SCHOLARSHIP APPLICATIOn

Please Read the Rules of Applying Scholarship Here

Find your District and Taluk Sanchalaka Details Here

APPLICANT'S PHOTO(Required)

Accepted file types: jpg, jpeg, png, gif.

Application ID

Applicant's Name(Required)

Gender(Required)

Age(Required)

Date of Birth(Required)

Mobile No.(Required)

Applicant's Email(Required)

Community(Required)

Sub Caste(Required)

BPL No.(Required)

Issuing Authority(Required)

AADHAR Card No.(Required)

PRESENT ADDRESS

Address(Required)

District(Required)

Taluk(Required)

PINCODE

PERMANENT ADDRESS

Address(Required)

District(Required)

Taluk(Required)

PINCODE

PARENT'S DETAILS

Mother's Name(Required)

Mother's Age

Mother's Occupation

Mother's Annual Income

Mother's Mobile No.

Father's Name(Required)

Father's Age

Father's Occupation

Father's Annual Income

Father's Mobile No.

If you are staying in Ediga hostel or Government Hostel Please mention the address

Hostel Address

DETAILS OF COLLEGE STUDYING FOR THE YEAR 2024 -2025

College Name(Required)

College Address(Required)

Course Studying(Required)

Fee Amount(Required)

Receipt No.(Required)

Receipt Date(Required)

Remarks

DETAILS OF MARKS SECURED IN PREVIOUS 3 YEARS

Academic year 2024-2025

Name of College/Institution(Required)

Course Studying(Required)

Total Marks(Required)

Marks Obtained(Required)

Percentage(Required)

Academic year 2023-2024

Name of College/Institution(Required)

Course Studying(Required)

Total Marks(Required)

Marks Obtained(Required)

Percentage(Required)

Academic Year 2022-2023

Name of College/Institution(Required)

Course Studying(Required)

Total Marks(Required)

Marks Obtained(Required)

Percentage(Required)

PARTICULARS OF PREVIOUS SCHOLARSHIP AVAILED (IF ANY)

1. Name of Organisation

Course Name

Year

Scholarship Amount

2. Name of Organisation

Course Name

Year

Scholarship Amount

3. Name of Organisation

Course Name

Year

Scholarship Amount

BANK DETAILS OF APPLICANT

Name as in Bank Records(Required)

Account No.(Required)

Name of Bank(Required)

Name of Branch(Required)

IFSC Code of Branch(Required)

Search IFSC Code of Branch Here

Declaration(Required)

I Hereby declare that the information given above is correct. I also hereby declare that I shall abide by the terms and conditions for sanction of Scholarship. I undertake that if, at any stage, it is found to the satisfaction of the sanctioning authority that the information given by me is false or if I violate the terms and conditions of the scholarship, the scholarship sanctioned to me, may be cancelled and the entire amount of scholarship will be refunded by me or recovered from me, apart from such penal action as warranted by law.

I, hereby, declare that I have submitted a self-attested photocopy of the required documents as mentioned below:
☐ Caste Certificate ☐ BPL Card ☐ AADHAR Card ☐ Current Year College Fee Receipt ☐ Marks Card of 2023-2024 ☐ Marks Card of 2022-2023 ☐ Marks Card of 2021- 2022 ☐ Bank Pass Book (First Page)

Signature of Applicant

Date

Signature and Seal of Head of Institution

Date

Signature of Applicant's Guardian

Date

ATTESTATION OF TALUKA MUKHYA SANCHALAKA

NAME:

SEAL & SIGNATURE

CELL NO:

ATTESTATION OF DISTRICT MUKHYA SANCHALAKA

NAME:

SEAL & SIGNATURE

CELL NO:

_______ For Office Use ________________________________________________________________

Scrutinized by:

Remarks:

Signature:

Date:

☐ SANCTIONED

☐ REJECTED