West Bengal Minorities' Development and Finance Corporation

A statutory Corporation under Minority Affairs & Madrasha Education Department, Government of West Bengal
"Amber", DD/27E,Salt Lake City Sector-I, Kolkata-700064, Toll free No:-18001202130

AIKYASHREE (FRESH)
APPLICATION FOR WB POST MATRIC SCHOLARSHIP 2023-24
Application ID: SSP2023020102289122 Application Date: 26-09-2023
BASIC INFORMATION
Student's Name: SAHIN ALI SAPUI Father's Name: SOLEMAN SAPUI
Date of Birth: 20-02-2006 Mother's Name: JAMILA BIBI
Gender: Male Annual Family Income: 96000
Marital Status: Unmarried Guardian's / Husband's Name: SOLEMAN SAPUI
E-mail Id: [email protected] Religion: Muslim
Mobile No: 9641464779 Aadhar No XXXXXXXX8991
Class X Registration No: 100 Name as per Aadhaar: SAHIN ALI SAPUI
Bangla shiksha ID: 03450019013754
ADDRESS INFORMATION
Permanent Address Present Address
Domicile State: WEST BENGAL State: WEST BENGAL
Domicile District: NORTH 24 PARGANAS District:NORTH 24 PARGANAS
Block/Municipality:Rajarhat(BLOCK) Block/ Municipality:Rajarhat(BLOCK)
Permanent Address: BALIGORI Present Address: BALIGORI
Post Office: CHAKPACHURIA Post Office: CHAKPACHURIA
Police Station: TECHNO CITY NEWTOWN Police Station: TECHNO CITY NEWTOWN
Pin: 700156 Pin: 700156
ACADEMIC INFORMATION
Previous Academic Information Present Academic Information
Previous Institute Name: PATHARGHATA HIGH SCHOOL Institution District :NORTH 24 PARGANAS
Previous Class / Course Name: X Institution Name: PATHARGHATA HIGH SCHOOL
Previous Year of Study: X Institution UDISE/AISHE/NCVT Code : 19110707302
Name of the Board of Current Class / Course Name : XI
last Exam Passed: West Bengal Board of Secondary Education Current year of Study :XI
Year of Passing Last Exam: 2023 Are you a Hosteller: No
% of Marks Obtained Name of the Board / Council / University : West Bengal council of Higher
in Last Examination: 55.55 Secondary Education
Course Duration : 2 Year
BANK ACCOUNT DETAILS
IFSC: SBIN0018016
Savings bank account no.: XXXXXXX3358
Name as per bank Account: SAHIN ALI SAPUI (Self)
Declaration:I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I
have not applied for any other scholarship/stipend, etc. from any other government sources(one-student-one-
scholarship).NB:The application of student applying for more than one scholarship application/scheme is liable to be rejected.

___________________
Signature of Student
DECLARATION OF INCOME
(To be given by the parents/ guardians)

Certified that the gross annual income from all sources in respect of my family is Rs.96000 . I further undertake that in the
event of the particulars given in the declaration being found false, I shall refund the whole amount of the Scholarship paid to
the said Scholarship holder SAHIN ALI SAPUI and the Government's decision in this regard shall be final and binding on me.

__________________________
Signature of the parents/ guardian
Instruction
Student is to submit this ***computer-generated filled-in application form (duly signed) to the educational
institution along with following supporting document within 7 days:

1. Photocopy of the bank-passbook where the details of bank a/c number,IFSC are mentioned clearly.

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