/kwjk Hkjs tkus ij f'k{kkFkhZ dks lwfpr fd, fcuk mls jí dj fn;k tk,xk rFkk 'kqYd Hkh ugha ykSVk;k tk,xkA
IMPORTANT: To be filled by the Candidate in DUPLICATE. Completed forms with attested photo copies of certificate and fees should be deposited with Accredited Vocational
Institution on or before the last date. Incomplete admission forms will be summarily rejected and fee forfeited without any intimation to the candidates. f'k{kkFkhZ ds gLrk{kj Signature of the Student

ukekadu la[;k ¼,ohvkbZ@,l,vkbZbZMh }kjk nh tk,xhA½ / Enrolment Number (to be given by AVI /SAIED)
Hkkx&d@ PART-A
1. f'k{kkFkhZ dk iwjk uke ¼Li"V v{kjksa esa½@Full Name of Candidate in CAPITAL Letters

2. firk ;k vfHkHkkod dk iwjk uke ¼Li"V v{kjksa esa½@Father's or Guardian's Name in CAPITAL Letters

3. ekrk ;k fgrS"kh ekrk dk iwjk uke ¼Li"V v{kjksa esa½@Mother's or Mentor Mother's Name in CAPITAL Letters

4a- i=&O;ogkj ds fy, irk ¼Li"V v{kjksa esa½@Postal Address in CAPITAL Letters
irk@Address

ftyk@District
jkT;@State fiudksM@Pincode
bZ&esy@E-mail
,lVhMh dksM@STD Code nwjHkk"k@eksckby@Telephone/Mobile
4b- LFkk;h irk@ Permanent Address
irk@Address

ftyk@District
jkT;@State fiudksM@Pincode
vk/kj la[;k (;fn gS rks)@Aadhar No. (if available)
5. tUefrfFk@Date of birth 6. fyax@ Gender 8. fodykaxrk@ Disability

7. Js.kh@Category 9. oafpr oxZ@Disadvantaged Group

frfFk Date ekg Month o"kZ year

10 a. ftl ikB~;Øe ds fy, vkosnu fd;k gS ml [kkus esa þ fpg~u yxk,¡a b. ikB~;Øe dk uke@Name of the Course
Category of the Course Applied for (Mark ü):
c. fo"k; dksM la[;k@Subject Code No.
iSdst Ng ekg ,d lky nks lky thou le`f) i`Fkd :i okys
Package Six-Month One year Two year Life Enrichment Stand Alone

11. v/;;u dk ek/;e@Medium of Study 12. jk"Vªh;rk@Nationality 13. /keZ@Religion

14. vkidh iwoZ ;ksX;rk lgh [kkus esa þ djsAa 15. nloha vkSj ckjgoha cksMZ ijh{kk mÙkh.kZ djus dk o"kZ nloha ckjgoha
Year of Passing X and XII Class Examination X XII
Your Previous Qualification Put þ inside the Appropriate Box.
¼Ñi;k vko';drkuqlkj lacfa /kr dkxtkr@izek.ki= vo'; layXu djs½a
V VI VII VIII (Please enclose the relevent papers/certificates
positively as necessary)
cksMZ dk uke@Name of the Board%
IX X XI XII rFkk mlls Åij i) nloha d{kk ds fy,@For Class X
ii) ckjgoha d{kk ds fy, For Class XII
16. nh xbZ izos'k 'kqYd dh jkf'k@Amount of Admission Fee paid : Rs. P.T.O
" "
(f'k{kkFkhZ dks nh tkus okyh jlhn@ Receipt to be given to the candidate)
Received application form with Bank Draft No. ................ dt. ................ /Cash Rs. .................. from Mr./Ms. ......................................................... for
............................ Course(s)/Code(s) .....................
leUo;d ds gLrk{kj eqgj lfgr Signature of Coordinator with Stamp
 Hkkx ([k) (i`"BHkwfe lwpuk) PART B (BACKGROUND INFORMATION)
17. uhps nh xbZ lwpuk,a lgh&lgh HkjsaA lgh ckDl esa (ü ü) fpg~u yxk,¡A
ü) in appropriate box.
Please fill in the following information correctly. Put tick mark (ü

1. ifjokj esa lnL;ksa dh la[;k@ Number of members in your family : _________________

2. ifjokj dh okf"kZd vk; @Total family income per year :
1. 12,000 #- rd 2. 24,000 #- rd 3. 36,000 #- rd 4. 36,000 #- ls vf/kdA
1. Upto Rs. 12,000 2. Upto Rs. 24,000 3. Upto Rs. 36,000 4. Above Rs. 36,000
3. firk dh 'kSf{kd ;ksX;rk
Father’s Educational qualification :
1. vf'kf{kr 2. izkbejh rd 3. vkBoha rd 4. nloha rd 5. dkWyt
s rdA
1. No Education 2. Upto Primary 3. Upto Middle 4. Upto Secondary 5. Upto College
4. ekrk dh 'kSf{kd ;ksX;rk
Mother’s educational qualification :
1. vf'kf{kr 2. izkbejh rd 3. vkBoha rd 4. nloha rd 5. dkWyst rdA
1. No Education 2. Upto Primary 3. Upto Middle 4. Upto Secondary 5. Upto College
5. vki dgk¡ jgrs gS\a 1. 'kgj 2. xzke
Where do you live? 1. Urban 2. Rural
6. vkids ?kj esa dejksa dh la[;k
Number of rooms in your residence:
1. ,d 2. nks 3. rhu 4. rhu ls vf/kd
1. One 2. Two 3. Three 4. More than three
7. vkids ?kj esa buesa ls dkSu&dkSu lh phtsa gSa\
Which of the following do you have at home?
1. fctyh 2. ia[kk 3. jsfM;ks/Vªkfa tLVj 4. Vhoh 5. dSlsV/lhMh Iys;j
1. Electricity 2. Fan 3. Radio/Transistor 4. TV 5. Cassette/CD Player
6. lkbfdy 7. LdwVj 8. dkj 9. jlksbZ xSl 10. ohlhvkj@ohlhih 11. tujsVj@buojVj
6. Cycle 7. Scooter 8. Car 9. Cooking Gas 10. VCR/VCP 11. Generator/ Invertor
12. eYVhehfM;k daI;wVj 13. VsyhQksu 14. daI;wVj 15. dscy
12. Multimedia Computer 13. Telephone 14. Computer 15. Cable Connection
8. vki dke djrs gSa ;k csjkstxkj gSa\ 1. dke djrs gSa 2. viuk jkstxkj 3. csjkstxkj gSa
Are you employed or unemployed? 1. Employed 2. Self-employed 3. Unemployed
9. ?kks"k.kk Declaration
eSa izekf.kr djrk gw¡ fd@Certified that:-
d½ esjs ikl ikB~;Øe ds fy, vko';d U;wure 'kSf{kd ;ksX;rk gS@eSaus ,uvkbZvks,l ds vkBoha d{kk ikl rd dh ;ksX;rk okys ikB~;Øe ds fy, v/;;u
djds i;kZIr ;ksX;rk izkIr dj yh gSA a) I possess the minimum educational qualification for the course / I have studied enough to pursue NIOS
Vocational Education Courses where entry level qualification is upto class VIII pass.
[k½ eSaus foojf.kdk esa nh xbZ ;ksX;rk 'krs± i<+dj le> yh gSaA eSa blds ;ksX; gw¡A
b) I have read and understood the eligibility conditions as laid down
in the Prospectus. I fulfil these criteria.
x½ eSaus lkjh t:jh lwpuk,a vkSj nLrkost lgh&lgh ns fn, gSaA eSa tkurk gw¡ fd ;fn ;s lwpuk,a xyr ;k Hkze esa Mkyus okyh gksaxh] rks ,uvkbZvks,l }kjk
esjh mEehnokjh lekIr dj nh tk,xhA c) I have furnished the necessary information/documents correctly. I understand that my candidature
is liable to be cancelled by NIOS if this information is found incorrect or misleading.
?k½ eSa ,uvkbZvks,l ds lHkh fu;eksa dk ikyu d:¡xk vkSj , oh vkbZ @,l,vkbZbZMh ds vuq'kklu vkSj e;kZnk dks cuk, j[kw¡xk@j[kw¡xhA d) I shall abide by
all the rules and regulations of NIOS and shall maintain discipline and decorum at the AVI/SAIED.
³½ eSaus fdlh ,ohvkbZ@,l,vkbZbZMh esa fdlh vU; ,uvkbZvks,l O;kolkf;d ikB~;Øe esa nkf[kyk ugha fy;k gSA e) I have not taken
admission in any other NIOS Vocational Education Course at any AVI/SAIED.
___________________________________ ___________________
18. ekrk firk@vfHkHkkod ds izfrgLrk{kj ¼frfFk lfgr½ f'k{kkFkhZ ds gLrk{kj
Countersignatures of Parent/Guardian Date............. Signature of Candidate Date ................
irk@ Address __________________________________________________
___________________________________________________ fiu PIN _____________

layXudksa dh tk¡p lwph lgh ckDl esa (ü ü) fpg~u yxk,¡A CHECKLIST OF ENCLOSURES Please tick (ü ü)

izo's k QkWeZ dh nwljh izfr Duplicate copy of the admission form 'kSf{kd ;ksX;rk lac/a kh izek.k i= Certificate of Educational qualification vPNh rjg
ls fpidkbZ xbZ QksVks Photograph duly pasted vuqHko izek.ki= ¼;fn ykxw gks½ Experience Certificate, if applicable tUefrfFk izek.ki= Certificate of
Date of Birth
_________________________________________
frfFk Dated : .................... Full Signature with seal of Co-ordinator of the AVI/SAIED
, oh vkbZ@,l,vkbZbZMh ds leUo;d ds iw.kZ gLrk{kj eqgj lfgr
nwljh izfr
DUPLICATE
Appendix - B
QkeZ la-@FORM NO.

;gka QksVks fpidk,¡ tks fd leUo;d@

jk"Vª h ; eq D r fo|ky;h f'k{kk la L Fkku] uks , Mk ¼m-ç-½ ckWDl ds vkdkj dk f'k{kkFkhZ
ç/kku@ljiap@ç/kkukpk;Z ;k National Institute of Open Schooling, NOIDA (U.P.) dk QksVks ;gk¡ fpidk,¡
jktif=kr
vf/kdkjh }kjk lR;kfir gksA
O;kolkf;d ikB~;Øeksa esa ços'k ds fy, vkosnu QkWeZ-2017 tks lR;kfir u gksA
PASTE PHOTOGRAPH HERE OF THIS Application Form for Admission to Vocational Courses-2017 PASTE HERE
BOX SIZE DULY ATTESTED BY
COORDINATOR/PRINCIPAL/
QkeZ fganh ;k vaxzst+h ds cM+s o.kks± esa HkjsaA dsoy uhys ;k dkys ckWy ikbaV isu dk gh ç;ksx djsaA ,d [kkus esa dsoy PHOTOGRAPH OF
PRADHAN/SARPANCH OR ,d o.kZ fy[ksaA [kkuksa ls ckgj dgha Hkh dqN u fy[ksaA bl QkeZ dh QksVks dkWih dk iz;ksx u djsaA dsoy vjch THE STUDENT OF THE
GAZETTED OFFICER vadksa dk iz;ksx djsa tSls 1, 2, 3... Write in Hindi or English (CAPITALS). Use only Blue/ Black Ball Point Pen. SIZE OF THIS BOX ONLY
Write one letter in one Box. Do not write outside the boxes. DO NOT USE PHOTOCPOY OF THIS FORM . Use Arabic Numericals only DO NOT ATTEST
egÙoiw.kZ % QkWeZ f'k{kkFkhZ }kjk nks izfr;ksa esa Hkjk tk,A 'kqYd rFkk çek.ki=ksa dh lR;kfir QksVks dkWih ds lkFk iwjk QkWeZ Hkjdj vafre frfFk ;k mlls igys ekU;rk çkIr laLFkk esa
tek djsaA QkWeZ v/kwjk Hkjs tkus ij f'k{kkFkhZ dks lwfpr fd, fcuk mls jí dj fn;k tk,xk rFkk 'kqYd Hkh ugha ykSVk;k tk,xkA
IMPORTANT: To be filled by the Candidate in DUPLICATE. Completed forms with attested photo copies of certificate and fees should be deposited with Accredited Vocational
Institution on or before the last date. Incomplete admission forms will be summarily rejected and fee forfeited without any intimation to the candidates. f'k{kkFkhZ ds gLrk{kj Signature of the Student

ukekadu la[;k ¼,ohvkbZ@,l,vkbZbZMh }kjk nh tk,xhA½ / Enrolment Number (to be given by AVI /SAIED)
Hkkx&d@ PART-A
1. f'k{kkFkhZ dk iwjk uke ¼Li"V v{kjksa esa½@Full Name of Candidate in CAPITAL Letters

2. firk ;k vfHkHkkod dk iwjk uke ¼Li"V v{kjksa esa½@Father's or Guardian's Name in CAPITAL Letters

3. ekrk ;k fgrS"kh ekrk dk iwjk uke ¼Li"V v{kjksa esa½@Mother's or Mentor Mother's Name in CAPITAL Letters

4a- i=&O;ogkj ds fy, irk ¼Li"V v{kjksa esa½@Postal Address in CAPITAL Letters
irk@Address

ftyk@District
jkT;@State fiudksM@Pincode
bZ&esy@E-mail
,lVhMh dksM@STD Code nwjHkk"k@eksckby@Telephone/Mobile
4b- LFkk;h irk@ Permanent Address
irk@Address

ftyk@District
jkT;@State fiudksM@Pincode
vk/kj la[;k (;fn gS rks)@Aadhar No. (if available)
5. tUefrfFk@Date of birth 6. fyax@ Gender 8. fodykaxrk@ Disability

7. Js.kh@Category 9. oafpr oxZ@Disadvantaged Group

frfFk Date ekg Month o"kZ year

10 a. ftl ikB~;Øe ds fy, vkosnu fd;k gS ml [kkus esa þ fpg~u yxk,¡a b. ikB~;Øe dk uke@Name of the Course
Category of the Course Applied for (Mark ü):
c. fo"k; dksM la[;k@Subject Code No.
iSdst Ng ekg ,d lky nks lky thou le`f) i`Fkd :i okys
Package Six-Month One year Two year Life Enrichment Stand Alone

11. v/;;u dk ek/;e@Medium of Study 12. jk"Vªh;rk@Nationality 13. /keZ@Religion

14. vkidh iwoZ ;ksX;rk lgh [kkus esa þ djsAa 15. nloha vkSj ckjgoha cksMZ ijh{kk mÙkh.kZ djus dk o"kZ nloha ckjgoha
Year of Passing X and XII Class Examination X XII
Your Previous Qualification Put þ inside the Appropriate Box.
¼Ñi;k vko';drkuqlkj lacfa /kr dkxtkr@izek.ki= vo'; layXu djs½a
V VI VII VIII (Please enclose the relevent papers/certificates
positively as necessary)
cksMZ dk uke@Name of the Board%
IX X XI XII rFkk mlls Åij i) nloha d{kk ds fy,@For Class X
ii) ckjgoha d{kk ds fy, For Class XII
16. nh xbZ izos'k 'kqYd dh jkf'k@Amount of Admission Fee paid : Rs. P.T.O
" "
(f'k{kkFkhZ dks nh tkus okyh jlhn@ Receipt to be given to the candidate)
Received application form with Bank Draft No. ................ dt. ................ /Cash Rs. .................. from Mr./Ms. ......................................................... for
............................ Course(s)/Code(s) .....................
leUo;d ds gLrk{kj eqgj lfgr Signature of Coordinator with Stamp
 Hkkx ([k) (i`"BHkwfe lwpuk) PART B (BACKGROUND INFORMATION)
17. uhps nh xbZ lwpuk,a lgh&lgh HkjsaA lgh ckDl esa (ü ü) fpg~u yxk,¡A
ü) in appropriate box.
Please fill in the following information correctly. Put tick mark (ü

1. ifjokj esa lnL;ksa dh la[;k@ Number of members in your family : _________________

2. ifjokj dh okf"kZd vk; @Total family income per year :
1. 12,000 #- rd 2. 24,000 #- rd 3. 36,000 #- rd 4. 36,000 #- ls vf/kdA
1. Upto Rs. 12,000 2. Upto Rs. 24,000 3. Upto Rs. 36,000 4. Above Rs. 36,000
3. firk dh 'kSf{kd ;ksX;rk
Father’s Educational qualification :
1. vf'kf{kr 2. izkbejh rd 3. vkBoha rd 4. nloha rd 5. dkWyt
s rdA
1. No Education 2. Upto Primary 3. Upto Middle 4. Upto Secondary 5. Upto College
4. ekrk dh 'kSf{kd ;ksX;rk
Mother’s educational qualification :
1. vf'kf{kr 2. izkbejh rd 3. vkBoha rd 4. nloha rd 5. dkWyst rdA
1. No Education 2. Upto Primary 3. Upto Middle 4. Upto Secondary 5. Upto College
5. vki dgk¡ jgrs gS\a 1. 'kgj 2. xzke
Where do you live? 1. Urban 2. Rural
6. vkids ?kj esa dejksa dh la[;k
Number of rooms in your residence:
1. ,d 2. nks 3. rhu 4. rhu ls vf/kd
1. One 2. Two 3. Three 4. More than three
7. vkids ?kj esa buesa ls dkSu&dkSu lh phtsa gSa\
Which of the following do you have at home?
1. fctyh 2. ia[kk 3. jsfM;ks/Vªkfa tLVj 4. Vhoh 5. dSlsV/lhMh Iys;j
1. Electricity 2. Fan 3. Radio/Transistor 4. TV 5. Cassette/CD Player
6. lkbfdy 7. LdwVj 8. dkj 9. jlksbZ xSl 10. ohlhvkj@ohlhih 11. tujsVj@buojVj
6. Cycle 7. Scooter 8. Car 9. Cooking Gas 10. VCR/VCP 11. Generator/ Invertor
12. eYVhehfM;k daI;wVj 13. VsyhQksu 14. daI;wVj 15. dscy
12. Multimedia Computer 13. Telephone 14. Computer 15. Cable Connection
8. vki dke djrs gSa ;k csjkstxkj gSa\ 1. dke djrs gSa 2. viuk jkstxkj 3. csjkstxkj gSa
Are you employed or unemployed? 1. Employed 2. Self-employed 3. Unemployed
9. ?kks"k.kk Declaration
eSa izekf.kr djrk gw¡ fd@Certified that:-
d½ esjs ikl ikB~;Øe ds fy, vko';d U;wure 'kSf{kd ;ksX;rk gS@eSaus ,uvkbZvks,l ds vkBoha d{kk ikl rd dh ;ksX;rk okys ikB~;Øe ds fy, v/;;u
djds i;kZIr ;ksX;rk izkIr dj yh gSA a) I possess the minimum educational qualification for the course / I have studied enough to pursue NIOS
Vocational Education Courses where entry level qualification is upto class VIII pass.
[k½ eSaus foojf.kdk esa nh xbZ ;ksX;rk 'krs± i<+dj le> yh gSaA eSa blds ;ksX; gw¡A
b) I have read and understood the eligibility conditions as laid down
in the Prospectus. I fulfil these criteria.
x½ eSaus lkjh t:jh lwpuk,a vkSj nLrkost lgh&lgh ns fn, gSaA eSa tkurk gw¡ fd ;fn ;s lwpuk,a xyr ;k Hkze esa Mkyus okyh gksaxh] rks ,uvkbZvks,l }kjk
esjh mEehnokjh lekIr dj nh tk,xhA c) I have furnished the necessary information/documents correctly. I understand that my candidature
is liable to be cancelled by NIOS if this information is found incorrect or misleading.
?k½ eSa ,uvkbZvks,l ds lHkh fu;eksa dk ikyu d:¡xk vkSj , oh vkbZ @,l,vkbZbZMh ds vuq'kklu vkSj e;kZnk dks cuk, j[kw¡xk@j[kw¡xhA d) I shall abide by
all the rules and regulations of NIOS and shall maintain discipline and decorum at the AVI/SAIED.
³½ eSaus fdlh ,ohvkbZ@,l,vkbZbZMh esa fdlh vU; ,uvkbZvks,l O;kolkf;d ikB~;Øe esa nkf[kyk ugha fy;k gSA e) I have not taken
admission in any other NIOS Vocational Education Course at any AVI/SAIED.
___________________________________ ___________________
18. ekrk firk@vfHkHkkod ds izfrgLrk{kj ¼frfFk lfgr½ f'k{kkFkhZ ds gLrk{kj
Countersignatures of Parent/Guardian Date............. Signature of Candidate Date ................
irk@ Address __________________________________________________
___________________________________________________ fiu PIN _____________

layXudksa dh tk¡p lwph lgh ckDl esa (ü ü) fpg~u yxk,¡A CHECKLIST OF ENCLOSURES Please tick (ü ü)

izo's k QkWeZ dh nwljh izfr Duplicate copy of the admission form 'kSf{kd ;ksX;rk lac/a kh izek.k i= Certificate of Educational qualification vPNh rjg
ls fpidkbZ xbZ QksVks Photograph duly pasted vuqHko izek.ki= ¼;fn ykxw gks½ Experience Certificate, if applicable tUefrfFk izek.ki= Certificate of
Date of Birth
_________________________________________
frfFk Dated : .................... Full Signature with seal of Co-ordinator of the AVI/SAIED
, oh vkbZ@,l,vkbZbZMh ds leUo;d ds iw.kZ gLrk{kj eqgj lfgr
 Appendix - C
jk"Vªh; eqDr fo|ky;h f'k{kk laLFkku
National Institute of Open Schooling
uks,Mk@NOIDA
,uvkbZvks,l dh O;kolkf;d ijh{kk esa cSBus ds fy, vkosnu i=k
(foojf.kdk ds rkfydk 1 i`"B 12 esa fu/kZfjr 'kqYd ds lkFk vè;;u dsaæ ij tek djsaA)
Form for appearing in Vocational Examination of NIOS
(to be submitted in the Study Centre alongwith the requisite fees as mentioned in Table 1 of page 13 of Prospectus)
dsoy udn vkSj jk"VªhÑr cSda ksa ds cSd
a MªkWÝV gh Lohdkj fd, tkrs gSAa Ñi;k os fo"k; Hkjsa ftudh ijh{kk esa vki cSBuk pkgrs gSaA
pSd@/kukns'k Lohdkj ugha fd, tk,¡xsA Please fill correctly the subjects in which you desire to appear in the
Only Cash/Bank Drafts from Nationalised Banks are acceptable. Examination.
Cheques/Indian postal Orders are not acceptable. dksM ua/Code No. fo"k;/Subject
1. .......................................
1. ukekadu la[;k@Enrolment No. 2. .......................................
3. .......................................
4. .......................................
5. .......................................
6. .......................................
2. iwjk uke (Li"V v{kjksa esa) @Full Name in (Block Letters)

3. irk /Address .................................... ijh{kk 'kqYd 370@& izfr fo"k;

................................................. Exam. fee Rs. 370/- per subject.
.................................................
fiu dksM/PIN CODE
f'k{kkFkhZ ds gLrk{kj / Signature of the Candidate
+ ,sls f'k{kkFkhZ ftuds ,ohvkbZ jn~n dj fn, x, ;k dk;Z ugha dj jgs gSa] os vius {ks=kh; dsaæ ij ijh{kk iQkWeZ ^lfpo* ,uvkbZvks,l* ds i{k esa rFkk lacaf/kr {ks=kh; dsaæ ij ns; Mªk¶V
ds lkFk ijh{kk iQkWeZ tek dj ldrs gSaA
+ Candidate whose AVIs stand cancelled or not functioning can deposit his/her examination fees at the respective Regional Centre (RC) by
submitting examination form alongwith Bank Draft drawn in favour of "Secretary", National Institute of Open Schooling, payable at the
respective Regional Centres.
* f'k{kkFkhZ vius ijh{kk dsaæ ds ckjs esa tkudkjh çkIr djus ds fy, vius ,ohvkbZ@,l,vkbZbZMh@{ks=kh; dsæ ls laidZ djsaA ;fn dksbZ f'k{kkFkhZ fu/kkZfjr ijh{kk dsaæ ds vfrfjDr fdlh
nwljs ijh{kk dsaæ ls ijh{kk esa cSBrk gS rks mldk ijh{kkiQy ?kksf"kr ugha fd;k tk,xkA
* Application form will not be accepted after the prescribed date.
Student may contact his/her AVI/RC or NIOS for information regarding his/her examination centre. If a candidate appears from an exam. centre
other than the one allotted to him on his own, his result will be withheld.
fVIi.kh@NOTE. i) viw.kZ@xyr lwpuk okys ijh{kk iQkeZ dks vLohdkj dj fn;k tk,xkA Examination form with incomplete/wrong information shall be rejected.
ii) tks ykxw u gks mls dkV nsAa Strike off whichever is not applicable.
iii) fo"k; dksM (dksMks)a ds fy, foojf.kdk dk v/;k; 5 rkfydk&2 ns[ksAa Please see table 2 of Chapter 5 of the Prospectus for the Subject Code(s).
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------
jlhn (f'k{kkFkhZ dks nh tk,)@RECEIPT (TO BE ISSUED TO THE STUDENT)
fuEufyf[kr fo"k; dksMksa ds fy, jk"Vªh; eqDr fo|ky;h f'k{kk laLFkku dh O;kolkf;d ijh{kk ds fy, -------------------------------------------------------------------------
------------------ls ukekadu la- -------------------------------- ijh{kk iQkeZ ds lkFk --------------------------------------- #- 'kqYd çkIr fd;kA
Received examination form alongwith fee of Rs. ................................ from ............................... Enrolment No. .......................................
for the ..................... Vocational Examination of National Institute of Open Schooling in the following subject Codes :

fnukad@Date:............ gLrk{kj@Signature
leUo;d@Coordinator
,ohvkbZ la-@AVI No.
 Appendix - D
jk"Vªh; eqDr fo|ky;h f'k{kk laLFkku
National Institute of Open Schooling
,&24/25] baLVhV~;w'kuy ,fj;k] lsDVj&62] uks,Mk&201309@A-24/25, Institutional Area, Sector-62, NOIDA-201309
vadrkfydk vkSj ewy izek.ki=k dh nwljh izfr izkIr djus gsrq vkosnu QkWeZA
Application Form for Obtaining Duplicate Certificate/Marks Statements etc.

1- vuqØekad@Enrolment No. ................................................................................................................

2- f'k{kkFkhZ dk uke (lkQ v{kjksa esa)
Name of the student (in CAPITAL letters) ................................................................................................................
3- firk@ekrk dk uke
Father's/Mother's Name ................................................................................................................
4- ml izek.ki=k dk uke tks pkfg,
Name of Certificate Required ................................................................................................................
5- ijh{kk dk uke vkSj o"kZ
Name and Year of Exam ................................................................................................................
6- ijh{kk ifj.kke/Result ................................................................................................................
7- 'kqYd dk Lo:i % udn@cSad MªkÝV ................................................................................................................
cSd
a MªkÝW V la[;k ------------------------------------ jkf'k ---------------------------------------------- fnukad --------------------------cSd
a dk uke ----------------------------
Mode of Payment : Cash/Bank Draft
B.D. No. ------------------------------------ Amount --------------------------------------------- Date --------------------------Bank -------------------------------------------------
(funsZ'k% cSad Mªk¶V lfpo] jk"Vªh; eqDr fo|ky;h f'k{kk laLFkku] uks,Mk ds i{k esa rFkk uks,Mk esa ns; gksuk pkfg,A)
(N.B.: Bank Draft Must be drawn in favour of Secretary, NIOS, NOIDA, payable at NOIDA.)
8- irk@Address (in CAPITAL letters) ..............................................................................................................................................
................................................................................................................ fiu dksM (PIN Code) ....................................................
LFkku@Place :
fnukad@Date: ....................................................................... ..................................................................
f'k{kkFkhZ ds gLrk{kj@Signature of the Student
dsoy dk;kZy; iz;ksx ds fy,
FOR OFFICE USE ONLY

vuqØekad@Enrolment No ..........................................................................................................................................................................
f'k{kkFkhZ dk uke@Name of the Student ......................................................................................................................................................
izkIrkad fooj.k@Marks Obtained ...............................................................................................................................................................
fo"k; dksM fl)kar iz;ksx vkarfjd ;ksx
Subject Code TH PR INT Total
1. ......................................................................................................................................................................................................
2. ......................................................................................................................................................................................................
3. ......................................................................................................................................................................................................
4. ......................................................................................................................................................................................................
5. ......................................................................................................................................................................................................
6. ......................................................................................................................................................................................................
ifj.kke@RESULT : ....................................................................................................................................................................................

dk;kZy; lgk;d ds gLrk{kj@Signature of D.A.

 vko';d funsZ'k/Important Notes
vkosnu QkWeZ dks Hkjus ls igys funsZ'kksa dks lko/kuh ls i<+sa% / Read the Instructions carefully before filling the form
1- çR;sd çek.ki=k ds fy, vyx&vyx iQkWeZ dk ç;ksx djsaA Use seperate form for each certificate.
2- çek.ki=k dh nwljh izfr ds fy, vkosnu uhps fn, x, funsZ'kkuqlkj çFke Js.kh eftLVsªV }kjk lR;kfir 'kiFk i=k ds lkFk çLrqr djsaA The
application for duplicate passing certificate must be accompanied with an affidavit executed in front of a Ist class Magistrate
in the format given below.
3- ewy çek.ki=k dh r`rh; çfrfyfi rc rd tkjh ugha dh tk,xh] tc rd funs'kd (ewY;kadu) çek.k i=k dh f}rh; çfrfyfi ds okLro esa [kksus@u"V
gksus dh iqf"V ls iw.kZr% larq"V u gksaA Triplicate copy of the passing certificate shall not be issued unless the Director (Eva.) is
satisfied that duplicate copy has been actually lost/destroyed.
4- lk/kj.kr% iw.kZ vkSj Bhd rjg ls Hkjs x, vkosnu i=k ds vk/kj ij ek¡xs x, çek.ki=k nks gÝrksa (vodk'kksa dks NksM+dj)ds ckn tkjh fd, tk,¡xsA
The documents applied for will ordinarily be issued after two weeks (excluding holidays) from the date of receipt of the
application form and fee, provided the application is found complete in all respects.
5- ;fn vkosnd 'kqYd tek djus ds ckn rhu eghus ds Hkhrj Hkh çek.ki=k çkIr ugha djrk gS] rks mUgsa fn, x, irs ij lk/kkj.k Mkd ls Hkst fn;k
tk,xkA vkosnu i=k esa irk u fy[kus dh fLFkfr esa çek.ki=k fujLr dj fn;k tk,xk vkSj f'k{kkFkhZ dks mlds fy, iqu% vkosnu djuk gksxkA In
case the documents is not collected by the applicant within three months from the date of depositing the fee it will be sent by-
ordinary post at the address given. In case the address is not given the documents will be cancelled and the student will have
to apply afresh.
lHkh çek.ki=k fdlh Hkh dk;Z&fnol esa vijkg~u 3 cts ls 5 cts rd 'kqYd dh jlhn ,oa vuqØekad dks fn[kkus ds ckn tkjh fd, tk,¡xsA 'kqYd
lHkh dk;Z&fnolksa esa çkr% 10 cts ls vijkg~u 4 cts rd tek fd;k tk ldrk gSA All Certificates will be delivered on the production
of receipt of payment with Enrolment No. between 3.00 P.M. to 5.00 P.M. on working days. The fee can be deposited between
10.00 A.M. to 4.00 P.M. on all working days.
çek.ki=kksa ds fy, fu/kZfjr 'kqYd fuEu çdkj gSa% / Fees prescribed for various certificates are as follows :
1- çek.ki=k dh nwljh çfr/Duplicate copy of Certificate : Rs. 200.00
2- vadrkfydk dh nwljh çfr/Duplicate copy of the Statement of Marks : Rs. 200.00
3- Mkd 'kqYd (;fn çek.ki=k iathÑr Mkd }kjk pkfg,)/Postal Charges (if the documents is required by Regd. post) : Rs. 40.00
fVIi.kh % vadrkfydk dh nwljh çfr rqjUr çkIr djus dk fu/kZfjr 'kqYd 400 #- gS rFkk ;s nLrkost+ vkosnu çkIr dh frfFk ls 48 ?kaVs ds vanj
miyCèk djk fn;k tkrs gSaA
Note : Prescribed fee for the issue of urgent Duplicate Marksheet is Rs. 400/- and these documents will be issued within
48 hours from the date of receipt of application.
'kiFk i=k 2-00 #i, ds LVkEi isij ij çFke Js.kh eftLVªsV }kjk lR;kfir gksuk pkfg,A (dsoy mu f'k{kkfFkZ;ksa ds fy, ftUgsa ewy çek.ki=k dh nwljh
çfr ds fy, vkosnu djuk gS) vksFk dfe'uj@uksVjh }kjk gLrk{kfjr@lR;kfir 'kiFk&i=k Lohdkj ugha fd;k tk,xkA Form of Affidavit to be executed
on Non-judicial Stamp Paper of Rs. 2.00 (For Candidate applying for duplicate copy of qualifying certificate) The affidavit attested
by oath Commissioner/Notary is not acceptable.
eSa ------------------------------------------------------ iq=k@iq=kh ------------------------------------------------------ 'kiFkiwoZd ?kks"k.kk djrk gwa fd esjk jk"Vªh; eqDr fo|ky;h f'k{kk
laLFkku (blls iwoZ jk"Vªh; eqDr fo|ky;) fnYyh dh ijh{kk ------------------------------------ ebZ@uoEcj ------------------------------------ dk ewy çek.k&i=k u"V gks
x;k@[kks x;k gSA mi;qZDr fn, x, lHkh rF; esjh tkudkjh esa iw.kZr% lgh gSaA
I .......................................... Son/Daughter of .......................................... declare on oath that my certificate of having passed the
................................................... Exam. of May/Nov. ...................................... from National Institute of Open Schooling, (Formerly
National Open School) Delhi, has been lost/destroyed certified that the fact stated above is true to the best of my knowledge and
belief.

vuqØekad/Roll No. ................................................. f'k{kkFkhZ ds gLrk{kj/Signature of the Student. .............................................

fnukad/Date ............................................................ irk/Address. ..................................................................................................

LFkku/Place ............................................................. ......................................................................................................................

U;k;ky; dh eksgj % çFke Js.kh eftLVªsV/Court Seal : Sworn before me Ist Class Magistrate.