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TH ALL INDIA

MATHS SCIENCE TALENT EXAMINATION 2015 -16

REGISTRATION FORM

Name of the School: ______

Sr. No. / Name of the Student / Class in which studying / Booklet Required
(Yes/No)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

·  Use separate photocopy sheet for more no. of students.

·  The Regn. Form may even be mailed at

Name of the School : ______

Address : ______

______State:______Pin: ______

Phone No: STD Code: ______No.: ______

E-mail ID : ______@______

School Principal

(a) Name : Mr./Mrs.______

(b) Phone No. : ______Mobile: ______

(Please provide mobile no. for better coordination)

Coordinating Teacher

(a) Name : Mr./Mrs.______

(b) Phone No. : ______Mobile: ______

(c) E-mail ID : ______@______

(Please provide mobile no. for better coordination)

FEES DETAILS:

Schools may keep Rs.20 per student (out of examination fee of Rs.100/-) and Rs.5/- per booklet (out of Rs.60/- collected towards cost of booklet).

1.  Total No. of Students : ______

2.  Total Fees remitted @ Rs.80/- per student : ______

3.  Total no. of Booklets required :______

4.  Total cost of Booklets @ Rs.55/- :______

5.  Total amount to be paid (2+4) :______

Details:

Class / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / Total
No. of Students
No. of Booklets required

Total amount remitted via Demand Draft No. ______dated ______drawn on ______Bank, ______(Branch) favouring Centre for Excellence payable at Delhi / remitted via depositing in IDBI Bank in Current Account No. 0268102000006026 with account name: Centre for Excellence, IDBI Bank, Branch: Vivek Vihar, Delhi – 110095, MICR Code:110259033, IFSC Code: IBKL0000268 (DD/Original counterfoil of pay-in-slip enclosed)

______

Principal/ School in-charge School seal Signature with date

Terms & Conditions:

-  In case of any dispute, all matters are subjected to the exclusive jurisdiction of the courts in Delhi only.

-  If the exam is not conducted for incidents that are beyond our control, like natural calamities/extreme weather conditions or any other unforeseen circumstances, the liability of the Centre is limited to the extent of the exam fee paid.

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AIMS TALENT EXAM 2015-16