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SCHOLARSHIP

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networkak7
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3 views

SCHOLARSHIP

Uploaded by

networkak7
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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SS THE INSTITUTE OF MANAGEMENT – Tedhi bazaar,


Ghazipur - 233001
We would like to learn a little bit more about you.

APPLICATION DATE ______________________________

REGISTRATION NO _______________________________
PHOTO
COURSE NAME __________________________________________________________

STUDENT NAME __________________________________________________________

FATHER’S NAME __________________________________________________________

MOTHER’S NAME __________________________________________________________

APPLICATION DETAILS

AADHAR NO _____________________________________________________________

GENDER _________________________ D.O.B. ______________________________

RELIGION _________________________ CITIZENSHIP _________________________

MARITAL STATUS __________________________________________AGE_________________________________

E-MAIL ADDRESS _______________________________________________________________________________

CONTACT NO (linked with aadhar) ________________________________ IInd CONTACT ______________________________

YES/NO
CAST CATEGORY ___________________ Is Resident of Uttar Pradesh ______________________________________

CAST CERTIFICATE NO __________________________ INCOME CERTIFICATE NO ___________________________

FATHER ANNUAL INCOME ________________________________________________________________________

LANDMARK _______________________ STATE _____________________DISTRICT __________________________

TAHSHIL _______________________ BLOCK_____________________ ZIP CODE __________________________

APPLICANT QUALIFICATIONS
AK
LAST ATTENDED SCHOOL/COLLAGE/INSTITUTE _______________________________________________________

HIGH SCHOOL MARKS ______________________BOARD __________________PASSING YEAR _________________

INTERMIDIATE MARKS ______________________ BOARD __________________PASSING YEAR _________________

* Have you read and understand the instructions


Linked to above? Yes, I have
Authorized Signature Student signature:

Note: Along with this form, attach photocopy of your Aadhar Card, Income Certificate, Caste Certificate, Residence Certificate , & Qualification
Certificate .

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