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