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    Application Form

    Uploaded by

    Vijayangg Viji
    1) This document is an application form for a scholarship provided by the Sitaram Jindal Foundation. It requests information from applicants such as name, address, family income, details of their course of study, fees, and a recommendation from their school or college principal. 2) The form collects personal details of applicants like their name, DOB, nationality, family contact information and annual family income. It also asks for details of their previous educational qualifications and the class/trade and institution they are currently studying at. 3) Applicants must provide documents like income certificate, marksheets and hostel receipts depending on the type of course they are pursuing. The principal is also required to fill a report

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Application Form

    Uploaded by

    Vijayangg Viji
    23K views2 pages
    1) This document is an application form for a scholarship provided by the Sitaram Jindal Foundation. It requests information from applicants such as name, address, family income, details of their course of study, fees, and a recommendation from their school or college principal. 2) The form collects personal details of applicants like their name, DOB, nationality, family contact information and annual family income. It also asks for details of their previous educational qualifications and the class/trade and institution they are currently studying at. 3) Applicants must provide documents like income certificate, marksheets and hostel receipts depending on the type of course they are pursuing. The principal is also required to fill a report

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    APPLICATION-FORM

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    1) This document is an application form for a scholarship provided by the Sitaram Jindal Foundation. It requests information from applicants such as name, address, family income, details of their course of study, fees, and a recommendation from their school or college principal. 2) The form collects personal details of applicants like their name, DOB, nationality, family contact information and annual family income. It also asks for details of their previous educational qualifications and the class/trade and institution they are currently studying at. 3) Applicants must provide documents like income certificate, marksheets and hostel receipts depending on the type of course they are pursuing. The principal is also required to fill a report

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    23K views2 pages

    Application Form

    Uploaded by

    Vijayangg Viji
    1) This document is an application form for a scholarship provided by the Sitaram Jindal Foundation. It requests information from applicants such as name, address, family income, details of their course of study, fees, and a recommendation from their school or college principal. 2) The form collects personal details of applicants like their name, DOB, nationality, family contact information and annual family income. It also asks for details of their previous educational qualifications and the class/trade and institution they are currently studying at. 3) Applicants must provide documents like income certificate, marksheets and hostel receipts depending on the type of course they are pursuing. The principal is also required to fill a report

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    Application Form for Scholarship

    FOR FOUNDATION USE ONLY


    (Not to be filled in by the student)

    APPLICATION NO: Category………… Max.Limit ……… No. of Scholarship


    Ref. No. : Sanctioned so far ………

    1. Name Mr./Miss………………………………………………….. 6. Amount of Scholarship Rs………………….. p.m.


    ………………………………………………………( ) (Rupees……………………………………………. per month)

    2. Studying in………………………………………………………… 7. Period of Scholarship……………… years……..months


    3. Duration of course ……………………. Years………………
    4. Last exam. Passed …………………………………( %)

    5. Family Income Rs………………… p.a. 1. 2. 3.

    Sitaram Jindal Foundation Annexure II


    11 Green Avenue, Bhatta Road, Behind Sector D-3, Vasant Kunj, New Delhi - 110 070
    Jindal Nagar, Tumkur Road, Bangalore - 560073
    Affix Passport
    (to be filled in by the student very carefully) Size Photograph
    attested by the
    Principal with
    1) Name in Full …………………………………………………………
    Seal
    (CAPITAL LETTERS- as per marksheet)

    2) Date of Birth : ……………………………… 3) Nationality: ……………………………………….


    4) Addresses with Pin Code (a) Present address and : ……………………………………………………………………..
    Telephone No. ……………………………………………………………………..
    ……………………………………………………………………..

    (b) Permanent address and : ……………………………………………………………………..


    Telephone No. ……………………………………………………………………..
    ……………………………………………………………………..

    5) Father’s/ Guardian’s name with phone number and : ……………………………………………………………………..


    email-id

    6) Are you physically handicapped or Ward/Widow of Ex- : ……………………………………………………………………..


    Serviceman (State Clearly)

    7) Occupation of Father/ Guardian & annual income of : ……………………………………………………………………..


    entire family from all sources Rs.……………………………………………………….…. p.a.

    8) Particulars of last examination passed : ……………………………………………………………………..


    Total marks & Percentage of marks obtained : …………………………..……% ………………………………

    9) Class/Trade in which studying at present : ……………………………………………………………………..


    Whether regular or part time or by correspondence ………………(Regular/ Part Time/Correspondence)

    10) Name, address and e-mail id of School/ College/ : …………………………………………………………………….


    Institute : ……………………………………………………………….……

    11) Duration of the Course : ………….. Years

    12) Month & Year of Final Exam of Course : ………. Month ……… Year

    13) Total annual fees : Rs.………………………………………. p.a.

    14) Whether staying in Hostel (only ITI & College Students) : Yes/No……………………………………………………………
    (If yes, what are the charges incurred per month) : Rs.………………………………………. p.m.

    P.T.O.
    15) Are you getting any stipend/ freeship/ scholarship : …………………………………………………………..Yes/No
    from any other source.
    If so mention source and amount. : Rs.…………………………………………………………. p.m.

    16) Have you applied previously to us for scholarship, Yes/ No Ref/ File No. …………..
    whether it was sanctioned, if so, reference/file No.
    17) Scholarship amount required : Rs.…………………………………………………………. p.m.

    18) Name and location of Bank branch along with full : ……………………………………………………………………
    details of the account of the Student. ……………………………………………………………………

    I hereby certify that the information disclosed by me is true. I agree to abide by the Terms and Conditions of the
    Foundation prevailing from time to time.

    …………………………………………… ………………………………………
    (Signature of Father/ Guardian) (Signature of the Student)
    Place :
    Date :

    Documents to be attached :
    For BPL Students : Photocopy of BPL Card duly attested by the Principal and copy ofMarks Card of previous
    (School Girls) & (College Boys & Girls) Examination

    For ITI students : In case student stays in hostel, submit payment receipts alongwith original Hostel Certificate/
    Letter from Warden duly attested by the Head of the Institution where studying.

    For College Students : 1) Photocopy of income certificate issued by competent authority duly attested by the Principal/
    (both graduate and post graduate) Head as per ANNEXURE-IV.
    2) Photocopy of the marks sheet of class X, XII and last qualifying examination passed duly
    attested by the Principal/ Head.
    3) In case student stays in hostel, submit payment receipts alongwith original Hostel Certificate/
    Letter from Warden duly attested by the Head of the Institution where studying.

    Additional documents to be attached in case of :


    (i) BPL student : Photocopy of BPL Card duly attested by the Principal/ Head.

    (ii) Physically Handicapped Students : Photocopy of the disability certificate issued by the competent authority duly attested by the
    Principal/ Head.

    (iii) Widows and wards of Ex-servicemen :


    (a) Attested photocopy of discharge book and PPO of the ex-serviceman
    (b) Attested copy of ex-serviceman/ widow identity card issued by Rajya/ Zila Sanik Board
    (c) Attested copy of relationship/ dependency certificate from OIC records.

    Please refer our website www.srjf.org for list of ITI trades, graduation & post graduation courses eligible and other conditions before filling up
    the form.
    (Attestation of the photograph by the Principal with Seal is must)

    Principal/ Head’s Report


    It is hereby certified that
    a) the particulars given by the student are correct as per the records of the School/ College/Institute.
    b) the student bears a good moral character.
    c) the student is/is not receiving financial assistance from any other source.
    d) the student is/is not physically handicapped/disadvantaged.
    e) our school/ institute/ college is Govt./ Govt. Aided or Private …………………………….. (State clearly)
    f) our school/ institute/ college is affiliated to ………………………………………………. Board/ University/Council
    g) number of students in school (class IX to XII)/ institute/ college is ………………………………………..Nos.
    h) the foundation shall be informed, if the student leaves studies.

    It is further recommended that the student may be awarded a scholarship f Rs………………… p.m. till
    ……………………………………….. (State month & year of last final exam of the course).

    Signature of School/ College/ ITI Principal with seal


    Date :

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