Application Form (Post Matric Scholarship To SC/ST/OBC 2012-13)

APPLICATION FORM (Post Matric Scholarship to SC/ST/OBC 2012-13)
Closing Date:- 30-09-2012 Eligible students are advised to submit their application in the prescribed format to their respective schools/colleges/institutes Heads along with the following documents. Individual application of students will not be entertained. 1. One copy of the passport size photograph with signature of the students thereon. 2. One attested copy of certifications, diploma degree etc. in respect of the last examination passed. 3. Attested copy of caste certificate issued by competent authority should be attached with application, Domicile Certificate of Delhi, if the caste certificate is not issued by the competent authority of Govt. of N.C.T of Delhi. 4. (i) For family income latest salary slip in the case of parent/guardian in government service and an affidavit from notary regarding other source of family income. (ii) Income declaration by way of an affidavit on non-judicial stamp paper in the case of parent/guardian in private job/service. 5. Hostellers certificate from competent authority. (if hosteller) 6. Fee receipt & fee structure from college. APPLICATION FORM (i) (ii) (iii) (Iv) Name & Roll No. of student:.. Date of Birth of Student.. Name of Father/Guardian:.. Residential Address & Phone No (iv) (v) (vi) (vii) (ix) (x) Yearly Family Income:... Class in which he/she studying:.. Hosteller/Day Scholar: Category (SC/ST/OBC):.. Whether availed this scholarship last year. Nature of disability in the case of handicapped students Affix Passport size photo of student duly Signed by him/her Signature
In case of handicapped students, particulars of additional allowance as per eligibility should be filled in and photocopies of supporting documents/vouchers should be attached to the application form in an envelope. (i) .... (ii) (iii) (iv) .... Certified that the information given above is true to the best of my knowledge & belief. If any state, it is found that the information given by me is false, the scholarship granted to me could be withdrawn and legal action as deemed fit, may be taken against me. Date: Place: Signature of the student
The concerned College/Institute Heads may for ward all the application received from the eligible students along with the consolidated statement prescribed below. Consolidated Statement (Post Matric Scholarship) (SC/ST/OBC) (2012-13) 1. Name & Address of the School/College/Institute___________________________________________________ 2. Contact No._______________________ 3. E-mail address:_______________________________________________________ ___________________________________________________________________________________________ Sl. Name & Roll No. D.O.B. of Class in which Fathers/Guardians No. of the student Student presently studying Name 1 2 3 4 5 --------------------------------------------------------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------Family Income Hostellers/ Rate of Category Date of Remarks, Per annum Day Scholars Scholarship Admission if any 6 7 8 9 10 11 --------------------------------------------------------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------Certified that the above information particularly in respect of income of family and caste status of the students have been verified on the basis of supporting documents produced by the parents/guardians of the student. NOTE:1. Certified that the above particulars have been checked with the office record and found correct. 2. Certified that no eligible student studying in the school is left out for grant of scholarship and this list may be treated as final. 3. Certified that the SC/ST/OBC/certificates in respect of all the students have been issued by the competent authority along with Domicile Certificate of Delhi, if required. 4. Certified that the scholarship or the stipend holders named above have been regular in attendance and have confirmed to the rules under which their scholarship of their stipends are granted. 5. Certified that the scholarship drawn on the last time with the exception of those refunded by deduction have been paid to the right persons and their receipt taken in acquaintance forms have been forwarded to Dy. Director SC/ST. 6. Certified that the amount has been disbursed to the eligible students in the presence of authorized person. 7. Certified that the eligibility of the student have been rechecked discrepancy is noticed/discrepancy noticed has been reported to the department vide letter no..Dated 8. Certified that the student is not in receipt of the scholarship under the recently launched scheme by the Govt. of India i.e. Central Sector Scholarship Scheme of Top Class education (June, 2009) 9. Certified that attested copy of fee structure (specify compulsory and noncompulsory fee) approved by Centre/state Govt. is attached.
Signature with seal of The Principal/Head of the School
ELECTRONIC CLEARING SERVICE Particulars of Student (To be submitted in duplicate)
1. Name of the Student: (along with full postal address & PIN code) 2. Name of the College/Institute: (along with full postal address & PIN code) 3. Telephone No. :. 4. E-mail ID. :... Particulars of Bank Account (Please attach a photo copy of cheque) 5. Bank A/c operated by: 6. Bank Name:. 7. Branch Address:.. 8. Bank Telephone No.:. 9. M.I.C.R. (9 digit number):.. 10. Bank A/c type (Saving/Current): 11. Bank A/c Number:...
Signature of the Bank account operator
Dated:
ELECTRONIC CLEARING SERVICE Particular of College/Institute (To be submitted in duplicate)

1. Name of College/Institute: (along with full postal address & PIN code) 2.College/Institute Code No. (New):... 3. College/Institute Telephone No.:... 4. College/Institute E-mail ID Particulars of Bank Account (Please attach a photo copy of cheque) 5. Bank A/cooperated by (Whether Principal/D.D.O. may be specified).......................... 6. Bank Name:... 7. Branch Address:. 8. Bank Telephone No:..... 9. M.I.C.R. (9 digit number):. 10.Bank A/c type (Saving/Current):.. 11. Bank A/c Number:
Signature of the Bank account operator with official seal..
Dated :

Application Form (Post Matric Scholarship To SC/ST/OBC 2012-13)

Uploaded by

Copyright:

Available Formats

Application Form (Post Matric Scholarship To SC/ST/OBC 2012-13)

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Application Form (Post Matric Scholarship To SC/ST/OBC 2012-13)

Uploaded by

Copyright:

Available Formats

APPLICATION FORM (Post Matric Scholarship to SC/ST/OBC 2012-13)

Signature with seal of The Principal/Head of the School

ELECTRONIC CLEARING SERVICE Particulars of Student (To be submitted in duplicate)

Signature of the Bank account operator

ELECTRONIC CLEARING SERVICE Particular of College/Institute (To be submitted in duplicate)

Signature of the Bank account operator with official seal..

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.