IITs I NITs I IIITs I BITS I Medical I KVPY I NTSE APPLICATION FORM

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1 IITs I NITs I IIITs I BITS I Medical I KVPY I NTSE APPLICATION FORM TALENT REWARD CUM ADMISSION TEST Only students presently in class 8/9/10 are eligible Fee amount : ` Date of application : for office use only Roll No. TRCAT Name of e Student (In Capital) : Affix your recent colour passport photograph Faer's/ Guardian Name (In Capital) : Occupation : Designation : Category (Please tick) : Gen. OBC SC ST Class : Faer's/ Guardian's annual income : Date of Bir (Student) : D D M M Y Y Y Y Nationality : Name of e School : Board affiliated to (Please tick) : CBSE ICSE MP Oer (Specify) Percentage / Grade obtained in e last school examination : Achievements (NTSE / Olympiads / School or Class Rank / Oers) : ADMIT CARD Talent Reward cum Admission Test Roll No. (for office use only) Date & Time : TRCAT 10 Jan 2016 (Sunday) 10:30 am to 12:30 pm Exam Centre: (for office use only) Student's Name (In Capital) : Faer's Name (In Capital) : School Name : Class (Please tick) : Student's Signature Sign. & Seal of Manager (MOMENTUM) Affix your recent colour passport photograph

2 Residential address : Pin Code Phone (Res.) wi STD code : Faer's Mobile No. Student's Mobile No. Id (Student): (Parent): Which Competitive exam(s) do you plan to take? ENGINEERING MEDICAL OLYMPIAD KVPY Oers: "Could you share wi us e name of a teacher who has specially influenced/motivated/generated interest in you to take future studies in Science" Name of Teacher : Subject: Contact No. Feedback about e Teacher : Your feedback will be used to reward ree teachers who are favorite to students. IMPORTANT 1. Incomplete form will not be accepted. 2. Retain your admit card at e time of submitting your application form. Our official will write e name and address of your exam centre in e admit card and allot you a Roll No. 3. Collect your sample test paper at e time of submitting e form. 4. Please ask for detailed terms & conditions of e scheme at e time of submitting is form. You need to understand e detailed terms & conditions and acknowledge it. 5. Decision of management shall be final & binding in all regards. Student's Signature Faer's/Guardian's Signature 1. A student must report to his / her exam centre by 10:15 am on e date of e exam. 2. You must bring your admit card to e exam centre. You will not be allowed to take is exam wiout admit card. 3. Carry a ball point pen wi you. 4. Use of calculator / mobile / log table is not permitted. 5. Students using any unfair means will be barred from taking e exam. 6. Do not help oers in your own interest. 7. Follow all e instructions carefully.

3 Pen Your Future... Wi TRCAT 2016 Talent Reward Cum Admission Test For Students Presently in Class 9 10 Guarantee for Success in Competition + Guarantee for Performance in Board + Scholarships * Conditions apply 8 NOTE : SMS your name to & if you have any query. Our executive will call to assist you. R R 1525, Near Stadium, Wright Town, JABALPUR & /28/29, , momentumacademy@gmail.com

4 TRCAT (Talent Reward Cum Admission Test ) (bl o kz ls ;g ijh{kk Class 10 ds vykok Class 8 & 9 ds fy, Hkh vk;ksftr dh tk jgh gs) TRCAT,d Nk+=o`fÙk rfkk Selection Guarantee ;kstuk gsa bl ;kstuk dk ;g prqfkz o"kz gsa blds rgr~ es/kkoh Nk=ksa dks ns'k ds Js"Bre~ bafu;fjax dkwystksa ¼tSls IIT, NIT br;kfn½ rfkk esfmdy dkwystksa esa p;u dh l'krz fyf[kr guarantee nh tkrh gs A lkfk esa lsdm+ksa Nk=ksa dks eksesuve esa dksfpax ds fy, Nk=o`fÙk Hkh nh tkrh gs ftldk dqy ewy; yk[kksa :i;s gksrk gsa izr;sd o kz dh rjg bl o kz Hkh fo kffkz;ksa dks Selection Guarantee rfkk eksesuve dh dksfpax Qhl esa NwV ds tfj;s Nk=o`fÙk nh tkosxha ;g ijh{kk jfookj 10 tuojh 2016 dks vk;ksftr dh tk;sxha blesa 3000 ls T;knk Nk=ksa ds 'kkfey gksus dh iwjh lahkkouk gsa blesa 'kkfey gksdj vki Nk=o`fÙk ik ldrs gsa rfkk vius dks gtkjksa fo kffkz;ksa ds chp Js"B lkfcr dj ldrs gsa A TRCAT ds ek/;e ls ge vf/kdkf/kd es/kkoh Nk=ksa dks fpfugr dj mudk p;u ns'k ds Js"B bafu;fjax vksj esfmdy dkwystksa esa djkuk pkgrs gsa A nsj u djsa vksj vkt gh layxu QkeZ Hkjdj mfpr Qhl ds lkfk gekjs dk;kzy; esa tek djsa A gekjs Nk= lksiku us o"kz 2013 esa iwjs Hkkjr escbse a 12 Board dh ijh{kk esa izfke LFkku izkir fd;k A 2011 vksj 2013 esa gekjs Nk=ksa us ns'k dh lcls cm+h bafu;fjax izfr;ksxh ijh{kk JEE Main / AIEEE esa iwjs e/;izns'k esa izfke LFkku izkir fd;k A 3 o"kksza esa 2 ckj ;g dkjukek djus okyk eksesuve,dek= lalfkku gs A IIT dh ijh{kk JEE Advanced esa gekjs Nk= iwjs egkdks'ky esa Js"B izn'kzu djrs jgs gsa A bl o"kz Hkh gekjs Nk= foosd eqn~xy us 975oha jsad ikdj iwjs tcyiqj esa lozjs"b izn'kzu fd;k gs A 2015 esa gekjs lalfkku ls dqy 65 fo kffkz;ksa dk p;u IIT esa gqvk gs tks tcyiqj ds fy, fjdkmz gsa esfmdy izos'k ijh{kkvksa esa Hkh gekjs Nk=ksa us mrd`"v izn'kzu fd;k gs A AIPMT 2015 esa gekjs Nk= lq; k ckxm+h us iwjs izns k esa 28oha jsad gkfly dh blh Øe esa kqhke fe=k us AIIMS dh ijh{kk esa 1291 jsad gkfly fd;k A 2015 esa gekjs 20 fo kffkz;ksa us AIPMT ijh{kk dks DokyhQkbZ fd;ka cksmz ijh{kk esa Hkh eksesuve lalfkk ds Nk= losz k tsu us 96-2 izfr kr vad gkfly dj iwjs tcyiqj esa VkWi fd;k rfkk dqy 28 fo kffkz;ksa us 94 izfr kr ls vf/kd vad gkfly fd;sa How to Apply You can get e application form at our office. You can also download e application form from our website Fill e Application Form and submit it to our Wright Town / Ranjhi / Rampur / Adhartal Centre or at oer Collection Centers along wi e fee amount as mentioned below. Photocopy of e application form can also be used. Detailed terms & conditions can be obtained from our office. Application received on or before 20 Dec - ` 200/- only. Application received between 21st Dec. to 31st Dec. ` 500/- only. After 31st Dec - `1000/- only. Collect e sample test paper at e time of submitting e application form. All students enrolled for is test will get a chance to meet and interact our previous years toppers. We are trying to organize a get togeer*. (*Subject to availability of our Ex students)

5 Scholarships / Prizes * (for class 10) (Moving to 11) EX A1 A2 A3 B1 B2 B3 B4 B Selection Guarantee in JEE / MEDICAL Guarantee to score 90% in Board (PCM/B) Guarantee to score 80% in Board (PCM/B) Grade Discount in two year course fee ` Students getting grades will be considered qualified for admission in our 2 yrs. foundation course. (11 & 12 ) Scholarships / Prizes * (for class 8 & 9) (Moving to 9 & 10) Scholarship for class - 8 &9 Written Guarantee for performance in School / Board exam. Scholarship in our (Scoremax + PFC) Course. ( Upto 100% waiver of PFC fee) WHAT IS SCOREMAX - It is our regular course for student of class 9 & 10. Its centers are at Rampur / Ranjhi / Adhartal. New centers are proposed for Vijay Nagar, Sadar & Wright Town. WHAT IS PFC ( Pre Foundation Course) - It is our weekend programme for class 9 & 10 students to prepare em for competitive exam. * Terms and conditions apply. For details visit our office.

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