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    Directorate of Higher & Technical Education Application Form

    Uploaded by

    Tangha Muklom Kuncha
    This document contains an application form for Arunachal Pradesh Scheduled Tribe students to apply for stipends for the 2017-18 academic year. It requests information such as the student and parents' names, tribe, address, school and enrollment details, and bank account information. The student must provide documents like caste certificate, marksheets, ID card, and bank passbook. The form also includes an undertaking where the student agrees to rules like maintaining attendance and not taking other scholarships. The head of the institution must certify attendance, program details, and that the student has not applied for other scholarships. Only regular students of recognized schools are eligible and the application must be submitted by September 30.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Directorate of Higher & Technical Education Application Form

    Uploaded by

    Tangha Muklom Kuncha
    175 views3 pages
    This document contains an application form for Arunachal Pradesh Scheduled Tribe students to apply for stipends for the 2017-18 academic year. It requests information such as the student and parents' names, tribe, address, school and enrollment details, and bank account information. The student must provide documents like caste certificate, marksheets, ID card, and bank passbook. The form also includes an undertaking where the student agrees to rules like maintaining attendance and not taking other scholarships. The head of the institution must certify attendance, program details, and that the student has not applied for other scholarships. Only regular students of recognized schools are eligible and the application must be submitted by September 30.

    Original Description:

    stipend

    Original Title

    Stipend Form17

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    This document contains an application form for Arunachal Pradesh Scheduled Tribe students to apply for stipends for the 2017-18 academic year. It requests information such as the student and parents' names, tribe, address, school and enrollment details, and bank account information. The student must provide documents like caste certificate, marksheets, ID card, and bank passbook. The form also includes an undertaking where the student agrees to rules like maintaining attendance and not taking other scholarships. The head of the institution must certify attendance, program details, and that the student has not applied for other scholarships. Only regular students of recognized schools are eligible and the application must be submitted by September 30.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    175 views3 pages

    Directorate of Higher & Technical Education Application Form

    Uploaded by

    Tangha Muklom Kuncha
    This document contains an application form for Arunachal Pradesh Scheduled Tribe students to apply for stipends for the 2017-18 academic year. It requests information such as the student and parents' names, tribe, address, school and enrollment details, and bank account information. The student must provide documents like caste certificate, marksheets, ID card, and bank passbook. The form also includes an undertaking where the student agrees to rules like maintaining attendance and not taking other scholarships. The head of the institution must certify attendance, program details, and that the student has not applied for other scholarships. Only regular students of recognized schools are eligible and the application must be submitted by September 30.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    DIRECTORATE OF HIGHER & TECHNICAL EDUCATION

    GOVT. OF ARUNACHAL PRADESH


    ITANAGAR

    APPLICATION FORM
    FOR GRANT OF STIPEND TO ARUNACHAL PRADESH SCHEDULED TRIBE STUDENTS FOR THE ACADEMIC SESSION 2017-18

    Paste your recent


    Passport size coloured
    Photograph here
    (Do not use stapler)
    To be attested by Head of
    Institution

    PART-I

    1. Name of Student(in block letters) : _______________________________________________

    2. Fathers Name : _______________________________________________


    3. Mothers Name : ________________________________________________
    4. Tribe (APST) : ________________________________________________
    5. Address for Communication : ________________________________________________
    Post Office ___________City/Town_________ Pin _______
    District ______________State________________________
    Contact Number: ____________________
    6. Permanent Address : Post Office _________ City/Town ____________Pin _____
    District ________________State____________________
    Contact Number: ___________________
    7. Name of the last examination passed : _____________ %age of marks obtained____________
    8. Name of the course undertaking : ________________________________________________
    9. Year/Semester studying in : ________________Roll No. / Enrolment No. ____________
    10. Date of admission in the current
    Academic session : ________________________________________________
    11. Name & Complete Postal : ________________________________________________
    Address of Institution of ________________________________________________
    Institution City / Town________________________ Pin __________
    District ____________Sate _________________________

    12. SBI SB Account Details of the students : Name of Account Holder __________________________
    (Do not provide Tiny / Micro A/C No.)

    13. Aadhar Card No. :


    14. The following enclosures duly attested must be accompanied with this form.

    a. APST Certificate
    b. Mark sheet of the last examination passed
    c. Student Identity Card
    d. First page of SBI Saving Bank Account Passbook containing details of Account Holder Bank Account should
    be normal SB Account.
    e. Aadhar Card (Mandatory for grant of Stipend)
    f. Admission Receipt of student for current Academic session.


    Full Signature of Student
    FORM OF UNDERTAKING TO BE SUBMITTED BY THE STUDENTS FOR AWARD OF STIPEND

    I Mr./Ms._____________________________________________ a student of ___________________ (Course Name)


    ______________________ (Semester/Year) (Pass/Hons) bearing Roll No. _______________ of college/University
    _______________________________________________________ during the session _____________, do hereby
    solemnly declare that I will strictly adhere to the Rules & Regulations 2012 for grant of Stipend and undertake that:

    1. I shall secure 75% attendance in all subjects.


    2. I am not on Pay roll of any establishment on account of my employment.
    3. I have duly passed the last Board/ University Examination
    4. I shall abide by all the Rules and Regulation and maintain discipline in the Institution.
    5. My Bank account in SBI is normal Savings Account and is not Tiny / Micro Account.
    6. I have not applied for grant of Stipend/ Scholarship from any other sources.

    In case of non-fulfillment of the above condition and violation of stipend rules, my claim for stipend shall be rejected by
    the authority. Further, I shall inform the Principal of the college immediately if I get any employment with monetary
    benefit.

    Signature of Student ____________________


    Name of Student ____________________
    Roll No. ____________________
    Date ____________________

    PART- II

    CERTIFICATE TO BE COMPLETED BY THE HEAD OF INSTITUTION WHERE THE STUDENT IS STUDYING


    1. Do you recommend the award of Stipend : Yes / No
    2. Duration of course : ___________________________________
    3. Period of Academic Session : ___________________________________
    4. Date of joining of the Student in the Institution : ___________________________________
    5. State whether any disciplinary action is taken
    against the applicant : ___________________________________
    6. Institution affiliated to : ___________________________________
    (Specify the affiliated University/Board of council etc)
    7. %age of attendance (Mandatory) : ___________________________________
    8. The minimum qualification required for
    admission to this course. : ___________________________________
    Certified that he/she has not applied for grant of stipend / scholarship from any other source.

    Name & Seal of Head of Institution ____________________


    Round Seal of Institution Designation ____________________
    Signature ____________________
    Date ____________________

    Note Below:
    1. Duly filled up application form should be submitted to the Director, Higher & Technical Education, ESS-Sector,
    PO/PS- Itanagar, Pin - 791111 on or before 30th September.
    2. No application shall be received thereafter.
    3. Incomplete application form shall be summarily rejected. Therefore, candidates should take proper care while
    filling up of the application form.
    4. Stipend is granted to APST students who are studying on regular basis in recognized Institutions only. Students
    pursuing course in Distance Education Programme / Mode are not eligible for award of stipend.
    5. Student pursuing course relating of Medical and Para Medical and Skill development, ITI are to submit their
    application to concerned Department. Their cases shall not be entertained in the Directorate of Higher &
    Technical Education.
    6. SBI Bank account should be normal Savings Account and should not provide Tiny / Micro Account where more
    than Rupees Ten Thousand cannot be deposited.

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