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Registration Form for Certificate in Computer Application

Please, take note that the online submission of this form is only for cross reference purpose. Also, read the Instructions carefully before filling out the form.

You are supposed to take a print out of the form, fill it as directed and send it along with the required documents to :

National Open School,
Vocational Education Program,
B - 35, Kailash Colony,
New Delhi - 110048.

General Information and Instructions for Filling up the Application Form for Admission

Course Name:Certificate in Computer Applications

Course Code Course Description
711 Module-I Basic Computing Skill
712 Module-II Computer Applications

Duration and entry qualification: The duration of the course is one year and entry qualification is class tenth (Xth) pass from recognised board.

  1. Candidate is advised to ensure his/her eligibility before filling the form. If any eligibility criteria as per Prospectus have not been fulfilled, he/she is advised not to submit from and remit fee otherwise fee if remitted will be forfeited without any intimation to him/her.
  2. Name of the Candidate: Candidate should mention his/her name as already recorded in his/her previous school/college certificate.
  3. Name of Parents: In this column, the candidate should mention his/her Father’s as well as Mother’s name. It should tally with his/her previous records. This will be recorded in the Certificate. No change will be permitted.
  4. Permanent/Postal Address: Candidate are requested to provide complete address with House No., Father’s Name if required, Ward No. Village, Tehsil, District, State and Pin Code. NOS will not be responsible for Non-Delivery of items/letters/materials if any, to the candidate, due to incomplete address.
  5. Date of Birth: Candidates are requested to mention their date of birth correctly. Attested copies of documents in proof of date of birth are compulsorily to be attached with admission form failing which the candidature will be summarily rejected.
  6. Sex: Provide your Sex Code No. In the appropriate box.
  7. Category: This information must be supplied for NOS records.
  8. Nationality: Provide your nationality Code No. in the appropriate box.
  9. Please mark ( ) in the appropriate box for educational qualifications. Attach attested copy of all documents marksheet candidate preference if any of age etc.
  10. Amount of Fee Paid: Please does not leave this column blank. Required details of fee remitted should be filled in both the Forms at appropriate place. Amount of fee to be remitted is given below. You should not pay any extra amount over and above what has been prescribed by NOS.
  11. Please pay fee as per the Fee Structure applicable to the course you are offering.
  12. Signature of the Candidate and Counter Signature of Parents/Guardian if required is clearly put at the appropriate place. Candidates and Parents are requested to sign the declaration with date.
  13. Candidates are requested to affix their Passport size photograph on both copies of forms. These photos are to be duly attested by any one of the following.

ADMISSION FEES STRUCTURE

Certificate in Computer Applications (CCA) = Rs. 1500/- for the whole course. Payment should be made in the form of Bank Draft only in favour of The Secretary, National Open School, payable at New Delhi.

 

Enrolment No. :
( to be given by  NOS)

Photograph duly attested
by Co-ordinator of the
Study center / Pradhan
Panchyat / Sarpanch of
Village / Tehsildar Principal
of recognised school /
Institute District
Manager / Gazetted Officer
PART A

Name of Candidate :

Name of Parents to be recorded on the Certificate

Father  :
Mother :
Residential /
Postal Address :


Phone No.  :

Date of Birth : Day   Month   Year

Sex :

Male :   Female :
Category Disability

Disadvantaged Group

1. General            1. Blind           1. Street Children
2. SC 2. Orthopedic 2. Drug Addict
3. Ex-Serviceman 3. Hearing impaired 3. Orphan
4. Handicapped 4. Deaf/Dump
5. Other
Nationality  : Indian:     Other: 
Educational  Qualifications :       X  :      XII  :  
Year of Passing : X : 19    XII : 19

PART B ( BACK GROUND INFORMATION )

Number of Members in your Family :
Total family income : Upto Rs.12,000    Upto Rs.24,000   
Upto Rs.36,000    Above Rs.36,000   
Fathers Educational Qualifications : No Education        Upto Primary
Upto Secondary    Upto College
Mothers Educational Qualifications : No Education      Upto Primary
Upto Secondary  Upto College
Area in which you live ? Urban   Rural   Tribal  
Hilly      Slum
Number of rooms in your
residence ?		 One    Two  Three
More than three
Which of the following you
have at home ?		 Electricity   Fan   Radio/Transistor   TV
Cassette/CD Player   Cycle   Scooter
Car   Cooking Gas   VCR/VCP
Generator/Inverter   Multimedia
Telephone   Computer   Cable Connection
Employment Status : Employed   Unemployed
Own Profession Self-Employed

Declaration

Certified that :

  1. I posses the minimum educational qualification required for the course
  2. I have read and understood the eligibility conditions as laid down in the prospectus. I fulfil these criteria.
  3. I have furnished the necessary information/documents correctly. I understand that my candidature is liable to be cancelled by NOS in the event of this information is having been found to be incorrect or misleading.
  4. I shall abide by all the rules and regulation of NOS and shall maintain discipline and decorum at the AVI/Study Centre.
Counter Signature of Parent/Guardian
(In case the applicant is less that 18 yrs. of age)

____________________________________

 Signature of Candidate
(with date)

____________________________

 

Permanent Address :


Student to provide AVI to check the enclosures : ( Duly Attested ) before sending the original admission form

Duplicate copy of the admission form :

Certificate of Date of Birth :

Filled in Identity Card with Photo pasted on it :

Transfer Certificate from the school last attended :

Self certificate regarding Educational qualifications :

Pass Certificate of Class X Board Examination ( If applicable ) :

Photograph duly pasted :

Certificates attested :

Any other documents attached /sent :

Full Signature with seal of Co-ordinator of the AVI

_____________________________________

Dated :

 

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