AnnexureI

UNIVERSITY GRANTS COMMISSION

BAHADURSHAH ZAFAR MARG
NEW DELHI 110002

Passport

SA-III SECTION

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Joining Performa for fresh awardees

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SPECIAL SCHOLARSHIP SCHEME FOR NORTH EASTERN REGION

Name of student:_______________________________________________________
Award letter number and date: (to be filled after the selection)_______________________________
Candidate ID number____________________________________________________
This is to certify that Mr./Ms. ________________S/o/D/o ________________________
is a bonafied student of ________year regular, non-professional undergraduate degree
course____________________ in the subject of ________________. He / She joined
the Ist year Undergraduate degree course on dated____________________ in this
Institution/College/Department_____________________________________________
affiliated to _________________________________________University.

Signature
Signature
Name
Name
Date
Date
(Head of Deptt.)
(Awardee)
Ph. /Mobile No.
Seal of HoD
e-mail :
Ph. No.
Bank A/c No.
IFSC Code :
MICRcode:
12-digit unique (aadhaar) number, if you have:

Signature
Name
Date
(Registrar / Director / Principal)
Seal of University / Institution / College
Ph. No.