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 (RENEW)
APPLICATION FOR WB SVMCM SCHOLARSHIP 2023-24
Application ID: SSP2021050300597918 Application Date: 28-12-2023
BASIC INFORMATION
Student's Name: SK ANAS ADNAN Father's Name: SK AKBAR ALI
Date of Birth: 18-10-2003 Mother's Name: SHABANA BEGAM
Gender: Male Annual Family Income: 72000
Marital Status: Unmarried Guardian's / Husband's Name: SK AKBAR ALI
E-mail Id: adnananas503@gmail.com Religion: Muslim
Mobile No: 6291738316 XXXXXXXX6230
Class X Registration No: 5181201917 Name as per Aadhaar: Sk Anas Adnan
ADDRESS INFORMATION
Permanent Address Present Address
Domicile State: WEST BENGAL State: WEST BENGAL
Domicile District: HOWRAH District:HOWRAH
Block/Municipality:Uluberia(MUNICIPALITY) Block/ Municipality:Uluberia(MUNICIPALITY)
Permanent Address: CHENGAIL, KALABAGAN Present Address: CHENGAIL, KALABAGAN
Post Office: CHENGAIL Post Office: CHENGAIL
Police Station: ULUBERIA Police Station: ULUBERIA
Pin: 711308 Pin: 711308
ACADEMIC INFORMATION
Previous Academic Information Present Academic Information
Previous Institute Name: PRABHU JAGATBANDHU COLLEGE Institution District :HOWRAH
Previous Class / Course Name: BACHELOR OF COMMERCE Institution Name: PRABHU JAGATBANDHU COLLEGE
(B.COM) Institution UDISE/AISHE/NCVT Code : C-12005
Previous Year of Study: 2nd Year Current Class / Course Name : BACHELOR OF COMMERCE (B.COM)
Name of the Board of Current year of Study :3rd Year
last Exam Passed: CALCUTTA UNIVERSITY Are you a Hosteller: No
Year of Passing Last Exam: 2023 Name of the Board / Council / University : CALCUTTA UNIVERSITY
% of Marks Obtained Course Duration : 3 Year
in Last Examination: 61.12
BANK ACCOUNT DETAILS
IFSC: PUNB0098220
Savings bank account no.: XXXXXXX7054

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.72000 . 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 SK ANAS ADNAN 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)