APPLICATION FOR STUDY SCHOLARSHIP

1. Name of the applicant (in CAPITAL letters):

___________________________________________________________________________
2. Name of the parents:
Father ______________________________________________________________________
Mother _____________________________________________________________________
3. Permanent residential address:
___________________________________________________________________________
___________________________________________________________________________
4. Present residential address (if not same):
___________________________________________________________________________
___________________________________________________________________________
5. Mobile phone number of the applicant: __________________________________________
6. Mobile phone number of the father/mother: ______________________________________
7. Educational Details:
Serial Name of the Exam Subjects/ Marks obtained
Year Percentage Remarks
no. passed/appeared Stream/Course out of total

I.

II.

III.

IV.

8. Details of current occupation (‘student’ if pursuing studies):

9. Name of the course of study currently pursued:
10. Name and address of the current educational institute:
11. Scholarship applied for the stream/course of study:
12. Academic period for which the scholarship is applied for:
13. Nature of scholarship applied for: Full educational support/Fixed educational support
14. Yearly quantum of scholarship applied for (in ₨):
15. If any other scholarship either applied for or already obtained and continuing: YES / NO
16. If YES (against point 11 above), please specify the details of scholarship and amount (in ₨):
 17. Details of documents enclosed in support of application:
Annexure Description of document Issued by

I.

II.

III.

IV.

18. Declaration: I do hereby certify that the information given above is absolutely true and
original documents in support of my claim for this instant scholarship are available with me.

Place: ____________________ __________________________________

Date: ____________________ Full signature