West Bengal Minorities' Development and Finance Corporation

A statutory Corporation under Minority Affairs & Madrasha Education Department, Government of West Bengal
"Amber", DD/27E,Salt Lake City Sector-I, Kolkata-700064, Toll free No:-18001202130

AIKYASHREE (FRESH)
APPLICATION FOR WB POST MATRIC SCHOLARSHIP 2023-24
Application ID: SSP2023020605920907 Application Date: 23-09-2023
BASIC INFORMATION
Student's Name: WASHIKUR RAHAMAN Father's Name: SAFIKUL ISLAM
Date of Birth: 08-11-2002 Mother's Name: SAMSUNNAHAR BIBI
Gender: Male Annual Family Income: 48000
Marital Status: Unmarried Guardian's / Husband's Name: SAFIKUL ISLAM
E-mail Id: sahildeewana1088@gmail.com Religion: Muslim
Mobile No: 6296373129 Aadhar No XXXXXXXX1226
Class X Registration No: 6191-140447 Name as per Aadhaar: WASHIKUR RAHAMAN
ADDRESS INFORMATION
Permanent Address Present Address
Domicile State: WEST BENGAL State: WEST BENGAL
Domicile District: MURSHIDABAD District:MURSHIDABAD
Block/Municipality:Beldanga - I(BLOCK) Block/ Municipality:Beldanga - I(BLOCK)
Permanent Address: MOKRAMPUR Present Address: MOKRAMPUR
Post Office: BISHANNAGAR Post Office: BISHANNAGAR
Police Station: BELDANGA Police Station: BELDANGA
Pin: 742133 Pin: 742133
ACADEMIC INFORMATION
Previous Academic Information Present Academic Information
Previous Institute Name: BELDANGA C.R.G.S. HIGH Institution District :MURSHIDABAD
SCHOOL Institution Name: SEWNARAYAN RAMESWAR FATEPURIA COLLEGE
Previous Class / Course Name: XII Institution UDISE/AISHE/NCVT Code : C-44050
Previous Year of Study: XII Current Class / Course Name : BACHELOR OF ARTS (B.A)
Name of the Board of Current year of Study :1st Year
last Exam Passed: West Bengal council of Higher Secondary Are you a Hosteller: No
Education Name of the Board / Council / University : KALYANI UNIVERSITY
Year of Passing Last Exam: 2023 Course Duration : 3 Year
% of Marks Obtained
in Last Examination: 53.00
BANK ACCOUNT DETAILS
IFSC: PUNB0670500
Savings bank account no.: XXXXXXX4812
Name as per bank Account: WASHIKUR RAHAMAN (Self)
Declaration:I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I
have not applied for any other scholarship/stipend, etc. from any other government sources(one-student-one-
scholarship).NB:The application of student applying for more than one scholarship application/scheme is liable to be rejected.

___________________
Signature of Student
DECLARATION OF INCOME
(To be given by the parents/ guardians)

Certified that the gross annual income from all sources in respect of my family is Rs.48000 . I further undertake that in the
event of the particulars given in the declaration being found false, I shall refund the whole amount of the Scholarship paid to
the said Scholarship holder WASHIKUR RAHAMAN and the Government's decision in this regard shall be final and binding on
me.

__________________________
Signature of the parents/ guardian
Instruction
Student is to submit this ***computer-generated filled-in application form (duly signed) to the educational
institution along with following supporting document within 7 days:

1. Photocopy of the bank-passbook where the details of bank a/c number,IFSC are mentioned clearly.

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