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    ApplicantForm PDF

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    Salman Raza
    This document is an application for a post-matric scholarship from the government of Chhattisgarh for the year 2018-2019. It contains personal details of the applicant such as name, father's name, date of birth, category, Aadhar number, and academic details including the name of the institution and course enrolled in. It also includes details of the applicant's family income, bank account, contact information, and a declaration signed by the applicant and his father confirming the accuracy of the information provided. Documents to be attached with the application are also listed.

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    © All Rights Reserved
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    ApplicantForm PDF

    Uploaded by

    Salman Raza
    120 views2 pages
    This document is an application for a post-matric scholarship from the government of Chhattisgarh for the year 2018-2019. It contains personal details of the applicant such as name, father's name, date of birth, category, Aadhar number, and academic details including the name of the institution and course enrolled in. It also includes details of the applicant's family income, bank account, contact information, and a declaration signed by the applicant and his father confirming the accuracy of the information provided. Documents to be attached with the application are also listed.

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    This document is an application for a post-matric scholarship from the government of Chhattisgarh for the year 2018-2019. It contains personal details of the applicant such as name, father's name, date of birth, category, Aadhar number, and academic details including the name of the institution and course enrolled in. It also includes details of the applicant's family income, bank account, contact information, and a declaration signed by the applicant and his father confirming the accuracy of the information provided. Documents to be attached with the application are also listed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    120 views2 pages

    ApplicantForm PDF

    Uploaded by

    Salman Raza
    This document is an application for a post-matric scholarship from the government of Chhattisgarh for the year 2018-2019. It contains personal details of the applicant such as name, father's name, date of birth, category, Aadhar number, and academic details including the name of the institution and course enrolled in. It also includes details of the applicant's family income, bank account, contact information, and a declaration signed by the applicant and his father confirming the accuracy of the information provided. Documents to be attached with the application are also listed.

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    © All Rights Reserved
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    Fresh Application Government of Chhattisgarh

    State Scholarship Portal 2.0


    Application Form for Year 2018-19

    Scheme : Post Matric OBC Scholarship

    Unique Applicant ID: 1522353 Application ID: 10094672

    Version No: 1 Verification Code: 62950 Lock Date: 14/03/2019 IP Address : 122.168.88.165
    1. Personal Details
    Name : MANOJ KUMAR YADAV Gender : Male

    Father's Name : RUKHAMANASAHU Mother's Name : ANUSUIYA


    Date of Birth : 24/05/1999
    Category : OBC Aadhar No: ********4159

    2. Academic Details Admission Date : 09/07/2018

    Institute : [1797]-Mahant Laxmi Nara. Das College Raipur,Dharsiwan [Raipur]


    Course : [1077]-Commerce-B. Com.-1st Year Enrollment No : RESN1069201
    8
    10th Class Details: State Board /2016-2017 /1161820629 Last Exam Result % : [PASS]58.00

    3. Hostel Status
    Hosteller : No

    4. Total Annual Family Income


    Annual Family Income from all Sources: Rs.65000/-

    5. Bank Details :
    IFS Code of Branch : BARB0SANNAG Account Number : 57430100003613

    6. Contact Details :
    Correspondence GOKUL NIWAS BORIYAKHURD RAIPUR Permanent GOKUL NIWAS BORIYAKHURD
    Address CHHATTISGARH, DISTRICT :- Raipur , Address RAIPUR CHHATTISGARH, DISTRICT :-
    STATE :- Chhattisgarh , PIN CODE :- Raipur , STATE :- Chhattisgarh , PIN
    492013 CODE :- 492013

    Contact Numbers : 7000330100 Email Address : MANOJS90901[AT]GMAIL[DOT]


    COM

    ]ȯ‘€fȲ”ȡ›€€ȧƒȪŸŽȡDeclaration From Student and his Parent

    1. We, MANOJ KUMAR YADAV S/o RUKHAMANASAHU and RUKHAMANASAHU hereby declare that
    Board Roll No, caste certificate and income certificate, bank account details and all other information
    given in the application form is complete and correct. We have not submitted any other application for
    scholarship for current academic year in any other institution in India. We also undertake that, if any
    information given above is found to be false at any stage, entire amount of scholarship will be recovered and
    competent authority will be free to initiate legal penal action against us.

    ¡˜MANOJ KUMAR YADAV S/o RUKHAMANASAHU kšRUKHAMANASAHU ƒȪŸŽȡ€šȯ¡ɇ


    ͩ€`”šȪƠ‡ȡ“€ȡšȣ ¡ȣ¡ȰfȲ€¢ȡCB–ȪŒ[”šȣ¢ȡ€ȧ˜ȡ€[žȢŠ‡ȡǓȡ]™Ĥ˜ȡŽ”ğ–ɇ€\€ȡ`ȲŠȡ\ۙͪšŽ”ǗŽ[fȲ ¡ȣ¡Ȱ@
    ]ȯ‘€“ȯ”ȪŠ[›”š^  ğ˜ȯè€Ȫ›šͧž”€ȯͧ›f€ȯ›f€¡ȣ]ȯ‘“ͩ€™ȡ¡Ȱ@\‚š`”šȪƠ‡ȡ“€ȡšȣ‚›”ȡ_‡ȡȢ¡ȰȪ™¡]ȯ‘“
    Ǔ“šè¡Ȫ‡ȡȯ‚ȡfȲšȡͧžȡͪ” ›ȣ‡ȡȯ‚ȢfȲ¡˜ȡšȯͨ›ȡ•€ȡ“Ǘ“Ȣ€ȡ™[ȡ¡ȣ€ȧ‡ȡȯ‚Ȣ@

    Page 1/2 Generated by Chhattisgarh State Scholarship Portal as on 14/3/2019


    Fresh Application Government of Chhattisgarh
    State Scholarship Portal 2.0
    Application Form for Year 2018-19

    Scheme : Post Matric OBC Scholarship

    Unique Applicant ID: 1522353 Application ID: 10094672

    Version No: 1 Verification Code: 62950 Lock Date: 14/03/2019 IP Address : 122.168.88.165

    ™Ǒ‘]”‚›Ø™ɉ€ȯ]’ȡš”š†ȡğǙǓ›ȯȯ¡Ǖ]”ȡf‚™ȯȪ¡˜ȡšȣ†ȡğǙͪƣǓ“šè€š‘ȣ‡ȡȯ‚Ȣȡ†ȡğǙͪƣ€ȧǔ‡“Ȣš€˜‘ȣ‚_
    ¡Ȱ` ȯȡ” ›ȯ›ȣ‡ȡȯ‚Ȣ)^ š¡€ȯͩЙȡ€›ȡ” ȯ ˜ǔےͪ’ȡȸ€Ȫ¡˜ȯžȡ€ȯͧ›fͩ€ Ȣ—Ȣ™Ȫ‡“ȡ€ȯ\ۏ‚[ͩ€ Ȣ—Ȣ†ȡğǙͪƣ
     ȯͪǔ‡[
    ŒȢȡš €šǑ‘™ȡ‡ȡ™ȯ‚ȡȡͪ’ȡȸ€Ȫ€ȡ›ȣ Ǘ…Ȣ
    ޛȰ€ͧ›èŠ ˜ɅŒȡ›Ǒ‘™ȡ‡ȡ™ȯ‚ȡȡ†ȡğǙͪƣèȢ€Ǚ€ȡ[\ͬ’€ȡšȣ\ȡ
    \ۙ ¢˜\ͬ’€ȡšȣ]æ™€ ˜ˆȯ‚ɅȪ` €ȯͪǽڑ—ȡšȢ™‘ÖŒ ȲǑ¡ȡ€ȧ’ȡšȡjȲfȲ€ȯ¡
    f•]_]š‘‡[€šȡ_‡ȡ€š É€ȡ™[ȡ¡ȣ€ȧ‡ȡȯ‚Ȣ)
    ˜ɇ€Ȫ [”ǗŽ[¡Ȫ“ȯ€ȯ”¡›ȯ€Ȫ [ Ȳèȡ†Ȫ°‘ȯȡ‘ȯȢ¡ǗȱȪ™¡˜ȯšȣ”ǗŽ[ǔ‡à˜ȯ‘ȡšȣ¡Ȫ‚Ȣ€ȧ˜ȯšȯƮȡšȡ”Ǘ[˜Ʌ Ȳ–Ȳͬ’€Ȫ [€ȯͧ›™ȯĤȡƯ
    †ȡğǙͪƣžȡ “€Ȫ Ȳ–Ȳͬ’ǔ‡›ȡ€ȡ™ȡ[›™€ȯ˜ȡڙ˜ ȯ…ȡ›ȡ“ ȯȡ” €š‘Ǘȱ‚ȡ‘ǗȲ‚Ȣ)†ȡğǙͪƣȡ” “€š“ȯ€ȧǔèǓ˜Ʌžȡ “˜ȯšȯ
    ͪǽƨ€Ȫ_—Ȣ€ȡ™[ȡ¡ȣ€š“ȯ€ȯͧ›™ȯ蝏Ȳğš¡ȯ‚ȡ)

    (Signature of Parent / ”ȡ›€ͪ”ȡ€ȯ¡èȡ¢š Date (Signature of Student / ]ȯ‘€€ȯ¡èȡ¢š

    Check List
    Document to be attached : -

    1. Caste Certificate issued from the competent authority


    2. Residential Certificate
    3. Income Certificate from the concerned authorized authority/Persons
    4. H.S.C Certificate (Photo Copy) Attested by Competent authority
    5. Photo Copy of the first page of Bank Passbook having account no
    6. Last Year Mark Sheet

    (Signature of Student / ]ȯ‘€€ȯ¡èȡ¢š

    Page 2/2 Generated by Chhattisgarh State Scholarship Portal as on 14/3/2019

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