APPLICATION FORM

STATE LEVEL NATIONAL MEANS-CUM-MERIT SCHOLARSHIP EXAMINATION, 2024-2025

(For Student Studying in Class – VIII)
Applicable only for those candidates with parental income not more than 3.5 lakhs per annum.
Read the Instruction carefully given on the next page before filling the application form. You may
take the help from your teacher/parent for filling up the application form.

- Date of Examination : 23rd November, 2024

Space for the
- Name & Address of the Agency : Mizoram Scholarship Board, Photograph
for conducting NMMS Examination Dawrpui Vengthar, Aizawl, Mizoram (Passport Size)
-

- Name of the State/UT :

(where the candidate is studying in the class VIII as a regular student)
-

- Name of the Examination Centre : The Photograph should

(where the candidate is studying in the class or likely to appear in Exam) be endorsed by the
-
Head of the
- Application fee, if any (write NIL if there is no fee) : Institution/Gazetted
-

Officer
AMOUNT DD Number Date of DD Name of Bank Application No. if any

State Level 12 digit Roll Number

Class VIII Code State code Year Centre code Serial No. (Office to fill) Class Date of Birth
1 1 5 2 4 08
0
Date Month Year
1. Name of the candidate (Do not write Miss/Mister)

2. Father’s Name (do not write Mrs/Mr/Dr/Er)

3. Sex 4. Area to which candidate resides 5. Caste category of candidate 6. Disability Status as per PWD act
1 2 1 2 1 2 3 4 5 6 1 2 3 4 5
Male Female Rural Urban General SC ST OBC Oth. 1 Oth. 2 Orthopedic Hearing Blind LowVision None

7. Adhaar No.

8. Postal address for correspondence (Do not write father’s or your name)

Pin Code
9. Name and Address of the Institution in which studying at Class VIII level

Pin Code
10. Type of the Institution in which studying at Class VIII level (See definition overleaf*) 11. Area in which the school is
located
1 Govt 2 Local Body 3 Govt. Aided Rural 1 Urban 2

12. Medium of Examination (a) at the state level (b) at the NCERT Level 13. Father’s Education 14. Father’s Occupation

15. School DISE Code

16. Parental annual income (should not be more than 3.5 lakhs.)
17. Mobile No. STD Code 18. E-mail Address

To be filled in by the Head of the Institution / Gazetted Officer

Certified that:
(1) Master/Miss ……………………………..……………..is regular student of this School and he/she accrued % marks in
the class VII annual examination ie. when he/she was promoted from Class VII to Class VIII. He/She has
occurred……………………..marks out of …………(Candidate must fulfill the announced by State/UT)
(2) The particulars given by him/her in the application from have been verified and found in order.
(3) Master/Miss……………………………………….belongs to Schedule Caste/Schedule Tribe category as per the record
maintained in the institution (to be filled for SC/ST candidates only)
……………………………………………………
………………………………. Signature of Headmaster/Headmistress/Gazetted Officer
Date with Seal
Contact No.:_______________________
(See Instruction overleaf)
 Coding Plan
Read Instruction carefully before filling up the Application Form
1. Use only Blue Ball Point Pen. WRITE IN CAPITAL LETTERS. Do not mark or white outside the boxes.
2. Leave one box blank between two words. Limit your name and/or address within the space provided for it. Please example as given below.
3. Cross (X) only one of the appropriate boxes in items nos. 4,5,6,9 and 20.
4. Please write code number in items nos. 11,12,13,14 and 15 as given overleaf.
5. It is the responsibility of the candidate and the Principal of the school to deposit the filled in form with the state concerned Officer 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.
6. Incomplete or defective applications are liable to be rejected.

Example for writing Name and Address

Region State/UT Code
Father’s Name: G P G U P T A

Arunachal
Postal Address: Do not try to write complete address in one line, break it appropriately as shown below. 11
Pradesh
1 4 5 / 6 M O U N T R O A D
Assam 12
C H E N N A I PIN 6 0 0 0 1 5 North Manipur 13
East Meghalaya 14
Mizoram 15
Medium of Examination Education of Father and Mother Nagaland 16
(Refer to item 11 (Refer to item Nos. 12 & 14) Sikkim 17
Tripura 18
Assamese 11 Upto 1
A and N
Bangla 12 Upper Primary 2 19
Island
English 13 Secondary 3
Gujarat 14 Senior Secondary 4 Bihar 20
East
Hindi 15 Graduation 5 Jharkhand 21
Kannada 16 Post Graduation 6 Orissa 22
Marathi 17 Doctoral 7 West
23
Malayalam 18 Medicine, MCA, MBA etc 8 Bengal
Oriya 19 Any other 9
Chandigarh 24
Punjabi 20
Tamil 21
Delhi 25
Telugu 22
Jammu &
Urdu 23 26
Kashmir
North Haryana 27
Father’s/Mother’s Occupation Himachal
28
(Refer to item Nos. 13 & 15) Pradesh
Punjab 29
Occupation Code
Rajasthan 30
Professional Technical and Related Worked 1
Uttar
Administrative, Executive and Managerial Worker 2 31
Pradesh
Clerical and Related Worker 3
Uttaranchal 32
Sales/Service Worker 4
Farmer, Fisherman and Related Worker 5
Production and Related Worker, Transport 6 Chhattisgarh 33
Operators and Labourer Worker not classified by the above accupation 7
Not employes 8 Daman
34
and Diu
* TYPE OF SCHOOL/INSTITUTION (Refer to item No. 9) D&N
West 35
Haveli
Goa 36
GOVERNMENT A Government School is that which is run by the State Gujarat 37
Government or Central Government or Public Sector Madhya
38
Undertaking or an Autonomous Organisation completely Pradesh
financed by the Government. Maharashtra 39
Andra
40
LOCAL BODY A Local Body School is that which is run by Panchayati Raj Pradesh
and local body institution such as Zila Parishad, Municipal Karnataka 41
Corporation, Municipal Committee, Notified Area South Kerela 42
Committee and Cantonment Board. Lakshadweep 43
Pondicherry 44
PRIVATE UNAIDED A Private Aided School is that which is managed by an Tamil
45
individual or a private organization and does not receive any Nadu
grant either from government or local body. Abroad 46