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    HARDIK

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    parmarchirag194

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    © All Rights Reserved
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    HARDIK

    Uploaded by

    parmarchirag194
    7 views3 pages

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    © © All Rights Reserved

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    Copyright:

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    7 views3 pages

    HARDIK

    Uploaded by

    parmarchirag194

    Copyright:

    © All Rights Reserved
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    of 3

    GOVERNMENT OF GUJARAT Submit Date :

    Application No:
    VKY 158 Swami Vivekanand Stipend scheme for ITI Courses 242500000001154209
    (diploma technical professional and industrial courses)
    Fresh Application

    Student Basic Details

    Name of Student : RANA HARDIK KANTIBHAI


    Name of Student (As per Aadhar) : HARDIK KANTIBHAI RANA
    Mother's Name : JASHIBEN
    Date of Birth : 09/12/2006 Gender : Male
    Category : ST(7ȵkɅl‡ISKWĤiS  Religion :Hindu
    Caste : Bhil [j_ 

    Aadhaar Status Verified: Yes(07/11/2024 18:53:10)

    Ration Card No. : 303005003240695 Ration Card Member No. : 303005003240695005


    Name As Per Ration Card: (Hardik Kantibhai Rana / ehˆU‘DDh5iS[h:^hRh
    EKYC Status As Per Ration Card: Yes EKYC Date: 14-11-2024
    Aadhar Number Matched With Ration Card: Yes
    Consent Status: I hereby give my consent to use my personal data available with food and civil supply department. I hereby give my consent to
    government of Gujarat for fetching my identity for the purpose of post matric scholarship.

    Annual Income of Parents/Guardian/Husband (Rs): 60000 Habitation Type: Urban


    Mobile Number : 9099283001 E-mail Address : [email protected]
    Aadhar No : 55xxxxxx1873 Parent/Guardian occupation: Labour(\ȩl^Ž
    Is Orphan: NO Day Scholar / Hosteller : Day Scholar
    Marital Status : Unmarried Hostel Type:

    Current Address: Permanant Address:


    State Gujarat State Gujarat

    District Patan District Patan

    Taluka Patan Taluka Patan

    Village Village
    PinCode 384265 PinCode 384265

    Address:BHIL SOCIETY, BAGVADA DARVAJA PASE, PATAN Address:BHIL SOCIETY, BAGVADA DARVAJA PASE,
    PATAN

    Student Bank Account Detail/Aadhar Bank Detail


    I voluntarily give my consent to use my Aadhaar details.
    Aadhar Number : 55xxxxxx1873 Bank name : -
    NPCI Date : 11/19/2024 12:00:00 AM NPCI Status : Accept
    I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
    Account No : 78xxxxxx6402 IFSC Code : IDIB000P190
    Student Name(As per Bank Name): HARDIK KANTIBHAI RANA

    Name of Bank : INDIAN BANK

    Branch Name & Address : PATAN


    I hereby accept that
    1.Details provided by me are correct to best of my knowledge

    Page 1 of 3 242500000001154209 Print Date :19/11/2024


    2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
    3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
    4.I will refund the excess amount credited to my account, if any.

    Student Academic Details


    Present Course/Class/Trade Type: ITI

    Present Course/Class/Trade Name : ITI Industrial Training Institute (2 Year Course)

    Present Course/Class/Trade Year : 1ST YEAR(1st Semester/2nd Semester)

    Studying in : Gujarat Enrollment No:

    Present Institute District : Patan Present Institute : PATAN-ITI

    Admission Type : Regular Seat(Government Quota) Present Branch Course : ELECTRICIAN

    Enter Your Research/Thesis Subject :


    Present Class Start Date : 02-Sep-2024 Present Course Completion Date : 21-Jun-2026

    Course Duration In Years : 2

    Educational Break : No No. Of. Year in Break :


    Are You Employed in any Organization/Establishment with leave without pay? : Not Applicable

    Previous Education Detail


    Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
    9th Std/10th Std 10TH SSC C3022754 2024 46.16

    Disablity Detail
    Is Disability : No Type of Disability : -

    Percentage of disability : - Required Guide/Coaching Guide: No


    Guide Name: -
    Guide Address: -

    List of documents which you have attached :

    1 Caste Certificate From the Competent Authorities

    2 First Page Of Bank PassBook/Cancelled Cheque

    3 Fee Receipt of Current Course Year

    4 Self Attested Certificate of Previous academic marksheet

    5 Income Certificate From the Concerned Authorised Authority/Persons

    6 Identity Card (College/School)

    I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
    application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
    central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
    false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
    process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
    binding on me.

    Date : 19/11/2024

    Place : Signature of the applicant

    Page 2 of 3 242500000001154209 Print Date :19/11/2024


    It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
    all the Documents has been checked.

    It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
    regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority

    Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
    recommended for sanction of scholarship.

    This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2024
    -2025. If student will irregular, than we will immediately reported to the said authority.

    The actual School/College/University year began on __________________ and will be ended on _____________________

    Signature Of Head Of The School/College/Institute/University With Official Seal

    Place :

    *Note : Stamp Signature will not be accepted

    Date :

    Page 3 of 3 242500000001154209 Print Date :19/11/2024

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