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    asdsadasd
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    1. Amit Majumdar, a 5th year student from the Indian Institute of Technology Roorkee, has applied for an institute scholarship for SC students for the 2017-18 academic session. 2. He provides his enrollment number, name, discipline, semester, caste category, CGPA, hostel details, contact information, and parent occupation and income details in the application. 3. He is applying for free messing with a monthly stipend of Rs. 250 and has enclosed required documents like the application form, income certificate, and last semester grade sheet.

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    Scholarship Form

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    1. Amit Majumdar, a 5th year student from the Indian Institute of Technology Roorkee, has applied for an institute scholarship for SC students for the 2017-18 academic session. 2. He provides his enrollment number, name, discipline, semester, caste category, CGPA, hostel details, contact information, and parent occupation and income details in the application. 3. He is applying for free messing with a monthly stipend of Rs. 250 and has enclosed required documents like the application form, income certificate, and last semester grade sheet.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    7 views2 pages

    Scholarship Form

    Uploaded by

    asdsadasd
    1. Amit Majumdar, a 5th year student from the Indian Institute of Technology Roorkee, has applied for an institute scholarship for SC students for the 2017-18 academic session. 2. He provides his enrollment number, name, discipline, semester, caste category, CGPA, hostel details, contact information, and parent occupation and income details in the application. 3. He is applying for free messing with a monthly stipend of Rs. 250 and has enclosed required documents like the application form, income certificate, and last semester grade sheet.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    INDIAN INSTITUTE OF TECHNOLOGY ROORKEE

    APPLICATION FOR GRANT OF INSTITUTE SCHOLARSHIP (SC/ST) FOR THE SESSION 2017-18

    Enr. No.: 13110004 Name: AMIT MAJUMDAR


    Discipline: AR Semester: Fifth Year - 1st Sem (Autumn)
    Cat: SC Sub Cat:
    CGPA: 6.09 YGPA: 6.17
    Bhawan: Jawahar Bhawan Room No.: ds21
    Mobile No:9997470570 Email ID: amitmajumdar154@gmail.com
    Aadhar Card No.:
    Bank: SBI Bank Account No.: 33235686735
    Address: 10, bhagwannagar , 1st floor, hari nagar ashram , new delhi delhi
    delhi 110014 India

    Contact No.: 9997470570

    Father's Occupation: late government Mother's Occupation: housewife


    servant
    Father's Annual Income: 0.00 Mother's Annual Income: 272,436.00

    Document Submitted: Document Submitted: pension document

    Applying for:
    Free Messing (Basic menu only) with Rs. 250/- per month for 10 month, as per allowance.

    I declare that the particulars mentioned above are correct. i herewith the latest parental income
    certificate (Mother and Father both) in the prescribed form, If I get any scholarship /financial aid from
    any other source. I will intimate the amount of scholarship. I understand that if any of information
    supplied is found to be incorrect, the amount of scholarship, if any, received by me will have to be
    refunded and the Institute can take any action against me as it may deem fit in the regard.

    Signature of Student
    Enclosures:
    1. Hard copy of compter generated application form. September 15, 2017 4:04:51PM
    2. Affidavit from all family members regarding income.
    3. Income Certificate signed by Revenue officer.
    4. Photo copy of last semester Grade Sheet.
    Enr. No.: 13110004 Name: AMIT MAJUMDAR
    Discipline: AR Semester: Fifth Year - 1st Sem (Autumn)
    Cat: SC Sub Cat:
    CGPA: 6.21 YGPA: 6.21
    Bhawan: Jawahar Bhawan Room No.: ds21
    Mobile No:9997470570 Email ID: amitmajumdar154@gmail.com
    Aadhar Card No.:
    Bank: SBI Bank Account No.: 33235686735
    Address: 10, bhagwannagar , 1st floor, hari nagar ashram , new delhi delhi
    delhi 110014 India

    Contact No.: 9997470570

    Father's Occupation: Late government Mother's Occupation: pensioner


    servent
    Father's Annual Income: 0.00 Mother's Annual Income: 316,800.00

    Document Submitted: Document Submitted: yes(pension slip and

    Applying for:
    Free Messing (Basic menu only) with Rs. 250/- per month for 10 month, as per allowance.

    I declare that the particulars mentioned above are correct. i herewith the latest parental income
    certificate (Mother and Father both) in the prescribed form, If I get any scholarship /financial aid from
    any other source. I will intimate the amount of scholarship. I understand that if any of information
    supplied is found to be incorrect, the amount of scholarship, if any, received by me will have to be
    refunded and the Institute can take any action against me as it may deem fit in the regard.

    Signature of Student
    Enclosures:
    1. Hard copy of compter generated application form. September 15, 2017 4:04:51PM
    2. Affidavit from all family members regarding income.
    3. Income Certificate signed by Revenue officer.
    4. Photo copy of last semester Grade Sheet.

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