JAM 2013 OMR Application Form

Read the following instructions carefully and follow the SAMPLE filled-in OMR Application Form on Page Nos. 13 and 14.
(i) Note down the OMR Application Form number and keep a photocopy of the completely filled-in form as a personal record for future reference.
(ii) The OMR Application Form will be processed by a machine, which picks up only black ink pen marks. The signature and address will be scanned by a machine that reads only dark black images and only from the
specified areas of the form. Ensure that you use Black Ink Ball Point Pen to fill the boxes and use the HB pencil to fill the bubbles wherever applicable. The colour photograph must be of good quality and taken not more than two months earlier.
(iii) Fill the form in English only. First, write in capital letters the required information in the boxes above the bubbles (wherever provided), and then darken the appropriate bubble underneath each letter. Darken the bubbles by using a HB pencil only.
(iv) Options filled in this form cannot be changed at a later stage.
(v) The name and date of birth should be exactly the same as recorded in the High School (10th Class) Certificate. Any departure, whenever discovered, may lead to cancellation of candidature.
(vi) If any change of name has been accepted by the government, a copy of the gazette notification has to be attached.
(vii) The application must be complete in all respects. Incomplete Application Forms will be summarily rejected. You may now proceed to fill the OMR Application Form for the item numbers as given below:
Item 1: Name of the Candidate
Fill in the name in CAPITAL letters using a black ink ball-point pen, as recorded in High School (10th Class)
Certificate. Write a single letter in each box. Do not leave any blank box within any part of the name. Leave only one blank box between any two parts of the name. If the name has several initials, leave one blank after each of them. Darken the appropriate bubble under each letter of the name using a HB pencil. Any change in name/ surname at any stage has to be duly supported by a proper affidavit.
Item 2: Nationality

Darken the appropriate bubble corresponding to INDIAN or FOREIGNER.
Item 3: Gender
Darken the appropriate bubble for MALE or FEMALE.
Item 4: Category
Darken the appropriate bubble: GEN for General Category, OBC for Other Backward Classes (non creamy
layer), SC for Schedule Caste, ST for Schedule Tribe.
Item 5: Date of Birth
Fill in your date of birth as given in your High School (Class 10th) certificate in the space provided and darken the appropriate bubbles. Example: if the date of birth is 17 September 1989, fill in
 Item 6: Person with Disability (PD)
Darken the appropriate bubble, YES or NO PD candidates claiming concession for buying the Application Form must attach a duly self attested copy of Physical Disability Certificate (PD) issued by an appropriate medical authority. If any PD candidate requires the services of a scribe, darken the bubble YES. Otherwise, darken the bubble NO. Requests for scribe received at a later date may not be .considered. The role of the scribe will be to read the question paper for the candidate and darken the bubbles/write the answer as per the instructions of the candidate.
Item 7: Number of the Test Paper(s) Applied for
The total number of Test Paper(s) (1 or 2) the candidate wishes to appear must be entered in the box provided and the appropriate bubble must be darkened.
Item 8: Choice of Test Paper(s)
Depending on the number of test papers mentioned in Item 7, darken one or two bubble(s) shown against the choice(s) of test paper(s). If only one test paper scheduled in Session I (or Session II) is chosen, then all the bubbles shown against Session II (or Session I) must be left blank. If two test papers are chosen, it must be ensured that they are not scheduled in the same session and that one bubble shown against each session is darkened.
Item 9: Choice of Cities/Towns for the Test
A candidate must choose any two cities/towns for the test from the list of cities/towns of JAM 2013 centres given in Appendix–III. Write the codes (see Appendix-III) of FIRST Choice and SECOND Choice for the test city/town in the corresponding boxes and darken the appropriate bubbles.
Item 10: Name of the Qualifying Degree
Darken the bubble shown against the qualifying degree. If the qualifying degree is other than B.A., B.Sc., B.Sc.(Agri.) B.E./B.Tech., B.Pharma. MBBS, B.V.Sc., darken the bubble shown against OTHERS.
Item 11: Qualifying Examination Passed
If the candidate has already passed the final examination of the qualifying degree, darken the bubble shown against YES. If the candidate is going to appear or has already appeared in (and is awaiting results of) the final examination, darken the bubble shown against NO.
Item 12: Year of Qualifying Examination
Write the year of passing/appearing at the qualifying examination in the boxes provided and darken the appropriate bubbles.
Item 13: Percentage of Aggregate Marks/CGPA
In the first column, darken the bubble corresponding to the grading scheme followed at your institution. In the
boxes provided in the second column, write the percentage of aggregate marks/CGPA (calculated out of 10 considering all subjects, including languages and subsidiaries, all years combined) up to two decimal places, obtained in the qualifying examination or up to pre-final year/semester, if appearing in the qualifying examination in 2013, as the case may be. Darken the bubbles accordingly.
Item 14: Mobile Number
Write, in the boxes, the Mobile Number on which you may be contacted. Accordingly, darken the appropriate bubbles.
Item 15: Name and Complete Postal Address
Write the name, complete postal address with PIN code (in CAPITAL letters using a black ink ball-point pen) where your Admit Card or any other communication is to be sent.
Item 16: JAM 2013 Photograph
Paste (please do not staple) a 3.0 cm x 4.0 cm recent good quality colour photograph which should not be taken more than two months earlier. The photograph must not be larger than the space (box) provided for pasting it. Retain some spare copies of this photograph for future need. The photograph should neither be signed nor attested. However, the candidate must write his/her name and application form number on the reverse-side of photograph before pasting.
Item 17: Full Signature of the Candidate
Sign using a black ink ball-point pen within the box provided. The signature must not overflow or touch the border of the box provided. The signature must be in running hand. The signature here and the one below the declaration (Item 25) should be identical. Application Form without signatures or with different signatures at the two places will be treated as incomplete and rejected.
Item 18: E-mail Address
Write your e-mail address in the boxes without leaving space between words.
Item 19: Name of the Parent/Guardian
The name of parent or guardian must be written in CAPITAL letters. Write a single letter in a box. Darken the appropriate bubble under each letter of the name. Follow the instructions as given in Item 1.
Item 20: Relationship of Parent/Guardian to the

Darken the bubble against the relationship of parent/ guardian, whose name is given in Item 19, to the candidate.
Item 21: PIN Code
Write your PIN Code in the boxes provide same as given in Item 15. Darken the appropriate bubbles.
Item 22: Details of the Demand Draft Enclosed (if applicable)
Write the Demand Draft Number in the boxes and darken the bubbles below the boxes. Write the date of demand draft in the boxes under DD, MM and YY and darken the bubbles accordingly.
Item 23: Amount of Additional Fee Paid (if applicable)
Darken the appropriate bubbles shown against the amount of additional fee paid for appearing in the second
test paper. Refer Table 2.
Item 24: Landline Phone Number with STD Code (without “0”)
Write, in the boxes, STD Code (without “0”) and landline telephone number on which you may be contacted. Accordingly, darken the appropriate bubbles.
Item 25: Declaration by the Candidate
The declaration is to be signed by the candidate using a black ink ball-point pen. Read the declaration carefully before signing it. The place and date should be written at the places marked for this purpose. Unsigned OMR Application Form will not be considered. The signature must be in running hand and identical to the signature that the candidate has given in Item 17.
JAM 2013 Application Check List
The candidate should tick (T) the options in the check list. The check list for the offline application form is given on the back of the envelope.
List of JAM 2013 Application Enclosures
The candidate should tick (T) against the documents enclosed with the Application Form. For offline application form the list of enclosures is given on the back of the envelope. Correspondence with JAM office
For any correspondence with the JAM office of the Organising Institute, you must quote the Application Form Number until Admit Card is received.

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