Swami Vivekanada Merit-cum-Means Scholarship

YEAR GAP CERTIFICATE

I, Mr./Ms./Mrs. SRIJITA BHOWMIK, Registration. No.WB3231704526309, Roll No. 3108211111,

Son/Daughter of Mr./Mrs. SATYAJIT BHOWMIK do hereby solemnly state & affirm as under:-

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1. That I have passed HIGHER SECONDARY/EQUIVALENT class in the year 2022 from West
Bengal Council of Higher Secondary Education.

4.
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2. I got admission in Haldia Institute of Technology in the Year 2023 in the Department of
B.TECHto pursue COMPUTER SCIENCE & ENGINEERING (DATA SCIENCE) Programmeof 4.00
Years .
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3. I declared that during the GAP Year/s of 2022 to 2023 ,
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(tick any one)

(a) I did not take admission in any educational institute/college/school/university due to: Poor
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Financial Condition / Poor Health Condition(Medical Reason) / Preparation for Entrance

Examination to pursue Higher Studies after passing HIGHER SECONDARY/EQUIVALENT
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(b) I took admission (which I did not continue) in an educational

institute/college/school/university namely
_________________________________________________________________________ to pursue
_____________________________________________ course after passing qualifying exam from
___________________ to _______________________ and did not avail any Government
Scholarship/Financial Assistance.

(c) I took admission (which I did not continue) in an educational

institute/college/school/university namely
_________________________________________________________________________ to pursue
_____________________________________________ course after passing qualifying exam from
___________________ to _______________________ and availed Government Scholarship/Financial
Assistance from ___________________________________________ (Department) for an amount of Rs.
_______________________ .

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4. All above information furnished by me are true and genuine.

SRIJITA BHOWMIK SATYAJIT BHOWMIK

______________________________________ ______________________________________
Signature of Scholar Signatute of Parent

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__________/___________/_________________ __________/___________/_________________

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Date Date

4.
Verification:-

Verified that the contents of the above said declaration supported by the document(s)
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submitted on ________________ by the student are true and correct to the best of my
knowledge and belief and nothing has been concealed or misrepresented therein.
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______________________________________
__________/___________/_________________ ______________________________________
Signatute of HOI (With
Date Place
Stamp)
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