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28th National Children’s Science Congress 2020 REGISTRATION FORM – A
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PROJECT DETAILS - State
*
TAMIL NADU
Others
Required
District
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Choose
Ariyalur
Chengalpattu
Chennai
Coimbatore
Cuddalore
Dharmapuri
Dindigul
Erode
Kallakurichi
Kanchipuram
Kanyakumari
Karur
Krishnagiri
Madurai
Nagapattinam
Namakkal
Nilgiris
Perambalur
Pudukkottai
Ramanathapuram
Ranipet
Salem
Sivaganga
Tenkasi
Thanjavur
Theni
Thoothukudi (Tuticorin)
Tiruchirappalli
Tirunelveli
Tirupathur
Tiruppur
Tiruvallur
Tiruvannamalai
Tiruvarur
Vellore
Viluppuram
Virudhunagar
Area
*
Rural
Urban
Required
Category
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Senior (Children born between 01.01.2003 to 31.12.2006)
Junior (Children born between 01.01.2007 to 31.12.2010)
Required
Language Used
*
Tamil
English
Required
Project Title
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Your answer
Sub Theme
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Choose
Ecosystem for Sustainable Living
Appropriate Technology for Sustainable Living
Social Innovation for Sustainable Living
Design, Development and Modelling for Sustainable Living
Traditional Knowledge Systems (TKS) for Sustainable Living
DETAILS OF SCHOOL / INSTITUTION / ORGANISATION Type of School
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Govt./Govt. Aided School
Private School
Special – Out of School
Required
Name of the School / Institution / Organisation
*
Your answer
Name of the Head of School / Institution / Organisation
*
Your answer
E mail id of Head of School / Institution / Organisation
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Your answer
Phone No
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Your answer
Office Address - House / Bldg. / Apt. No
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Your answer
Street / Road / Lane
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Your answer
Area / Locality / Sector
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Your answer
Village / Town / Ciry
*
Your answer
PIN Code
*
Your answer
Post Office
*
Your answer
DETAILS OF THE GROUP LEADER -Name of the Group Leader
*
Your answer
Gender
*
Male
Female
Required
Whether Child with Disability (CWD)
*
Yes
No
Required
If ‘Yes’ type of Disability Code
Choose
VI - Visual Impairment
LV - Low Vision
TB - Totally Blind
MR - Mental Retardation
HI - Hearing Impairment
SI - Speech Impairment
MI - Multiple Disability
LD - Learning Disability
AUT - Autism
OI - Orthopedically Impaired
CP - Cerebral Palsy
Date of Birth
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MM
/
DD
/
YYYY
Age (as on 31.12.2020)
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Choose
10
11
12
13
14
15
16
17
Mobile No
*
Your answer
E mail id
*
Your answer
Details of Co-worker - Name of the Co-worker
Your answer
Gender
Male
Female
Date of Birth
MM
/
DD
/
YYYY
Age (as on 31.12.2020)
Choose
10
11
12
13
14
15
16
17
Whether Child with Disability (CWD)
Yes
No
If ‘Yes’ type of Disability Code
Choose
VI - Visual Impairment
LV - Low Vision
TB - Totally Blind
MR - Mental Retardation
HI - Hearing Impairment
SI - Speech Impairment
MI - Multiple Disability
LD - Learning Disability
AUT - Autism
OI - Orthopedically Impaired
CP - Cerebral Palsy
NAME AND ADDRESS OF GUIDE TEACHER - Name of the Guide Teacher
*
Your answer
Designation
*
Your answer
Name of the Institute
*
Your answer
Address of the Guide Teacher - House / Bldg. / Apt. No
*
Your answer
Street / Road / Lane
*
Your answer
Area / Locality / Sector
*
Your answer
Village / Town / Ciry
*
Your answer
PIN Code
*
Your answer
Post Office
*
Your answer
Phone No
*
Your answer
E mail id
*
Your answer
Date of Submission
*
MM
/
DD
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YYYY
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