AIR FORCE ASSOCIATION

AIR FORCE STATION, RACE COURSE, NEW DELHI – 110003

APPLICATION FOR AWARD OF SCHOLARSHIP (CLASS II – XII)

(Only For AFA Members)

Ward of : Air Veteran Widow of Air Veteran Ex-NCs(E)

PART – I

AFFIX PP SIZE
PHOTO SELF
1. Name of the Candidate : …………..………………………………. ATTESTED BY
(in Block Capitals) ……..…………...................................... CANDIDATE

2. Sex : Male Female

3. Class Studying : ..…………..…….……..……………………….………………
4. Name & Address of : …….... ……….…. ...…………………………………………
School .…………………………..……………………………………….
5. Marks obtained in the previous class : …….………………………Percentage .………
(Copy of Mark Sheet to be attached)
_______________________________________________________________________
PART – II

6. Particulars of Father :

(a) AFA Membership No. : …………………….... (b) Rank .………….....………….

(c) Name : .. …………………………..……… (d) Ser No : ……………………….
(e) Date of Enrol : ……………………… (f) Date of Retirement: ……….………....…
(g) Date of Death, if deceased : …..………………….
(h) Contact No.: ………. …………… (j) E-mail : …………..………….….………...

7. Particulars of Mother (In case of Widow AFA Member)

(a) AFA Membership No. : ………….. (b) Name : …………………………..………

(c) Contact No.: ………. …….………… (d) E-mail : …………..……………………...

8. Pension Details:
(a) Whether drawing pension : YES / NO
(b) If so, Amount of Pension : Basic Pension ……..……...… DA………….……
(c) Employment after Retirement : YES / NO. If Yes, Salary Rs. ...………………….

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9. Address for Correspondence: …..…………………………………..…………………..

……………………………………………….....……………….………………………………
………………………………………....……………… PIN Code : ..……………………..

10. Details for NEFT (Account must be in the name of Student):

(a) Beneficiary Name : …………………………………………………………...………

(b) Account Number : ………………...…………………………………………………
(c) IFS Code : ………………… …………………………………….…………
(d) Bank & Branch Name : …………………….…………………….…………………
(e) Cancelled Cheque No. (To be attached) …….…………………………………..

PART – III
(To be filled in by School/College/Head of Institution)

11. Certified that Mr./ Miss. ………………..……………....……………………………. S/D/O

….………………………………………..………… is a student of Class ……………… in our
school / college/ institution named….............................................................................
And As per original mark sheet produced by student,
It is verified that he / she has secured …………. marks out of …..………. i.e ……....%
in the previous Class .……… . A copy of the Mark sheet duly attested is enclosed herewith.

Place : …………………………………..
Signature of Principle/Head of Institution
Date: (with Seal/ Rubber stamp)

12. Certified that the particulars given in Part-I and Part II of the application are correct.
Any false statement made by me will disqualify the applicant for scholarship. The following
documents are attached herewith :

(a) Cancelled Cheque

(b) Copy of Relevant page of Discharge Book containing Dependent Details.
(c) Copy of AADHAR CARD of Student
(d) Copy of Mark Sheet duly attested by Principal

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Place……………… .…….……………..
..……………………..
Date………………… Signature of Student Signature of Parent/ Guardian

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