GOVT.

OF ASSAM
OFFICE OF THE PRINCIPAL: COTTON COLLEGE: GUWAHATI
No.CCF-28/2012/2 Dated Guwahati the 5th November, 2012

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Chief Minister’s Scheme for Financial Assistance to Meritorious

Students of Assam
Applications are invited from the students pursuing higher studies in National and
International level Institutions and Universities in India and abroad for one time grant/financial
assistance. The financial incentive is aimed to encourage meritorious students of the State for
working hard to achieve excellence in their relevant field of study.

The list of Institutes to be considered under this scheme is:

1. Indian Institute of Technology (IITs)

2. Indian Institute of Management (IIMs)
3. Indian Institute of Science (IISc), Bangalore
4. Indian Institute of Information and Technology (IIITs)
5. Tata Institute of Fundamental Research (TIFR)
6. All India Institute of Medical Sciences (AIIMS), New Delhi
7. Post Graduate Institute of Medical Education & Research, Chandigarh
8. Bhaba Atomic Research Centre (BARC)
9. National Law School, Bangalore
10. Indian School of Mines (ISM), Dhanbad
11. Indian Space Research Organization (ISRO)
12. Indian Institute of Foreign Trade (IIFT)

Students pursuing higher studies in other reputed Indian/International

Colleges/Universities/Institutions in India and abroad may also apply. However, the Governing
Council will take final decision.

Conditions of eligibility:

a) Students selected and admitted in any national and International Institutions as noted
above.
b) Students who are domiciles of Assam.
c) Students who obtain scholarship, grant-in-aid and sponsorship from Govt. of Assam,
Govt. of India and/or others donors are also eligible to obtain Assistance under the
scheme.
The rate of financial Assistance per student:

a) Rs. 30,000/- per year for Degree level courses

b) Rs. 36,000/- per year for Master Degree level courses
Or
One time amount of Rs. 1.00 Lakh instead annual financial assistance. (to the students who
have got admission in to IIT and IIM)

The financial assistance will be released to the selected students every year in a single
installment.The installment in subsequent years is to be released on satisfactory academic
performance during the previous year. Also, thescholar will be eligible only for the standard
period admissible to the relevant courses. No drop-out period will be covered under the scheme

How to apply:

Download the prescribed application formfrom the web site: www cottoncollege.org.in
and submit the filled up application to the Principal Cotton College, Guwahati on or before 31 st
December, 2012 along with necessary testimonials.
 APPLICATION FORM

Chief Minister’s Scheme for Financial Assistance to Meritorious

Students of Assam
1. Name of the Applicant(in block capital): ………………………………………………

2. Father’s Name: ………………………………………………

3. Mother’s Name: ………………………………………………

4. Date of Birth: ………………………………………………

(Enclose a copy of the birth/HSLC certificate)

5. Sex: Male/Female ………………………………………………

6. Permanent Address with PIN Code: ………………………………………………

………………………………………………
………………………………………………
………………………………………………

7. Address for correspondence with PIN Code: ………………………………………………

………………………………………………
………………………………………………
………………………………………………
8. Telephone No.
Land line ………………………………………………
Mobile ………………………………………………
9. Email id: ………………………………………………

10. Are you a permanent resident of Assam:

Yes/No ………………………………………………

(Enclose a copy of the PRC)

11. Academic Qualifications:

Sl. No. Examination passed Year Board/University % of marks secured

(Enclose copies of the mark sheets)

12. Name of the present course of study: ………………………………………………

13. Level of the present course of study

Degree/Masters ………………………………………………

14. Name and address of the Institutionwhere

studying at present: ………………………………………………
(Enclose a copy of the certificate issued by the Head of the Institution)

15. Date of Admission to the present course: ………………………………………………

16. Duration of present course: ………………………………………………

17. Designation of the Drawing and Disbursing

Officer of the institution where studying
at present: ………………………………………………

18. Applicant’s Account number, Bank name and

Branch Code ………………………………………………

Declaration:
I do hereby declare that the particulars furnished by me in this application form have
been filled in by me in my own handwriting and are correct and complete to the best of my
knowledge and belief. I have not concealed any fact or furnished any false information which
will render my application liable to be summarily rejected.

Signature of the applicant Countersignature by

Date : Head of the Institute with seal
Place: