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Students Registration Form For IOQM 2023-24

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MTA (I) IOQM 2023

MATHEMATICS TEACHERS' ASSOCIATION STUDENT REGISTRATION FORM


(INDIA)
Students born between August 01, 2004 and January 01, 2011, and studying in class 8, 9, 10, 11 or 12, are eligible
to write IOQM 2023. Please note that no student born after January 01, 2011 will be allowed to write IOQM 2023.

PERSONAL DETAILS

NAME OF THE STUDENT


(As per the School Records) : : FIRST NAME MIDDLE NAME LAST NAME

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

GENDER :: MALE /FEMALE CLASS/STANDARD :


(Male/Female)
(Male/ Female)

SCHOOL DETAILS

SCHOOL TYPE : KV JNV OTHERS

SCHOOL NAME : _______________________________________________________

SCHOOL ADDRESS : ________________________ ________ _____________________

CITY :_______________________ DISTRICT : _____________________

STATE :_______________ ________ PINCODE : _____________________

ADDRESS DETAILS

RESIDENT ADDRESS : __________________________________ ___________________

PIN CODE : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ STATE : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

PINCODE
DISTRICT : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ CITY : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

MOBILE NUMBER : ____________________ EMAIL ID. : _ _ _ _ _____________________

Please Tick your preferred IOQM – 2023 Language.


ENGLISH HINDI
Declaration:- I understand that if I have furnished any false/incorrect information, this will lead to my disqualification from the
Olympiad programme at any stage.
DATE :
(Signature of the Student)
PLACE :

ACKNOWLEDGEMENT (To be handed over to the Student)

Applied for IOQM-2023 (English/Hindi) Amount Received: _ _ _ _ _ _

Centre Registration Code: _ _ _ _ _ _ _ _ _ _ Institution Seal (Signature of Centre In-charge)


Note:-
1. Student should compulsorily provide passport size Photograph, School ID and Birth certificate.
2. Confirm your registration status through “Student Login/Search” within seven working days after submission or
else check with the respective Institution.

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