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Instructions:

Age limit : Wherever there is no age limit for taking admission (vide clause 4), the Government of Orissa will not be responsible for any regulation of service where such requirement for age exists. The candidate should take admission at his/her own risk as regards to age.

Medical Fitness : JEE will not be responsible if a candidate faces difficulty in employment on medical ground. Candidates claiming reservation under physically handicapped category will have to go through a Medical Board (Clause 2.1.3 of Information Brochure). The decision of the Medical Board will be final and binding.

Orissa State Candidates ( S- Category)
For admission to colleges under state category one has to satisfy at least one of the following three criteria. They will be eligible for admission to Government colleges on the basis of their merit rank. However, for MBBS / BDS course and lateral entry for diploma holders, the parents of the candidate must be permanent resident of Orissa.

Outside state category  (OS - Category)
Outside state candidates are eligible to appear for JEE-2005. They will be eligible for admission to Engineering/ Technology/ Pharmacy/MCA/MBA/HMCT/Architecture streams in private colleges of Orissa, on the basis of their rank secured in the merit list for the state quota seats only. They are not elligible for admission in Government Colleges to Engineering/Architecture / MBA / MCA / MBBS / BDS and admission under lateral entry Programme.

Non resident Oriyas  (NR - Category)
5% of seats are reserved in government engineering colleges for Oriya speaking people residing outside the State of Orissa. A candidate to be eligible to avail such facility should have oriya as a subject at High School or at level of Class - VII or at Primary level and he/she should produce attested copies of the mark-sheet / Certificate of concerned State in support of his/her claim at the time of counselling.

Instructions for Completing JEE Application Form

Name of the Candidate : (Item - 1)
Write your name in CAPITAL LETTERS as given in your original certificate of the High School or equivalent examination in Black / Blue ball pen. Write a single letter in each box. Within any one word of your name, do not leave any blank box. Leave one and only one blank box between any two words of the name. If your name has several initials leave one blank after each of them. If it requires more than 35 boxes abbreviate the middle name (s). Darken the appropriate circle under each letter of the name.

Category : (Item - 2)
Refer Clause No 2 of Information brochure for ascertaining the category to which you belong.

Reservation : (Item - 3)
Candidates belonging to S-Category and seeking admission under reservation in any of the followings are to darken the appropriate circles( multiple choice may be given).

Nationality : (Item - 4)
Darken the appropriate circle.

Gender : (Item - 5)
Darken the appropriate circle.

Course : (Item - 6)
Enter the appropriate codes in the boxes provided at the top and darken the corresponding circles below them against the course code (given below) that you want to appear. (e.g Engineering, Medical, MCA,MBA, Lateral entry in a particular discipline or possible combinations.) For example if you are appearing for Engineering only darken the circle 01. If you are appearing for both the Engineering and Medical, darken circle 05. Examination timetable will not permit other combinations of courses.

Mother Tongue : (Item - 7)
Use the language codes given below to indicate your mother tongue and darken the appropriate circle.

Date of Birth : (Item - 8)
Enter the date, month and year of your birth as per the English calendar and as recorded in your School/ Board/Pre-University examination certificate. Use numerals 01 to 31 for DATE, abbreviations JAN, FEB etc. for MONTH, and the last two digits of the YEAR of birth. For example, if born on 8th March 1987, the date should be entered as follows : 08 MAR 87. Darken the appropriate circle in each column.

Choice of Examination Centres : (Item - 9)
Table – VIII gives a list of the numerical codes of the places where centers for the JEE-2005 will be located. Select three different places in order of your preference. Enter the appropriate codes in the boxes provided at the top and darken the corresponding circles below them. The first preference must be entered under column-I and the second and the third preferences under column-II & III respectively. Outside state candidates are to opt for at least two centres located in Orissa, besides the centre of their choice. A JEE centre may be cancelled owing to poor response, operational difficulties or any other reason. Candidates may not necessarily be allotted a particular place as JEE centre of their choice.

Year of Qualifying Examination : (Item - 10) ( For Engineering/Medical/Architecture/Pharmacy/ HMCT)

Percentage of Marks : (Item - 11)

Photograph : (Item - 12)
Paste ( do not staple) a recent good quality black and white photograph of size 3 cm x 4 cm taken not more than two months earlier. It is expected that the candidate will have the same appearance at the time of examination and counselling as in this photograph. Incase your appearance changes, you are required to bring two new photographs at the time of examination. Do not sign on the photograph and do not get it attested.

Complete Mailing Address : (Item - 13)
Write the complete postal address to which any communication is to be sent till August 2005. The address must include your name, C/o name if required, and other details including the PINCODE for the mail to reach you. Indicate phone number, if any, with STD code. Please note that this block will be machine scanned and therefore, it should be written very clearly in black / blue ball pen only (not in pencil). If you make any mistake, cover the whole box with an exact sized white paper slip and write your address on it. You may also paste a typed address slip inside the box. Your address must not overflow this box.

Signature : (Item - 14)
Put your usual signature in black / blue ball pen within the box provided. Your signature must not overflow or touch the border of the box provided. Your signature establishes your identity. Hence, do not merely write your name in capital letters. This may lead to rejection of your application.

Board of Qualifying Examination : (Item - 15)
Darken the appropriate circle.

PINCODE of Address for Communication : (Item - 16)
Write PINCODE in the space provided. Darken the appropriate circle against each digit.

Phone Number including STD Code : (Item - 17)
Write your phone number, if there is any, with STD code, on which you can be contacted or a message can be left for you. Darken the appropriate circles below the phone number.

This Attempt at JEE : (Item - 18)
Will JEE-2005 be your first, second or a higher attempt? Darken the appropriate circle.

Name of one Parent / Guardian : (Item - 19)
Write the name of one of your parent or guardian exactly as in your 10th class or equivalent certificate, if given. Write the name of your father if no name is given in the 10th certificate. Write a single letter in a box. Within any word of the name, do not leave any blank box. Leave one and only one blank box between any two words of the name. Darken the appropriate circle under each letter of the name. If the name has several initials, leave one blank after each of them.

Relationship : (Item - 20)
Indicate your relationship with the parent/ guardian named in item 6.19 by darkening the appropriate circle.

Candidate’s Residence district (Item - 21)
Candidate’s belonging to S-category (Orissa State candidates) should mention the code against the name of the district where he/she studied +2 course in Government Colleges / Institutions.