Application for Merit-cum-Means Fellowship (Stipend, Tuition Fee Exemption and Book

Allowance)
To
The Anti-Discrimination Officer
Equal Opportunity Cell
EFL University, Hyderabad
Photo
Sir/Madam
I wish to apply for the Welfare Grant for the academic year 2021-22.

The following are my details:

1) Name (In Block Letters ) :

Contact No. :
E-Mail ID :
Bank Details : Name of the Bank
Branch
Type of Account
Account No.
IFSC

2) a) Father’s Name :
b) Mother’s Name :
c) Gender : Male Female

3) Percentage of marks / grade obtained

Name of the Programme Percentage of marks*
UG Programme Course Semester Marks* GPA

PG Programme Course Semester Marks* GPA

*Students admitted to semester 1 of a programme are required to enter

the marks obtained at the Entrance Test.
DD MM YYYYY
4) Date of Birth :

5) Nationality :

6) Category (as applicable) : Gen OBC SC ST PWD

7) Programme of study :

Academic Year : 2021-22

Semester I II III IV V VI

1
 8) Semester examination
(Certificates to be enclosed) : Semester Year of
Passing
Passed
Failed

9) Assistance sought for (as applicable) :

Hostel Resident Day Scholar

a. Stipend a. Tuition Fee Exemption
b. Tuition Fee exemption b. Book Allowance
c. Book Allowance

10) Whether receiving any other :

Fellowship/Stipend/Scholarship (Provide details
with relevant document)

11) Did you avail this benefit earlier? :

and if yes, the year (Provide details
with relevant documents)

12) Father’s /Mother’s /Guardian’s Occupation :

13) Annual/Monthly Income :

14) Any other relevant information :

I declare that I am a full-time registered student of the EFL University and I am not
employed anywhere. The information I have given above is true and correct to the best of
my knowledge. I have read the rules regarding the financial assistance requested and I
agree to abide by them.

Date: Signature of the Student

HOD Dean Provost

List of Documents enclosed:

 A Copy of ID Card
 Proof of residence in University Hostels & Bona Fide Certificate
 Latest Caste Certificate (SC,ST,OBC from a Competent Authority/MRO/RDO/Tahsildar)
 Latest Income Certificate of parents (from a Competent Authority/MRO/RDO Tahsildar)
 A copy of the previous semester’s grade card.
(The copies of the certificates should be self-attested)
 A copy of the Aadhar Card
 A photocopy of the Savings Bank Account Pass Book (only the First Page )

For Office Use

Recommendation:

Anti-Discrimination Officer Chairperson

Equal Opportunity Cell Grants Committee