REGISTRATION DETAILS APPLICATION ID UP202021007738937 RENEWAL DATE 14/11/2021 APPLIED FOR SCHEME MERIT-CUM-MEANS SCHOLARSHIP FOR PROFESSIONAL AND TECHNICAL COURSES CS SCHOLARSHIP STATE OF DOMICILE UTTAR PRADESH POST MATRIC/TOP CLASS/MCM CATEGORY DATE OF BIRTH NAME OF STUDENT MOHD UZAIF 24/07/1998 (DD/MM/YYYY) GENDER MALE RELIGION MUSLIM COMMUNITY/CATEGORY GENERAL FATHERS NAME ATEEQ AHMAD ANNUAL FAMILY MOTHERS NAME RUHINA KHATON 84000 INCOME AADHAR NUMBER XXXXXXXX0877 MOBILE NUMBER 9936652074 DAY EMAIL ID MDUZAIF786@GMAIL.COM DAY SCHOLAR SCHOLAR/HOSTELER ACADEMIC DETAILS GOEL INSTITUTE OF TECHNOLOGY AND MANAGEMENT, LUCKNOW (ID: C-46904) (C-46904) PRESENT INSTITUTE ADDRESS-NEAR INDIRA CANAL FAIZABAD ROAD LUCKNOW LUCKNOW, UTTAR PRADESH MASTER OF BUSINESS PRESENT CLASS/COURSE CLASS START DATE 15/09/2021 ADMINISTRATION(M.B.A) ROLL NO 2003600700048 SECTION PRESENT YEAR 2 MODE OF STUDY REGULAR/FULL TIME PREVIOUS BOARD/UNIVERSITY NAME PREVIOUS MASTER OF BUSINESS PREVIOUS PASSING 1 CLASS/COURSE NAME ADMINISTRATION(M.B.A) YEAR 10TH CLASS ROLL PREVIOUS CLASS(%) PASSED 2677399 NO. BOARD OF HIGH SCHOOL AND 10TH CLASS PASSING 10TH CLASS BOARD 2013 INTERMEDIATE EDUCATION UTTAR YEAR NAME PRADESH , ALLAHABAD 12TH CLASS PASSING 12TH CLASS ROLL NO. 1714528 2015 YEAR BOARD OF HIGH SCHOOL AND INTERMEDIATE EDUCATION 12TH CLASS BOARD NAME UTTAR PRADESH , ALLAHABAD BASIC DETAILS IS ORPHAN NO IS DISABLED NO PERCENTAGE OF TYPE OF DISABILITY - - DISABILITY MARITAL STATUS UN MARRIED BANK ACCOUNT IFSC CODE BARB0GOELUC 56800100007600 NUMBER CONTACT DETAILS STATE UTTAR PRADESH DISTRICT BARABANKI BLOCK NAWABGANJ DP/702 RAFI NAGAR DEWA ADDRESS PIN CODE 225001 ROAD BARABANKI
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SIGNATURE OF CANDIDATE WITH STAMP FROM ACADEMIC YEAR 2020-21, FEES OF THE STUDENTS WILL BE ENTERED DIRECTLY BY THE INSTITUTE 1/2 11/14/21, 4:12 PM