I wish to apply for scholarship of Rs. for pursuing my higher studies as detailed and submit below the required information.

Name(Mr./Mrs.):

Date of Birth:

Age

Gender

Nationality

Caste General OBC SC ST NT

Religion

Father's Name

Family Income

Permanent Residential Address

Phone No.

Present Postal Address

Phone No.

Email ID

Name of the Institution

University/Board Affiliation

Degree Course admitted to

Duration of the Course (In Years)

Whetherthe student is getting subsidy/scholarship /financial assistance fromother Institution / State or Central Government : Yes/ No If yes Amount Rs

Self Finance

Amount of Scholarship required

How did you finance the education till now ?

Passport Photo