Shivaji University,Kolhapur

"Shivaji University Merit Scholarship"

Application for General Category Scholarship
To,
The Registrar,
Shivaji University,Kolhapur. 416004
Subject : - Application for General Category Scholarship under "Shivaji University Merit Scholarship" for Academic
year 2022-2023
Respected Sir / Madam,

I am applying for for General Category Scholarship under "Shivaji University Merit
Scholarship" for Academic year 2022-2023.My personal information is as below-

Application ID : 439

Year : - 2022

Student Full Name : - JAIN RAHUL RAJKUMAR

Student PRN : - 2021075730 Gender : - Male

Postal Address : - Plot No.188, Near Naag Mandir, Mahaveer Nagar, Ranala Kamptee, Nagpur.

City : - Kamptee District : - Nagpur PinCode : - 441001

Mobile No. : - 7620169780 E-Mail : - rahulrajkumarjain5@gmail.com

Phone No. : - 7620169780

Aadhar Card No. 694439690912 Voter ID No. : - WYR9509258

Last year qualified Exam / Class and College/Department Details : -

Course : - Bachelor Of Technology-(Cr.) Part : - 1

Marks Obtained : - 1355 Marks Out of : - 1600 Percentage : - 84.69

Subjects : - -,-,-,-
Name of College /
Shivaji University,Kolhapur
Recognised Instituion /
Department : -
Place of College : - Urban
Current Year Course Details

Course : - Bachelor Of Technology-(Cr.) Part : - 2

Subjects : - -,-,-,-

Name of College / Shivaji University,Kolhapur

Recognised Instituion /
Department : -

Applied for any Other

Yes- 1
Scholarship : -

Bank Details

Account No. : - 33706782968

Bank Name : - STATE BANK OF INDIA

Branch Name : - KAMPTEE

ISFC Code: - SBIN0000400

MICR Code: - 440002019

Account Type. : - Saving

Information provided above is true to my knowledge and belief. If found otherwise appropriate action may be
taken. Kindly consider my application.

Place : -
Student Signature
Date : -
(Name:JAIN RAHUL RAJKUMAR)

Principal/In charge of the Institution/Head of Department

Seal & Signature
 Declaration Letter
I Mr./ Ms.____________________hereby declare that I have taken admission as a regular student in the Academic
Year 20 -20 I have applied for General category scholarship under Shivaji University Merit Scholarship. I will
complete the course as a regular student I declare that given above information is true and correct. If it found
otherwise or if you get adverse report regarding my presenty in classroom , I will surrender the total Scholarship
amount in single instalment.

Place: Signature of Student:

Date: (Name:JAIN RAHUL RAJKUMAR)

Certificate of College/Recognized Institution/ Department

I found the information furnished by Mr./ Ms. in his/ her application form is true and
correct. The present student has taken admission as regular student during the academic year 20 -20 in class
in college/ Recognized Institution/ Department. The student is regular and bears a good moral character. The student
has also been informed that if university gets or finds adverse report about his/ her presenty and behavior in the
classroom, he/ she has to return the certificate and the scholarship amount to the university.

Place:
Date:
Principal/In-charge of the Institution/
Head of Department
Seal & Signature

Advance Stamp Receipt

I received the amount of Rs. (In Words ) as General
category Scholarship under “Shivaji University Merit Scholarship” from ‘Finance and Accounts Officer.

Details of Bill Rs.

General Scholarship under "Shivaji University Merit

Scholarship"

Total : -

Student Signature

(Name:JAIN RAHUL RAJKUMAR)

Enclosed Documents : -

1. Attested copy of last Examination Marksheet

2. Attested copy of Nationalised Bank Passbook linked with Aadhar Card
3. Attested copy of Aadhar Card
4. Attested copy of Voter ID Card