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STATE COMPETITIVE SCHORLARSHIP EXAMINATION
FOR CLASS V
(Conducted by the Department of Education (S), Government of Manipur)
APPLICATION FORM
District Code
Year
Passport size
Photograph duly
Attested by the
Head of the
School to be
affixed
Serial number (to be filled by the ZEO Office)
(Refer to Instruction overleaf)
1. Name of the candidate( do not write Miss/Master)
2. Father’s Name ( do not write Mr./Dr./Prof.)
3. Date of birth
Date
6.
4. Sex
Month
Year
Caste Category of the Candidate
8.
Male Female
General
7. Person with Disability (PWD) Category
5. Area in which the candidate resides
VI
Rural
SC
Urban
ST
HI
OBC
SI
Postal Address for correspondence (do not write father’s name)
Pin Code
9. Name and address of the institution in which the applicant studied at Class V level
Pin Code
10.
11.
12.
13.
Type of the institution in which the applicant studied at Class V level
Govt.
Local Body
Private Aided
Private Unaided
Area in which the School is located
Rural
Urban
Medium of Examination
ENGLISH / MANIPURI
Telephone
STD Code
Phone/Mobile
LMI
To be filled in by the Head of the Institution
1. Certified that
Shri/ Kumari…………………………………………………..is a regular student of this school and he/
she has secured at least 60% (General) / 50% (ST/SC) marks in the Class V Annual Examination
i.e. when he/she was promoted from Class V to Class VI.
2. The particulars given by him/her in the Application form have been verified and are found in order.
3. Shri/ Kumari………………………………………………………………….. belongs to Schedule Caste/
Schedule Tribe/Other Backward Classes category as per the records maintained in the institution
( to be filled for SC/ST /OBC candidates only)
Date……………………..
………………………………
(Signature of the candidate)
………………………………………………
Signature of the Headmaster/Headmistress
With seal (See instruction)
…………………………………………………………
(Counter Signature of Zonal Education Officer
With seal
Instruction
Read instruction carefully before filling up the Application Form
1. Use only Blue or Black ball pen. WRITE IN CAPITAL LETTERS. Do not mark or write outside the
boxes.
2. Leave one box blank between two words. Limit your name and address within the space provided for it.
Please see Example as given below.
3. Tick (√) only one of the appropriate boxes in respect of item nos. 4, 5, 6, 7, 10 and 11.
4. It is the responsibility of the candidate and the Principal/Headmaster of the school to submit the filled in
form to the District concerned officer before the last date. No request for condoning delay in submission
will be entertained under any circumstances.
5. Incomplete or defective applications are liable to be rejected.
EXAMPLE FOR WRITING NAME AND ADDRESS:
Father’s Name
L A I S H R A M
B I J O Y
S I N G H
POSTAL ADRESS
Do not try to write complete address in one line. Break it appropriately as shown below.
S A G O L B A N D
K H U L E M
L E I K A I
I M P H A L
Pin 7 9 5 0 0 1
District Code:
(Zone-I) Imphal West – 01, (Zone-II) Imphal East – 02, (Zone-III) Thoubal – 03, (Zone-IV) Bishnupur – 04,
Jiribam (Imphal East) – 05, Ukhrul – 06, Senapati – 07, Kangpokpi (Senapati) – 08, Tamenglong – 09,
Churachandpur – 10, Chandel – 11, Kakching (Thoubal) – 12, Wangoi (Imphal West) – 13, Moirang
(Bishnupur) – 14.
* Local Body means Schools run by Small Town Committee, Municipal Council and District Council.
* VI – Visual Impairment, HI – Hearing Impairment, SI – Speech Impairment and LMI - Loco Motor
Impairment.
STATE COMPETITIVE SCHORLARSHIP EXAMINATION
FOR CLASS V
(Conducted by the Department of Education (S), Government of Manipur)
ADMISSION CARD
Roll Numbers:
District Code
Year
Serial number (to be filled by the ZEO Office)
Passport size
Photograph duly
Attested by the
Head of the
School to be
affixed
Shri/Kumari……………………………………………………………………..…………………………………………..
S/o, D/o, Shri………………………………………………………………………………….reading in class……….
in the ……………………………………………………………………………………..…………… is allow to appear
State Competitive Scholarship Examination for class VIII to held on ……………………………………………. at
………………………………………………………………………………………………… as per programme given
Below:
Class
Date
Time
Subject
Mark
10.00 to 11.00
MAT
50
VIII
12.00 to 13.30
SAT
75
According to his application form, his date of birth is ………………………………………………………………….
District Liaison Officer
With Office Seal
Scrutinized by:-
INSTRUCTION TO THE CANDIDATES
1. Keep your Admission-cum-Receipt Card very carefully and bring it with you in the examination Hall.
2. Report at your examination centre on the date of examination 15 minutes before the commencement of
the examination.
3. Please bring your own pen, pencil, ink etc. on the day of examination.
4. Marking to be done with blue or black ink, no pencil marking is allowed.
5. Write your District Code No., Roll No. (as given in your Admission cum Receipt Card ) on the Answer
Sheet in international Numerals only in the space provided for the purpose.
6. Handover the answer sheet to the invigilator before you leave the examination hall.
7. The District Code No., Roll No. should be indicated while making any reference to the Education
Department(S) in connection with the Result etc.
8. Candidate will have to bear the expenses for appearing at this Examination.
9. The ineligible candidate shall be cancelled at any stage.

STATE COMPETITIVE SCHORLARSHIP EXAMINATION
FOR CLASS VIII
(Conducted by the Department of Education (S), Government of Manipur)
APPLICATION FORM
District Code
Year
Passport size
Photograph duly
Attested by the
Head of the
School to be
affixed
Serial number (to be filled by the ZEO Office)
(Refer to Instruction overleaf)
1. Name of the candidate( do not write Miss/Master)
2. Father’s Name ( do not write Mr./Dr./Prof.)
3. Date of birth
Date
6.
4. Sex
Month
Year
Caste Category of the Candidate
8.
Male Female
General
7. Person with Disability (PWD) Category
5. Area in which the candidate resides
VI
Rural
SC
Urban
ST
HI
OBC
SI
Postal Address for correspondence (do not write father’s name)
Pin Code
9. Name and address of the institution in which the applicant studied at Class VIII level
Pin Code
10.
11.
12.
13.
Type of the institution in which the applicant studied at Class VIII level
Govt.
Local Body
Private Aided
Private Unaided
Area in which the School is located
Rural
Urban
Medium of Examination
ENGLISH / MANIPURI
Telephone
STD Code
Phone/Mobile
LMI
To be filled in by the Head of the Institution
1. Certified that
Shri/ Kumari…………………………………………………..is a regular student of this school and he/
she has secured at least 60% (General) / 50% (ST/SC) marks in the Class VIII Annual Examination
i.e. when he/she was promoted from Class VIII to Class IX.
2. The particulars given by him/her in the Application form have been verified and are found in order.
3. Shri/ Kumari………………………………………………………………….. belongs to Schedule Caste/
Schedule Tribe/Other Backward Classes category as per the records maintained in the institution
( to be filled for SC/ST /OBC candidates only)
Date……………………..
………………………………
(Signature of the candidate)
………………………………………………
Signature of the Headmaster/Headmistress
With seal (See instruction)
…………………………………………………………
(Counter Signature of Zonal Education Officer
With seal
Instruction
Read instruction carefully before filling up the Application Form
1. Use only Blue or Black ball pen. WRITE IN CAPITAL LETTERS. Do not mark or write outside the
boxes.
2. Leave one box blank between two words. Limit your name and address within the space provided for it.
Please see Example as given below.
3. Tick (√) only one of the appropriate boxes in respect of item nos. 4, 5, 6, 7, 10 and 11.
4. It is the responsibility of the candidate and the Principal/Headmaster of the school to submit the filled in
form to the District concerned officer before the last date. No request for condoning delay in submission
will be entertained under any circumstances.
5. Incomplete or defective applications are liable to be rejected.
EXAMPLE FOR WRITING NAME AND ADDRESS:
Father’s Name
L A I S H R A M
B I J O Y
S I N G H
POSTAL ADRESS
Do not try to write complete address in one line. Break it appropriately as shown below.
S A G O L B A N D
K H U L E M
L E I K A I
I M P H A L
Pin 7 9 5 0 0 1
District Code:
(Zone-I) Imphal West – 01, (Zone-II) Imphal East – 02, (Zone-III) Thoubal – 03, (Zone-IV) Bishnupur – 04,
Jiribam (Imphal East) – 05, Ukhrul – 06, Senapati – 07, Kangpokpi (Senapati) – 08, Tamenglong – 09,
Churachandpur – 10, Chandel – 11, Kakching (Thoubal) – 12, Wangoi (Imphal West) – 13, Moirang
(Bishnupur) – 14.
* Local Body means Schools run by Small Town Committee, Municipal Council and District Council.
* VI – Visual Impairment, HI – Hearing Impairment, SI – Speech Impairment and LMI - Loco Motor
Impairment.
STATE COMPETITIVE SCHORLARSHIP EXAMINATION
FOR CLASS VIII
(Conducted by the Department of Education (S), Government of Manipur)
ADMISSION CARD
Roll Numbers:
District Code
Year
Serial number (to be filled by the ZEO Office)
Passport size
Photograph duly
Attested by the
Head of the
School to be
affixed
Shri/Kumari……………………………………………………………………..…………………………………………..
S/o, D/o, Shri………………………………………………………………………………….reading in class……….
in the ……………………………………………………………………………………..…………… is allow to appear
State Competitive Scholarship Examination for class VIII to held on ……………………………………………. at
………………………………………………………………………………………………… as per programme given
Below:
Class
Date
Time
Subject
Mark
10.00 to 11.10
MAT
50
VIII
12.00 to 13.50
SAT
100
According to his application form, his date of birth is ………………………………………………………………….
District Liaison Officer
With Office Seal
Scrutinized by :-
INSTRUCTION TO THE CANDIDATES
1.
2.
3.
4.
5.
6.
7.
8.
9.
Keep your Admission-cum-Receipt Card very carefully and bring it with you in the examination Hall.
Report at your examination centre on the date of examination 15 minutes before the
commencement of the examination.
Please bring your own pen, pencil, ink etc. on the day of examination.
Marking to be done with blue or black ink, no pencil marking is allowed.
Write your District Code No., Roll No. (as given in your Admission cum Receipt Card ) on the
Answer Sheet in international Numerals only in the space provided for the purpose.
Handover the answer sheet to the invigilator before you leave the examination hall.
The District Code No., Roll No. should be indicated while making any reference to the Education
Department(S) in connection with the Result etc.
Candidate will have to bear the expenses for appearing at this Examination.
The ineligible candidate shall be cancelled at any stage.
