Application Form

vkosnu&i=
National Means Cum Merit Examination 2021-22, State Madhya Pradesh
jk"Vªh; ehUl&de&esfjV Nk=o`fRr ijh{kk 2021&22] jkT;&e/;izns'k
(Only for the students who are studying in class 8th in schools conducted by govt./govt.
aided, local bodies)
¼dsoy e-iz- esa fLFkr 'kkldh;@'kkldh; vuqnku izkIr@LFkkuh; fudk;ksa }kjk lapkfyr
fo|ky;ksa esa o"kZ 2021&22 esa d{kk 8oha esa v/;;ujr fo|kfFkZ;ksa ds fy,½

¼uksV& vafre i`"B ij vafdr funs'Z kksa dk ikyu djrs gq, lko/kkuhiwod
Z vkosnu&i= HkjsAa ½
vkosnd ;gk¡ viuk
vuqØekad 12 fMftV esa ¼dsoy vkfQl dk;Z gsrq½ uohure ikliksVZ
ijh{kk dk dksM jkT; dk dksM o"kZ dsUnz dk dksM ljy Øekad lkbZt dk QksVks
fpidk;sa ,oa vius
3 3 8 2 2
fo|ky; ds
iz/kkuk/;kid }kjk
tUe frfFk lR;kfir djk,A

fnukad ekg o"kZ

 fo|ky; ¼tgk¡ ijh{kkFkhZ v/;;jr gS½ dk Mkbl dksM&*

 ijh{kkFkhZ dk lexz vkbZ-Mh-uacj& ¼vfuok;Z½*

 ijh{kkFkhZ dk vk/kkj uacj*

(Stericcolumns are mandatory)

1- vkosnd dk uke ¼fgUnh es½a -------------------------------------------------------------------------------------------------------------------------------------------------
vaxszth dsdsfiVy v{kjksa es¼a uke o miuke ds chp ,d Cykd fjDr NksM½+s

2- firk dk uke ¼fgUnh es½a ---------------------------------------------------------------------------------------------------------------------------------------------------------------

vaxszth dsdsfiVy v{kjksa es¼a uke o miuke ds chp ,d Cykd fjDr NksM½+s

3- ekrk dk uke ¼fgUnh ea½s -----------------------------------------------------------------------------------------------------------------------------------------------------------------

vaxszth dsdsfiVy v{kjksa es¼a uke o miuke ds chp ,d Cykd fjDRk NksM½sa

4- fyax 5- {ks= tgkW vkosnd jgrk gS 6- vkosnd dh tkfr¼uksV&vU; fiNM+k oxZ ds fo|kFkhZ lkekU; oxZ esa ekU; gksxa s½

1 2 1 2 1 2 3
efgyk iq:"k xzkeh.k 'kgjh lkekU; ¼GEN½ v-tk- ¼SC½ v-t-tk ¼ST½
Øekad 6 dh tkudkjh ds fy;s ¼vkosnd Loa; ds uke dk lacaf/kr tkfr izek.k i= yxk;s½
 1 2
7- D;k fu%'kDrtu [Link] esa vkj{k.k gsrq fo|kFkhZ 40% ;k blls vf/kd fodykax gS
gk¡ ugha
8- ;fn gk¡] rks fu%'kDr fo|kFkhZ dh fodykaxrk dk izdkj
1 2 3 4 5 6
¼izek.k i= yxk;s½
vfLFk ckf/kr Jo.k ckf/kr n`f"V ckf/kr ekufld cgq dksbZ ugha
fodykaxrk fodykaxrk

9- fo|ky; dk uke ,oa irk tgkW vkosnd d{kk vkBoha esa i<+ jgk gS ¼fgUnh es½a ----------------------------------------------------------------------------------------

------------------------------------------------------------------------------------------------------------------------------ladqy dsUnz -------------------------------------------------------------------------------------

Cykd------------------------------------------------------------------------ftyk-------------------------------------------------------------------------------------fiu ---------------------------------------------------

vaxzsth esa ¼dsihVy v{kj es½a

ladqy dsUnz
fodkl[k.M
ftyk

fiu&

10- fo|ky; dk izdkj tgkW vkosnd d{kk vkBoha esa i<+ jgk gS11- {ks= tgkW Ldwy fLFkr gS
1 2 3 1 2

'kkldh; LFkkuh; fudk; 'kkldh; vuqnku izkIr xzkeh.k 'kgjh

12-ijh{kk dk ek/;e
1 2
fgUnh vaxzsth

13- firk dh f'k{kk 14- firk dk O;olk;

15- ekrk dh f'k{kk 16- ekrk dk O;olk;

17- ekrk firk ;k ikyd dk eksckbZy ua-

18-ekrk&firk dh ldy okf"kZd vk; ¼vadksa es½a :i;s ------------------------------ 'kCnksa esa ------------------------------------------------------------------------------------------

19-ekrk&firk dh ldy okf"kZd vk; dk oxhZdj.k 1 2 3

2
:- 50000 rd ¼:i;s 50001 ls 100000 rd½ ¼:i;s 100000 ls 150000 rd½
20- fo|ky;@ladqy dsUnz dk VsyhQksu u- &
21-bZ&esy
,l-Vh-Mh-dksM Qksu uacj
22- Nk= dk [kkrk Ø- *cSad dk uke*

'kk[kk dk uke * vkbZ,Q,llh dksM*

(Steric colomns are mandatory)

ladqy izkpk;Z ,oa iz/kkuk/;kid dk [Link].k

 [Link] fd;k tkrk gS fd Jh@dq -------------------------------------------------------------------------------------'kkldh;@'kkldh; vuqnku

izkIr@LFkkuh; fudk; }kjk lapkfyr fo|ky; dk@dh fu;fer Nk=@Nk=k gSA
 fo|kFkhZ us xsM
z izkIr dj lkroha d{kk [Link] dh gS ¼dsoy A,B,C xzsM izkIr½
 fo|kFkhZ ds ekrk&firk dh ldy okf"kZd vk; :i;s 1-50 yk[k ¼v{kjksa esa ,d yk[k ipkl gtkj ek=½ ls vf/kd ugha
gSA
 izek.k i= ds vuqlkj Jh @dq---------------------------------------------------------------dh tkfr vuqlfw pr tkfr@vuqlfw pr tutkfrgSsA
¼dsoy e/;izn's k ds ewy fuoklh vuqlfw pr tkfr@vuqlfw pr tutkfrds vH;fFkZ;ksa }kjk Hkjk tk,½
 l{ke vf/kdkjh }kjk tkjh fu%'kDRkrk izek.k i= ds vuqlkj Jh@dq- --------------------------------------------------------------------------fu%'kDr
[Link] ds ¼fodykax½ gSA budh fodykaxrk dk izfr'kr 40 izfr'kr ;k blls vf/kd gSA
 iz/kkuk/;kid dk eksckbZy ua-

 ladqy izkpk;Z dk eksckbZy ua-

 mDrkuqlkj vkosnu i= esa Hkjh xbZ lHkh tkudkjh dk feyku dk;kZy;hu fjdkWMZ ls dj fy;k x;k gSA
fnukad--------------------------------
vkosnd ds gLrk{kj
vkosnd dk uke ------------------------ izkpk;Z@iz/kkuk/;kid ds gLrk{kj
uke -----------------------------------
in eqnkz lfgr
ladqy izkpk;Z ds gLrk{kj
uke --------------------------------
in eqnkz lfgr
 vkosnu i= Hkjus ds funsZ'k
NMMSS p;u ijh{kk dk vkosnu i= Hkjus ls igys uhps fn, x, funsZ'kksa dks lko/kkuh iwoZd i<+as &
1- NMMSS ;kstuk ds rgr vkosnu i= Hkjus gsrq ik=rk dh 'krsZ &

 bl Nk=o`fRr gsrq dsoy e-iz- esa fLFkr 'kkldh;@'kkldh;vuqnku izkIr@LFkkuh;

fudk;ksa }kjk lapkfyr fo|ky;ksa esa o"kZ 2021&22 esa d{kk 8 oha esa v/;;ujr fo|kFkhZ
gh ik= gSA
 fo|kFkhZ us d{kk 7oha esa A,B vFkokC xzsM izkIr fd;k gksA
 fo|kFkhZ ds ekrk&firk dh ldy okf"kZd vk; :- 1]50]000@& ;k mlls de gksA
2- dsoy uhys ;k dkys cky isu ls gh vkosnu i= HkjsaA vaxzsth esa dsoy dsfiVy v{kjksa dk gh
iz;ksx djsAa ckDl ls ckgj u fy[ksaA
3- fcUnq dz- 4] 5] 6] 7] 8] 10] 11] 12] 19 esa lgh LFkku ds fy, ckWDl es√
a dk fu'kku yxk,A
4- fcUnq dz- 13] 14] 15] 16 esa dksM dz- uhps nh xbZ rkfydk esa fn, x, fooj.k vuqlkj HkjsAa
dksfMaxIyku
ekrk&firk dh f'k{kk fcUnq dz- 13 ,oa 15
f'k{kk dksM ekrk&firk dk O;olk; fcUnq dz- 14]16
vui<+@iwoZ izkFkfed Lrj rd 1 O;olk; dksM
izkFkfed Lrj rd 2 O;olk;h] rduhdh vkSj blls lacaf/kr 1
mPprj izkFkfed¼fefMy½ rd ds fy, 3 iz'kklfud] izca/kdh; 2
ek/;fed ¼[Link]½ Lrj rd 4 fyfidh; ;k lacfa /kr dk;Z 3
mPprj ek/;kfed¼lhfu;j [Link]½ rd ds 5 lsYl@lfoZl odZj 4
fy, fdlku] eNqvkjk ;k lacaf/kr dk;Z 5
Lukrd ¼xst z q,'ku½ 6 mRiknd vkSj ifjogu o mlls lacaf/kr dk;Z 6
LukrdksRrj ¼iksLV xsztq,'ku½ 7 vkWijsVj vkSj Jfed tks mi;ZqDr [Link] esa 7
MkDVksjVs ¼ih-,p-Mh-½ 8 lEefyr ugha
O;olkf;d ¼bathfu;j] 9 csjkstxkj 8
fpfdRld] ,elh,] ,ech,½
vU; dksbZ 10
5- vkosnu i= esa fu;r LFkku ij fo|kFkhZ dk ikliksVZ lkbt dk uohure QksVks vPNh rjg
fpidk;k tkos rFkk iz/kkuk/;kid }kjk fo|kFkhZ ds QksVks ij uhps dh vksj gLrk{kj ,oa mlds
uhps ineqnk ls bl izdkj lR;kfir fd;k tkos fd QksVks esa fo|kFkhZ dk psgjk Li"V :i ls
fn[kkbZ nsA
6- ladqy izkpk;Z ,oa iz/kkuk/;kid ds [Link].k esa ;fn fo|kFkhZ vuqlwfpr tkfr@vuqlwfpr
tutkfr oxZ dk gS rks lacaf/kr izfof"V djrs gq, tkfr izek.k&i= dh lR;kfir Nk;kizfr
vkosnu i= ds lkFk layXu dh tkosA
7- NMMSS Nk=o`fRr ;kstuk ds fy, vU; fiNM+k oxZ dks Hkkjr ljdkj }kjk vkj{k.k ugha fn;k
tkrk gS] oju mUgsa lkekU; oxZ esa gh ekU; fd;k tkrk gSA vr% vU; fiNM+k oxZ ds ik=
 fo|kFkhZ vkosnu i= ds fcanq dzekad 6 esa lkekU; ds [kkus esa √ dk fu'kku yxk,a rFkk mUgsa
fiNM+k oxZ dk tkfr izek.k i= layXu djus dh vko';drk ugha gSA
8- fu%'kDrtu ¼fodykax½ [Link] ds vkj{k.k dh ik=rk 40% ;k vf/kd fodykaxrk j[kus okys
fo|kFkhZ dks gSA vr% fodykax [Link] ds vkosnd }kjk l{ke vf/kdkjh ds fu%'kDrrk izek.k i=
dh lR;kfir QksVks izfr vkosnu i= ds lkFk layXu dh tkosA
9- vkosnu i= lgh&lgh Hkjk tkos rFkk fo|kFkhZ@vkosnd ds gLrk{kj] iz/kkuk/;kid ds
gLrk{kj ,oa ineqnzk rFkk ladqy izkpk;Z ds gLrk{kj ,oa ineqnzk vafdr dj [Link].k djk;k
tkosA rRi'pkr vius {ks= ds fudVre fd;ksLd dsUnz ij tkdj Hkjs gq, vkosnu i= dh
izfof"V vkWuykbu HkjokbZ tk;sA izR;sd vkosnu i= dh izfof"V mijkar ikorh ¼jlhn½ dh nks
izfr iznku dh tkosxhA bldh ,d izfr fo|kFkhZ ds ikl rFkk nwljh izfr vkosnu i= ds lkFk
layXu dj bls ladqy izkpk;Z ds dk;kZy; esa tekdj ,d o"kZ rd lqjf{kr :i ls j[kk
tkosxkA
10- NMMSS ijh{kk dk [Link] ?kksf"kr gksus ds mijkar vgZ ?kksf"kr fd, x, fo|kFkhZ dk vkosnu
i= tks iwoZ funsZ’k vuqlkj ladqy izkpk;Z dk;kZy; esa lqjf{kr jgsxkA fofgr vk; izek.k i=
tkfr izek.k i= rFkk lacaf/kr Nk= ds fudVre Hkkjrh; LVsV cSad ¼SBI½ ;k jk"Vªh;d`r cSad esa
[kksys x, cPkr [kkrs ,oa cSad 'kk[kk ds vkbZ-,Q-,l-lh- dksM bR;kfn dh lgh tkudkjh ,oa
iklcqd ls lacaf/kr i`"B dh Nk;kizfr lfgr ftyk f'k{kk vf/kdkjh dk;kZy; esa vfuok;Zr% tek
djs]a tgk¡ bls Nk=o`fRr vof/k esa ¼4 o"kZ rd½ lqjf{kr j[kk tkosxkA vko’;drk iM+us ij
ofj"B dk;kZy; dks miyC/k djok;sx
a As
11- e-iz- 'kklu Ldwy f'k{kk foHkkx] ea=ky; ds i= Øekad F@4112 R@08@chl&2@Hkksiky
fnukad 31-12-2008 vuqlkj NMMSS Nk=o`fRr gsrq fo|kFkhZ ds ekrk&firk@vfHkHkkod }kjk
fofgr izk:i esa fn, x, 'kiFk i= dks vk;&izek.k i= ds :i esa ekU; fd;k tk,xkA
¼izk:i layXu½
12- vkosnu i= dh Online izfof"V ds le; izR;sd fo|kFkhZ dk QksVks ,oa gLrk{kj Ldsu fd,
tk,axAs bl gsrq izR;sd fo|kFkhZ dh ikliksVZ lkbt ds ,d vfrfjDr QksVks ds lkFk fd;ksLd
ij mifLFkfr vko';d gksxhA vk/kkj dkMZ ij yxk QksVks Ldsfuax ds fy, ekU; ugha gksxkA