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    Generated by Chhattisgarh State Scholarship Portal On Dated 09-Feb-2024

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    Priyanka Mahilange is applying for renewal of her Post Matric SC scholarship for the 2023-24 year. She is currently enrolled in the 3rd year of a BCA program at Siddharth College in Bilaspur, Chhattisgarh, India. She provides her personal details including name, date of birth, gender, contact information, family details, and academic details from her current and previous programs of study. She also provides bank account, address, caste certificate, domicile certificate, and income certificate details. Both she and her father Ganesh Ram sign a declaration that the information provided is complete and accurate.

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    Generated by Chhattisgarh State Scholarship Portal On Dated 09-Feb-2024

    Uploaded by

    NG COMPUTER
    9 views2 pages
    Priyanka Mahilange is applying for renewal of her Post Matric SC scholarship for the 2023-24 year. She is currently enrolled in the 3rd year of a BCA program at Siddharth College in Bilaspur, Chhattisgarh, India. She provides her personal details including name, date of birth, gender, contact information, family details, and academic details from her current and previous programs of study. She also provides bank account, address, caste certificate, domicile certificate, and income certificate details. Both she and her father Ganesh Ram sign a declaration that the information provided is complete and accurate.

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    ScholarshipApplicationForm-23324097

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    Priyanka Mahilange is applying for renewal of her Post Matric SC scholarship for the 2023-24 year. She is currently enrolled in the 3rd year of a BCA program at Siddharth College in Bilaspur, Chhattisgarh, India. She provides her personal details including name, date of birth, gender, contact information, family details, and academic details from her current and previous programs of study. She also provides bank account, address, caste certificate, domicile certificate, and income certificate details. Both she and her father Ganesh Ram sign a declaration that the information provided is complete and accurate.

    Copyright:

    © All Rights Reserved
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    9 views2 pages

    Generated by Chhattisgarh State Scholarship Portal On Dated 09-Feb-2024

    Uploaded by

    NG COMPUTER
    Priyanka Mahilange is applying for renewal of her Post Matric SC scholarship for the 2023-24 year. She is currently enrolled in the 3rd year of a BCA program at Siddharth College in Bilaspur, Chhattisgarh, India. She provides her personal details including name, date of birth, gender, contact information, family details, and academic details from her current and previous programs of study. She also provides bank account, address, caste certificate, domicile certificate, and income certificate details. Both she and her father Ganesh Ram sign a declaration that the information provided is complete and accurate.

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    © All Rights Reserved
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    of 2

    RENEWAL APPLICATION Government of Chhattisgarh

    State Scholarship Portal


    Application Form for Year 2023-24
    Scheme : Post Matric SC Scholarship
    APPLICATION ID : 23324097 STUDENT ID : 12237510317
    APPLICATION DATE : 09-02-2024 VERIFICATION CODE : 18591 IP ADDRESS : 103.199.200.145

    1.Personal Details
    NAME : PRIYANKA MAHILANGE
    DATE OF BIRTH : 22-09-2001 GENDER : Female
    AADHAR NUMBER : XXXXXXXX6625 MOBILE NUMBER : 7489926172
    EMAIL ADDRESS : gaytrimahilange506@gmail.com RELIGION : Hindu
    IS ORPHAN : No
    FATHER/HUSBAND/GUARDIAN NAME : GANESH RAM MOTHER NAME : RUKHMANI
    FATHER/HUSBAND/GUARDIAN OCCUPATION : Farmer MOTHER OCCUPATION : Farmer
    IS DIFFERENTLY ABLED : No HOUSEHOLD CATEGORY : APL

    2.Academic Details
    Current Course's Details
    INSTITUTE : SIDDHARTH COLLEGE ( Institute Id - 23750038 ), Block- BELHA, District- BILASPUR
    ENROLLMENT NO : ENROLLMENT DATE : 31-08-2022
    ADMISSION TYPE : Merit Basis ADMISSION DATE : 05-09-2023
    MODE OF STUDY : Regular Course
    COURSE : B. C. A. (3 Year Course) / Branch- Computer Application / Year- 3rd Year

    Current Course's Last Year Exam Details


    COURSE YEAR : 2nd Year LAST EXAM RESULT (%) : [ PASS ] 63.12

    Previous Completed Course Details


    COURSE/ BRANCH/ YEAR/ PERCENTAGE : B. C. A. (3 Year Course)/ Computer Application/ 2020/ 73.28%

    SSC (10th Class) Details


    BOARD NAME : CGBSE YEAR OF PASSING : 2017
    ROLL NUMBER : 1173102599 PERCENTAGE : 50.60 %

    HOSTELLER OR DAY SCHOLAR : DAY SCHOLAR ANNUAL INCOME : 100000

    3.Bank Details:
    BANK NAME : UCO BANK BRANCH NAME : PARSADA BRANCH BILASPUR
    IFSC CODE : UCBA0003315 ACCOUNT NUMBER : 33150110030530

    4.Contact Details:
    CORRESPONDANCE ADDRESS : PERMANENT ADDRESS :
    DISTRICT NAME - BILASPURBLOCK NAME - HIRRI MINS, CHAKARBHATHA, Postoffice-
    TAKHATPURVIDHANSABHA NAME - Chakarbhata Camp S.O, City/Village-
    TAKHATPURHOME ADDRESS - HIRRI MINS, Chakarbhatha, Block- TAKHATPUR, District-
    CHAKARBHATHACITY NAME - CHAKARBHATHA, BILASPUR, Pincode- 495220
    Block- BELHA, District- BILASPUR

    5.Caste Certificate Details:


    Page 1 of 2 Generated by Chhattisgarh State Scholarship Portal on dated 09-Feb-2024
    RENEWAL APPLICATION Government of Chhattisgarh
    State Scholarship Portal
    Application Form for Year 2023-24
    Scheme : Post Matric SC Scholarship
    APPLICATION ID : 23324097 STUDENT ID : 12237510317
    APPLICATION DATE : 09-02-2024 VERIFICATION CODE : 18591 IP ADDRESS : 103.199.200.145

    IS AVAILABLE ONLINE : No CERTIFICATE NUMBER : 0704011625003497 CERTIFICATE DATE : 31-08-2016

    6.Domicile Certificate Details:


    IS AVAILABLE ONLINE : No CERTIFICATE NUMBER : 070711625004000 CERTIFICATE DATE : 09-07-2016

    7.Income Certificate Details:


    IS AVAILABLE ONLINE : Yes CERTIFICATE NUMBER : 0706012225038298 CERTIFICATE DATE : 19-10-2022

    Declaration From Student and his/her Parent - ]ȯ‘€fȲ”ȡ›€€ȧƒȪŸŽȡ


    1. We, PRIYANKA MAHILANGE D/o GANESH RAM and GANESH RAM hereby declare that board roll no,
    caste certificate and income certificate, bank account details and all other information given in the application
    form is complete and correct. We have not submitted any other application for scholarship for current academic
    year in any other institution in India. We also undertake that, if any information given above is found to be false
    at any stage, entire amount of scholarship will be recovered and competent authority will be free to initiate legal
    penal action against us.
    ¡˜PRIYANKA MAHILANGE D/o GANESH RAM kšGANESH RAM ƒȪŸŽȡ€šȯ¡ɇǑ€¡˜ȡšȯƮȡšȡĤ‘ȡ™`”šȪƠ
    ‡ȡ“€ȡšȣfȲ€¢ȡȢȲ”šȣ¢ȡ€ȧ˜ȡ€[žȢŠ‡ȡǓȡ]™Ĥ˜ȡŽ”ğ–ɇ€f€ȡ`ȲŠȡ\ۙǒšŽ”ǗŽ[Ǿ” ȯ ¡ȣ¡ɇ@
    ]ȯ‘€Ʈȡšȡ—ȡš˜ɅǑ€ Ȣ—Ȣ\ۙ†ȡğǙǒƣ€ȯǓ›f]ȯ‘““¡ȣȲǑ€™ȡ‚™ȡ¡Ȱ@¡˜™¡ “‘ȯȯ¡ɇǑ€™Ǒ‘`”šȪƠĤ‘ȡ™
    ‡ȡ“€ȡšȣǑ€ Ȣ—Ȣ菚”š\ י”ȡ_‡ȡȢ¡ȰȪ†ȡğǙǒƣ€ȧ”ǗšȣšȡǓž€ȧ Ǘ›Ȣ€ȧ‡ȡf‚ȢfȲ ¢˜ĤȡǓ’€ȡšȣƮȡšȡ¡˜ȡšȯ
    ǔ›ȡ•€ȡ“Ǘ“Ȣ‘ȲŒȡט€€ȡ™[ȡ¡ȣ€ȧ‡ȡ €Ȣ¡Ȱ@

    Signature of Parent Signature of Student

    Check List
    Document to be attached :-

    1. Caste Certificate issued from the competent authority.


    2. Residential Certificate
    3. Income Certificate from the concerned authorized authority/Persons
    4. H.S.C. Certificate (Photo Copy) Attested by Competent authority
    5. Photo Copy of the first page of Bank Passbook having account no
    6. Last Year Mark Sheet

    Page 2 of 2 Generated by Chhattisgarh State Scholarship Portal on dated 09-Feb-2024

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