SCHOLARSHIP FOR HIGHER EDUCATION APPLICATION FORM

Application Status: Submitted

Advertisement No: SHE- 2020
Application Ref. #: DST/INSPIRE/02/2020/019265
IVR No: 202000039133

Personal Particulars
Salutation: Miss

First Name: Kalyani Middle Name: Last Name: Kumari

Date Of Birth: 4/17/2002 Gender: Female Father's Name/Male Guardian

Name: Ramesh kumar

Mother's Name/Female Guardian Name: Sundara

10th Class Certificate or Marksheet as Proof of Date of Birth: Attached Place of Birth: Rural
Below

Email Address: guptakalyani2002@gmail.com

Social Community: General

Differently Abled: No Other:

Enrollment Information (B.Sc. / Integrated M.Sc. Level)

Program Enrolled: B.Sc.

Course Enrolled: Chemistry, Maths, Physics

Enrollment/Admission Year: 2020 Admission No:

State (In which college is located): HIMACHAL PRADESH

University Type: University University Name: Himachal Pradesh University

University Address:Summer Hills ShimlaPIN: 171005

College Name: G.B. Pant Memorial Govt. College RAMPUR BUSHAHAR. : Shimla

District (In which college is located): Shimla

Endorsement Certificate: Attached Below

Senior Secondary Performance Information (12th Standard)

Name of the Board: Himachal Pradesh Board of School Education

Passing Year: 2020 Rank in Class 12th: 29 Board Roll Number: 2043734063

Eligibility Note: Attached Below 12th Marksheet: Attached Below

Marks Information

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Subjects Marks Obtained Maximum Marks Grade

CHEMISTRY 93 100 1

MATHEMATICS 91 100 1

PHYSICS 92 100 1

ENGLISH 95 100 1

INFORMATION
98 100 1
TECHNOLOGY

Other Subjects

Subjects Marks Obtained Maximum Marks Grade

Nill

Total Marks Obtained: 469 Maximum Marks: 500 Overall Percentage(%): 93.8

School Name: Rani Rattan Kumari Memorial GSSS Nogli

School Address: VPO. - Nogli , teh.-Rampur, distt.- Shimla

State (In which school is located): HIMACHAL PRADESH

District (In which school is located): Shimla

PinCode: 172022

National Level Competitive Examinations

Rank
Examination Year Rank
Certificate/Certificate

Other Details
Year of Passing Class X:2018 Parents Annual Income: 40000

Have you attended INSPIRE If Yes, please provide details. I attended the Inspire Award in 2015, in which
Science Camps:Yes I participated in the Science Model.

Contact Information
Permanent Address
Address: VPO - Luhri, Teh. - Anni , Distt. -Kullu

Town/City: Kulu State: HIMACHAL PRADESH Pincode: 172001

Telephone Number (with STD Mobile Number: 8278839151

code): N/A

Communication Address
Address: VPO - Luhri, Teh. - Anni , Distt. -Kullu

Town/City: Kulu State: HIMACHAL PRADESH Pincode: 172001

Telephone Number (with STD Mobile Number: 8278839151

code): N/A

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Are you availing any other scholarships: N/A

Identification Proof : Aadhaar Card No :

Aadhaar Card XXXXXXXX5982

Declaration: It is certified that all particulars given by me in columns above are true to the best of my
knowledge. If any particulars are found false, I am aware that my application for scholarship are liable for
cancellation.

Place: Rampur Bushahar Submitted Date: 12/28/2020 State: HIMACHAL PRADESH

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