II ivaVa ivanayaona SaaoBato II

Janardan Bhagat Shikshan Prasarak Sanstha’s

CHANGU KANA THAKUR
ARTS, COMMERCE AND SCIENCE COLLEGE, NEW PANVEL (AUTONOMOUS)
Re-accredited ‘A+’ Grade by NAAC
‘College with Potential for Excellence’ Status Awarded by University Grants Commission
‘Best College Award’ by University of Mumbai

Scholarships under Rashtriya Uchchatar Shiksha Abhiyan (RUSA) Grant

Academic Year 2023 - 2024
Application for General Scholarship of Rs.500/- by the College under RUSA Grant

Class: PRN No. College ID No.

Personal Information:
Full Name:
(Surname) (First Name) (Father’s/ Husband’s Name) (Mother’s Name)

Gender: Male / Female / Other

Communication Address:
Flat/Room No./Block No.: Building/Village:
Road/ Street/ Post Office: Taluka:
District: State: Pin code:
Applicant’s Mobile No.: Email-id:

An Undertaking
All information given in this application is valid to best of my knowledge. The decision
given by the competent authority will be final and will be accepted by me. I hereby certify that,
the information provided is true and they are not false or fake. I am fully responsible for the false
or fake surveillance of the attached documents.

Student’s Signature
Recommended by

Class Teacher Dr. Shailesh Vajekar Prof. (Dr.) S.K. Patil

Coordinator Principal
Scholarship Monitoring Committee Changu Kana Thakur
Arts, Commerce and Science College,
New Panvel (Autonomous)
Note:
1. Attach photocopy of AADHAAR Card.
2. Attach the photocopy of college Identity Card