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Scholarship Form

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shahabuddin khan
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31 views2 pages

Scholarship Form

Uploaded by

shahabuddin khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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SCHOLARSHIP FORM

Scholarships Applied for:


1. ----------------------------------------------------------------------------------------------
2. ----------------------------------------------------------------------------------------------
3. ----------------------------------------------------------------------------------------------
4. ----------------------------------------------------------------------------------------------
5. ----------------------------------------------------------------------------------------------

1. Name:______________________________Dept.:________E-mail: _______
(Block letters)
2. Father’s Name:________________________________Category : GN/SC/ST

3. Guardian (if any) Name:______________________Relationship:__________

4. Reasons for being under Guardianship, if other than father:_______________

5. Scholarship/Financial Assistance/Loan etc. received from any source last year:

Name of Scholarship / Awarding Period for which Amount per Total Whether likely to be
financial Assistance / Authority awarded month Amount renewed for 2006-07
Loan Drawn
i)
ii)

6. Grade in Previous Semesters:

Academic year 1st Semester 2nd Semester CPI


2003-04
2004-05
2005-06
2006-07

7. Extra Curricular Activities:

8. Annual Income of parents through all sources:

Signature of Student: ____________________ Date: ________________


NOTE:

1. Please enclose parent’s annual income certificate:


a) Wards of salaried person (both government and private) should
enclose Form-16, Form Saral or Income tax return of year 2005-06.
b) Wards of Businessmen / Agriculturist (Income affidavit from court in
Rs. 10/- stamp paper for year 2005-06).

2. Please enclose photocopy of Grade-sheet.


3. Incomplete forms will not be considered and no correspondence will be
made in this respect.

4. The forms are attached in the mail. Please download the forms and fill
it up. Last date of submission of the forms duly filled will be January
31, 2007.
5. For all future notifications please look up the notice board outside of
the DOSA office.

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