Role of Students to Create Public Awarness on Plastic Waste Management and Solution

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  • Topic: Given name, Banking, Bank
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  • Published : July 26, 2012
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SCHEME OF PRE-MATRIC SCHOLARSHIP FOR STUDENTS BELONGING TO THE MINORITY COMMUNITIES

FORMAT OF APPLICATION
FOR OFFICIAL USE ONLY Sl. No. of application Year Course Whether approved

[To be filled up by applicant.] Part – I 1 A. FRESH OR RENEWAL?

Affix a selfattested passport size photograph

1. Full name Surname First Name Middle name 2. Father’s name:

(in block letters)

3. Mother’s name:

4.

State/UT of domicile

5. Name

Address for correspondence:

House no. Mohalla/Street City/ Town/ Village & P.O. District State Pin Code Tel No., including

mobile no., if any.

e-mail ID, if any

6. Name

Address of the parents.

House no. Mohalla/Street City/ Town/ Village & P.O. District State Pin Code Tel No., including mobile no., if any.

e-mail ID, if any

7. Name

Permanent address:

House no. Mohalla/Street City/ Town/ Village & P.O. District State Pin Code Tel No., including mobile no., if any.

e-mail ID, if any

8. D

Date of birth (Please enclose certificate) D M M Y Y Y Y

9. 10.

Whether male or female: Nationality:

11.

Religion:

12. Details of educational qualifications (Please enclose copies of certificates attested by a gazetted officer) School/ Institute/ Examination Board/ Council of passed Examination Main subjects Year of passing Percentage marks Division/ Class/ Grade

13.

Details of course for which scholarship is being sought: Name of class: Duration of class: Academic year: Class last attended/academic year: Total Marks obtained and percentage in last examination: (In case of students of class I, the income criterion only would be applicable) (i) (ii) (iii) (iv) (v)

14.

Details of school/institute, including residential ones: (i) (ii) Name of the school/institute where admitted: Address of school/institute:

15.

For renewal of scholarship: Name of examination passed Year Marks obtained Full marks % of marks

16.

Total Annual course fee:

Rs……………..

(Break up of course such as admission fee, admission fee, tuition fee, library fee, examination fee, etc. other than refundable deposits) Sl.No. 1 2 3 4 5 6 Total Item Annual fee

17.

Details of bank account of student:

(These details would be required only after sanction of scholarship and before disbursement of scholarship amount) (i) Name of the payee (as in the bank accounts) (ii) Name of the Bank (iii) Bank Branch (full address)_____________________________ _________________State___________District__________Pin_________ (iv) Branch Code number (v) Receipt in accordance of scholarship in the previous year duly countersigned by the Head of the School/Institutes. (vi) Bank Account Number________________________ (in words__________________________________________________) (vii) Type of bank Account_____________Saving/Current (viii) MI CR code of the Bank___________________ (ix) Mode of Electronic transfer available in the Bank ECA/RTGS/NEFT/CBS/ code number (if any). 18. Annual Income of parents/guardian of the student: Rs._______

(Declaration of annual income is to be given in the prescribed format given below and is to be signed by the parents/guardian of the student and enclosed along with the application. In case parents/guardian are employed, income certificate from the employer be enclosed). 19. (i) (ii) (iii) Documents enclosed with the application Self-attested passport size photograph with signature. Attested copies of certificates of educational qualifications as mentioned up in para 12. Income declaration – affidavit on non-judicial stamp paper worth Rs. 10/- for selfemployed parents/guardian or income certificate from the employer for employed parents/guardian. Proof of permanent residence on non-judicial stamp paper worth Rs. 10/-. Receipt in acknowledgment of scholarship in the previous year duly countersigned by the Head of the school/institute. Minority community declaration – affidavit on non-judicial stamp paper by the student that he/she belongs...
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