INDIAN INSTITUTE OF TECHNOLOGY KANPUR Senate Scholarship & Prizes Committee sestftin Faas fee DS fae 2014-16 1. Roll No. 2. Name 3. Gender 4, Department. 5, Program| 6. Year. 7. Category (Tick whichever is applicable) 8, a) All India Rank b) Category Rank c) PD Rank 9.) CPI (Current) b) SPI (Latest) 10.a) Father's Name GN [osc [sc [sT_ PD b) Father's Occupation c) Father's Income d) Mother's Name €) Mother's Occupation 11. Documents submitted for income proof £) Mother's Income g) Total Family Income |12. Extra Curricular (Attach proofs as required) (Please write the SINo. of Scholarships as per atached sheet for which applied) 14, Attachments: a) Grade sheet b) Income Proof _ c) Other relevant 14, Declaration: I hereby declare that particulars stated above are true to the best of my knowledge and belief. In the vent of suppression or distortion of any fact, 1 understand that my scholarship acquired is liable to cancellation. I also understand that the decision of Senate Scholarship & Prize Committee is final and I shall abide by the rules and norms of the discipline, constituted by Senate Scholarship & Prize Committee. Place: Date: Signature of the student:LIST OF SCHOLARSHIPS Si_No._[Name of Scholarship 1___|Aedunuthula Prasad Memorial Scholarship 2__[Anil and Reshma Nigam Scholarship 3 [Anita and Santosh Mehra Foundation Scholarship “4 _ [Anita and Santosh Mehra Scholarship 5 |Anurag Bartaria Memorial Scholarship 6 |Arakere and Karen Vasudev Scholarship 7 [Babu Ram Jain Memorial Scholarship ‘8 __ [Balasubramanian and Visalakshi Scholarship ‘9 [BGM Kumar Foundation 10 [Bhagwan Das Kapoor Memorial Scholarship 11___ [Bhagwan Das Sanghi Memorial Scholarship 12 [Bhuwan and Indira Joshi Scholarship 13 |Bimlavati and Nawal Kishore Kapur Scholarship 14 __[Bishwanath Jha Memorial Scholarship 15 [Class of 1984 Scholarship 16 [Dilip Kohli Memorial Scholarship 17 |Dr.D. R. Bhagat Scholarship (CSE) 18 [Dr. D. R. Bhagat Scholarship (EE) 19 |Dr. Gurucharan Singh Kainth Scholarship 20 |Dr. Hari Mohan and Pushpa Srivastava Scholarship 21 [Dr. KC. Saronwala Memorial Scholarship 22 |Dr. K.P. Gupta Scholarship 23 |Dr. M. Anantaswamy and Vijayalakshmi Rau Scholarship 24__|Dr. Prateek Mishra Memorial Scholarship 25 |Dr. RK. Singhal Memorial Scholarship 26 [Govinda and Indira Srikantiah Scholarship 27 [Guru Ji Ghashit Ram Scholarship 28 [Harish and Sushila Chandra Scholarship 29 [Indra Dhanush Award Scholarship 30__|IWA Bonn Scholarship 31 |K.N. Saluja Scholarship 32 |khem Chandra Yadav Scholarship 33 |khemchand Memorial Scholarship 34 |Kinra Scholarship 35___|Kunta Jha Scholarship 36__|M.M. Hasan Memorial Scholarship. 37 [Mahesh and Sashi Chandra Scholarship 38__ [Mathur Brother Scholarship 39 [Neeraj Kapoor Scholarship 40__[Neta Ji BalwanSingh Scholarship “41__ [Nirmala & Ashok Keshari Scholarsh 42 [Nita Goyal & Ashish Gupta Scholarship 43__|Nitish Thakor Scholarship “44__ NS Rajaraman Scholarship 45__|P.D. Murti Scholarship “46 __ |Prof. CNR Rao Science Talent Scholarship ‘47 [Prof. Girdhar Gopal Shukla Memorial Scholarship '48__|Prof. Netarlal Kopur Scholarship '49__ |Protima Ghosh Memorial Scholarship '50___ |PSB Prasad Memorial Scholarship 5S1__|Pt. Balajee Govind Hardiker Memorial Scholarship '52__|Rajnath Singh Scholarship 53 |Ram Prakash Chopra Memorial Scholarship54 Ram Rajendra Melhotra Education society Scholarship, 55 [Ramesh Chandra Yadav Scholarship '56__|S.C. Mehrotra Scholarship '57__ [Sandeep & Vinita Agarwal Scholars '58___ |Sarpanch Salik Ram Kativar Scholarship '59___ [Shanti and Ramkishore Sahai Saxena Memorial Scholarship {60__|Shanti Devi & Onkar Nath Scholarship 61__|Shiv Kumari Shukla Scholarship (62 __|Shiv Prakash and Dayawanti Sharma Memorial Scholarship (63 |Shri Bihari Lal Srivastava & Smt. Nalini Srivastava Memorial Scholarship (64__|ShriD.P. Shukla Scholarship 65__|SriR & RChari Scholarship (66__ |Shri Shanker Lal and Shrimati Prema Devi Agarwal Memorial Scholarship (67__|Sri Singhasan Singh Scholarship (68__|Srikant Mishra Scholarship 69___|Simran Mandeep Kainth Memorial Scholarship 70 |Shrimati Bhagwati Rameshwar Goyal Scholarship 71__ |Smt, Dharmavati Garg Scholarship 72 |Smt. Jagat Kaur Memorial Scholarship 73___|Smt. Padma Kapoor Memorial Scholarship 74__ |Smt, Padmavathy & Prof. R. Shankar Scholarship 75 |Smt. Sarswati Singh Scholarship 76 (a)__|Smt. Shyamlata Garg Scholarship 76(b) [Shree Anand Swaroop Garg Scholarship 760 _ |Smt. Shanti Devi Garg Scholarship 7é(d)_ [Shree Ramjee Lal Garg Scholarship 77___|sri Bishamber Gupta & Smt, Anguri Gupta Scholarship 78__|SriJamuna Prasad & Smt. Basanti Gupta Scholarship 79__ [Sri Temasek If Scholarship '80___ [Sudarshan Kasturia Memorial Scholarship. '81__[Suman Gupta Scholarship '82__ [Swami Sivananda Memorial Scholarship 83 [Swaminathan and Garg Scholarship ‘84 |Tapan Kumar & Sapana Bandyopadhyay Scholarship '85__ [Tarun Sondhi Memorial Scholarship 86 |Vasudeo Laxman Sahasrabuddhe Vaidya Scholarship '87___|Vimal Madan Memorial Scholarship '88__ [Vinay Kapoor Memorial Scholarship 89 |Yasoda Yadav Scholarship 30 [Yogendra Nath & Sushama Gupta Scholarship