PRMO 2019

Student Registration Form

Candidates born on or after August 1, 2000 and studying in Class 8, 9, 10, 11 or 12 are eligible to write PRMO 2019.
Further, the candidates must be Indian citizens. Provisionally, students with OCI cards are eligible to write the PRMO

STUDENT REGISTRATION INFO

FULL NAME AS PER

SCHOOL RECORDS. :_______________________________________________________

DATE OF BIRTH : D D M M Y Y Y Y

GENDER : (Male/Female)
(Male/Female)
(Male/ Female)

: /STANDARD
CLASS : _______________________________________________________

STUDENT STUDYING IN

SCHOOL TYPE : KV JNV OTHERS

SCHOOL NAME : _______________________________________________________

SCHOOL PLACE : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PINCODE _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

CITY: ____________________ DISTRICT ______________________

STATE _ _ _____________________________________________

RESIDENTIAL CORRESPONDENCE INFO

RESIDENTIAL ADDRESS : __________________________________ ___________________ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ CITY: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

DISTRICT : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ STATE : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

PINCODE : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ MOBILE NO _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

EMAIL ID : __________________________________ ____________________

Declaration: I hereby declare that the details furnished herein are true to the best of my knowledge.
DATE :

PLACE : (Signature of the Student)

Acknowledgement (To be handed to the Student)

Applied for PRMO 2019 Received Rs: _ _ _ _ _ _ _ _ _ _ _

Centre Registration No.: _ _ _ _ _ _ _ _ _ _ _ Institution Seal Signature of Centre In-charge

Note: Confirm your registration status through “Check your registration status” within seven working days after
submission or else check with the respective Institution.