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    Magizh Dye chem
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    © All Rights Reserved
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    359 views10 pages

    SC ST Scholarship Fresh Application 2021-2022

    Uploaded by

    Magizh Dye chem

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 10
    dius. 73 sublper@® 247 GOVERNMENT OF TAMIL NADU BSSMTOAL A oped UprSipuiloort Boos geo. ADI DRAVIDAR AND TRIBAL WELFARE DEPARTMENT Lod Hus / onpBleo 29761 acdaHl 2 sais Assen SMLLth ~ usta ys Costeyde Gio UpAADE Mu 2 GoNSAgsrEres Cugueusyerren Sletereemi a. FORM TO APPLY FOR THE GRANT OF GOVERNMENT OF INDIA / STATE GOVERNMENT POST MATRIC SCHOLARSHIPS FRESH FORM sen) Sysuen Seer Quit Name of the institution siirCurgy s6d68 Sig’ scooSiursin® Academic Year Gloncosns inssirm gs room Heiss QSiSsGULL .yoLuster ers Scholarship Student Id Generated in Online: (To be filled by the institution) Lorrevarsurfleat siiGurengiu spas. ,5e Doosan Cousin ia. T | uonsoraut Gust (Cgaflaurer sug gieeate) Full Name of the Student (in Block letters) supe English 2 | umeilem / Gender (ip& V Qeuuunyi) 1L.gysior / Male eal 2.@usist /Female C 3.eystypm ureSleria/ ‘Transgender{_} Sinise G58) / Date of Birth 4 | Quitpni sng) urgemast eeu / Parent or Guardian Details : (GupSpri Badeow arf ungiemeuevi aSleunid eyHahtax. GeusierGi) ni Gust /Name of the Mother gii50% Gui /Name of the Father urrgyesreusuit Quit /Name of the Guardian ‘ang Slam / Community Details: (a) uc yuss Glen sasi(SC) (b) Lupeirgipuileori(ST) (CAMS Siu UB SHHS urplu ups Qeorgsg5oui Scheduled Caste Converted to Christianity (SCC) on 2 Sifiny Quusi / Sub caste Name: 4B. 79-4.14,540 Cps.-2020 918.008, Gop prt sag UTE ETT Asma Parent or Guardian Occupation ioreoraufler GuiGant gjdmg) _ urgienauer usw oe / uMBo g76 | sefumt Ayer amputated, upseSudlér Guus, useythiy Pymerssir Hlomd. If the student’s Parent / Guardian is working in Govt of [India / State Govt / Private Sector, Designation and Office details. Unotiyfind apo ore T anbe gga 7 pelo PpTsP Gig Gopouc. —_agumrends sree GALAN Ocron axguoraargeng rags GowsinGrh. (amfiudansingy seis) Gamenerdsesi. Gasin Gia) Income as per Salary Certificate obtained from the Govt of India / State Govt / Private Organisation (Salary Certificate is to be enclosed) Obs AeirG axgurend 7 Family Annual Income (xin. uit auprihu — exgg.orenré enénfs Pd EPIL Oster eugene (9 Gausiar i) Spay / Note: HGuamnoier Queir Aecreorivemnt sreofles, semroufeir Custis Gumi aighuoreers ondrflsip 1 GC Glonsmréseiu. Cusin Gib. Married women applicants should enclose income .certificate of their husband. 8 [Diisr wanut gee GAS OLa Phorda paam oem GA OLA Permanent Address with Postal Pincode | Temporary Address with Postal Pincode 9 | ioresreuflet opm stein. . Student's Aadhaar Number 10 | orsmrant gong) QupGpmfsir AgrenaGudl asin/Student’s or Parent’s Phone Number 11 | taromreutiosr Detramgsae) apasautt Student's e-mail id 3 [12 BL Luray inTevereut bes Ugid 2ysin@ / Class of Study in Current Year (a) 1 Year 1 (b) II Year (a) IV Year (1) (e) V Year 13 ores out uSlgyeb um_gBloor uuu wipe ifs Gut / Course&Subject of Study of the applicant (Examble: Course - B.A., Subject ~Tamil) O O Course Name (c) Il Year O () VI. Year a) Main subject (ypsironot um LASiflay 1)Gunsyflenev augsciy / Higher Secondary Class(+ lor+2),Maths Biology, Commerce Computer, History, etc.) 2)@lerfienoi uoLtugly/U.G. Degree Course. Eg. B.A.,(tamii) B.Sc., (Maths) etc. S)upgibioned UCL. Gunpuyiay /P.G./ Research Course Eg, M.A., (Tamil) ,M.Sc.,(Maths), M.Phil. (Tamil/Maths) P.hD., etc.. 4)@gmp\ouipl / Professional Course Eg.B.E.,M.E.,B.L.,M.L.,M.B.B.S.,B.D.S., B.Sc,.(Nursing}, C.A., etc. SjutLucuiginy / Diploma Course Eg D.E.CE,, D.E.E.E.,ete Glenegyp uly / Certificate Course (uyiier anor gira 9G UBL Bess Gassin(@ia / Duration of Course should be atleast one year) 14 <8sbeil uidlgyta (penp / Category of Study 1)use Gpmb/Day Time 2)toneney Gp /Evening Time 3)ug 81 Com /Part Time 4]Qgnevmgrmia / Correspondence ‘oreeraut Ladigy uipieir Guang ere) js) Duration of the course pursued by the student 16 | Loncrraut uspmd agin Qungs Cota Cered | lay sreter. Quip syein® / usiay stein | Year and Year Registration No. Register number of Passing 10‘ Public Examination. 17 | wreerat uate ms aGLy unas Cera | ayer ‘up oot. GpitdA Gui ayein@ | ugly stein Year and Year Registration No. Register number of Passing 12% Public Examination. 4 [ 15 [laren UC LuniLigee Cree Oui pein 7] aye | ula, stair. Year and Register number of Year Passing Diplamo Public Examination. |__ Registration No. iy a. 19 | torrssoroutt LuSlgynh «peo / Category of Study (yd ¥ Gilani) orgy UTgioTeveat 2 L sr Hi) Hosteller usu / Day Scholar A) SG SUED

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