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 SVMCM SCHOLARSHIP 2022-23
Application ID: SSP2022050604473486 Application Date: 13-11-2022
BASIC INFORMATION
Student's Name: OBAID SAIKH Father's Name: WASEF ALI
Date of Birth: 03-09-2003 Mother's Name: ALIYA BEWA
Gender: Male Annual Family Income: 60000
Marital Status: Unmarried Guardian's / Husband's Name: WASEF ALI
E-mail Id: tilok.m77andal3@gmail.com Religion: Muslim
Mobile No: 8116660745 Aadhar No XXXXXXXX5522

ADDRESS INFORMATION
Permanent Address Present Address
Domicile State: WEST BENGAL State: WEST BENGAL
Domicile District: MURSHIDABAD District:MURSHIDABAD
Block/Municipality:Raninagar - I(BLOCK) Block/ Municipality:Raninagar - I(BLOCK)
Permanent Address: VILL-GOPINATHPUR Present Address: VILL-GOPINATHPUR
Post Office: GOPINATHPUR M.PARA Post Office: GOPINATHPUR M.PARA
Police Station: ISLAMPUR Police Station: ISLAMPUR
Pin: 742304 Pin: 742304
ACADEMIC INFORMATION
Previous Academic Information Present Academic Information
Previous Institute Name: LOCHANPUR N.K HIGH SCHOOL Institution District :MURSHIDABAD
Previous Class / Course Name: XII Institution Name: SUBHAS CHANDRA BOSE CENTENARY COLLEGE
Previous Year of Study: XII Institution UDISE/AISHE/NCVT Code : C-7108
Name of the Board of Current Class / Course Name : BACHELOR OF ARTS (B.A)
last Exam Passed: West Bengal council of Higher Secondary Current year of Study :1st Year
Education Are you a Hosteller: No
Year of Passing Last Exam: 2022 Name of the Board / Council / University : KALYANI UNIVERSITY
% of Marks Obtained Course Duration : 3 Year
in Last Examination: 60.20
BANK ACCOUNT DETAILS
IFSC: BARB0LOCHAN
Savings bank account no.: XXXXXXX4887

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.60000 . 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 OBAID SAIKH 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.

1/1

Powered by TCPDF (www.tcpdf.org)