Bazm-e-Niswan Charitable Trust (R)

No.37, Muniswamy Road, Tasker Town, Bangalore - 560051

www.bazmeniswan.org | 080-22860023 | 80505 75504 ( Scan QR code for
Google Map Location)

BAZM-E-NISWAN SCHOLARSHIP 2021

Dear BIBI ARBIYA BANU

The hardcopy of this filled Application (BZPU20213012) with student photo, student signature,
parent signature, Seal & Signature of College Principal and hard copy of documents uploaded Kindly paste the same
must be submitted by the Student in person to the office address given below on or photo which you have
before 19-10-2021.
uploaded in the online
application
Bazm-e-Niswan Charitable Trust (R)
No 37, Muniswamy Road, Tasker Town, Shivajinagar, Bangalore - 560051
Timings : 10am-4pm (Mon-Fri) & 10am-1pm (Sat). Sunday Holiday.

This Scholarship is only for Zakat Eligible Students. Poor & deserving Students who
belong to SYED CATEGORY will be given scholarship from NON Zakat Funds.

For Office use by Bazm-e-Niswan Charitable Trust :

Received by Verified by Approved by Status

Scholarship ID: BZPU20213012 (Fresh) Submitted on 2021-10-12 19:20:14

Student Name BIBI ARBIYA BANU
Gender FEMALE Date of Birth 13-Feb-2005
Aadhaar Number 761302742124 Mobile 9008239518
Email Id ASHARIFF646@GMAIL.COM
Permanent Address NO 742, SARAIPALYA, THANISANDRA MAIN ROAD
Landmark: OPP UMAR FAROOQ MASJID
BANGALORE - 560077
Current Address NO 742, SARAIPALYA
Landmark: OPP UMAR FAROOQ MASJID
BANGALORE - 560077
EDUCATION DETAILS
College studying GOODWILL PU COLLEGE FOR GIRLS , FRAZER TOWN PROMANADE RD
Course Commerce Class 1st PUC
Previous Exam / Year SSLC/10th - 2021 Marks Secured 412/625 - 65.92 %
Total College Fee 30000 Fee Paid 20000
Fee Due 10000
School studied ST JAVERIA ENGLISH HIGH SCHOOL, VIDYASAGAR, THANISANDRA MAIN ROAD
Year / Board 2021 - State Marks 412/625 - 65.92 %
FAMILY DETAILS
Father's Name ASLAM SHARIFF Mother's Name JOWHAR BANU
Father's Qualification Did not complete School Mother's Qualification Did not complete School
Father's Occupation COOLIE Mother's Occupation HOME MAKER
Siblings Elder Brothers - 0, Elder Sisters - 1, Younger Brothers - 1, Younger Sisters - 1

www.bazmeniswan.org BZPU20213012 Page 1 of 5

 ADDITIONAL DETAILS
Does your family have BPL No Eligible to receive Zakath Yes
Card? amount?
Are you physically disabled? No Own house or Rented house? Rented
Are you an Orphan? No Annual Income 60000
Did your father or mother lose No Did your father or mother die No
their job due to COVID-19 ? due to COVID-19 in 2021 ?
Your Achievements in Sports NOT INTERESTED IN SPORTS BUT IN EXTRACURRICULAR IS OFFERING PRAYER
& Extra Curricular Activities
What is your Ambition in life ? WANT WORK IN BANKING SECTOR, FINANCIAL INSTITUTION...

NOTE : Incomplete application with false information will be rejected

DOCUMENTS SUBMISSION LIST

Document Name Kindly tick the documents attached

SSLC (X) Marks Sheet Yes ( ) No ( )
Previous Semesters / Previous year Marks Sheet Yes ( ) No ( )
Aadhaar Card Yes ( ) No ( )
First Page of Bank Passbook/Cancelled Cheque Yes ( ) No ( )
Fee receipt Yes ( ) No ( )

DECLARATION BY THE PARENT / GUARDIAN

We hereby solemnly declare that the statement made and the information furnished in this application are
true. Should it however, be found that any information furnished herein is either false or not true in any material
particulars we shall be liable to criminal prosecution. We also agree that the education concessions awarded on
the basis of this declaration shall be liable to be cancelled and that any amount received by the applicant together
with an additional equal amount as penalty, shall be liable to be returned to the Secretary, Bazm-e-Niswan
Charitable Trust, Bangalore - 560 051.

Signature of Father Signature of Mother Signature of Guardian

(Not Applicable if expired) (Not Applicable if expired) (If both parents are not alive)

Date:

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 Bazm-e-Niswan Charitable Trust (R)
No.37, Muniswamy Road, Tasker Town, Bangalore - 560051

BAZM-E-NISWAN SCHOLARSHIP 2021

INSTITUTE VERIFICATION FORM
(To be signed by the College Principal where the student is currently
studying academic year 2021-22)

This is to certify that BIBI ARBIYA BANU , daughter of ASLAM SHARIFF is a

bonafide student of GOODWILL PU COLLEGE FOR GIRLS , FRAZER TOWN
PROMANADE RD studying Commerce - 1st PUC for the year 2021-2022

It is further certified that the Student Name, Address, Aadhaar No., Previous Exam
Marks provided by the student in Bazm-e-Niswan scholarship application form are
true and correct to best of my knowledge and belief.

The total fees of BIBI ARBIYA BANU studying Commerce - 1st PUC for the
academic year 2021-2022 is _____________.

Name of the College Principal: _______________________

Office Contact: _______________________

Seal & Signature of College Principal

Date:

www.bazmeniswan.org BZPU20213012 Page 3 of 5

 Bazm-e-Niswan Charitable Trust (R)
No.37, Muniswamy Road, Tasker Town, Bangalore - 560051

BAZM-E-NISWAN SCHOLARSHIP 2021

DECLARATION BY THE STUDENT

I BIBI ARBIYA BANU , Scholarship Application ID : BZPU20213012 daughter of ASLAM

SHARIFF residing at NO 742, SARAIPALYA, THANISANDRA MAIN ROAD
BANGALORE - 560077 studying in Commerce - 1st PUC at GOODWILL PU COLLEGE
FOR GIRLS , FRAZER TOWN PROMANADE RD , do hereby declare that, I have
applied for Bazm-e-Niswan Educational Scholarship for the year 2021-2022

1. My family circumstances are such that we cannot afford to pay for the expenses of PUC &
Degree course I intend to undertake. I assure that I shall pursue my studies very seriously and
become an asset for the community and nation.

2. In case the details furnished by me are found to be incorrect, the organization can initate suitable
action against me.

3. My Bank Details given below are correct and I have submitted them after verifying with my Bank
Documents.

Account Holder Name BIBI ARBIYA BANU Account Number 33906278317

Bank Name STATE BANK OF Bank IFSC Code SBIN0017060
INDIA

Signature of the Student

For Office use by Bazm-e-Niswan Charitable Trust

Bazm-e-Niswan Scholarship 2021 amount of Rs ____________________
(in words ____________________________________________________________) transferred
through
NEFT / Cheque No. ____________________________ on _______________ date from Bazm-e-Niswan
Charitable Trust Bank Account, Banglore.

Above details filled by: ________________

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 Bazm-e-Niswan Charitable Trust (R)
No.37, Muniswamy Road, Tasker Town, Bangalore - 560051

BAZM-E-NISWAN SCHOLARSHIP 2021

ACKNOWLEDGEMENT
(To be given to the student after recieving the Hardcopy of the Online Application at
Bazm-e-Niswan Office)

Scholarship ID BZPU20213012

Category Fresh

Student Name BIBI ARBIYA BANU

Class 1st PUC

Course Commerce

College GOODWILL PU COLLEGE FOR GIRLS , FRAZER TOWN PROMANADE RD

The below details to be filled by Bazm-e-Niswan Staff who received this application

Received by (name) To check the status of your Application,

BZPU20213012
Scan the below QR Code
Date of Receiving

Time of Receiving

Bazm-e-Niswan
Office Seal

www.bazmeniswan.org BZPU20213012 Page 5 of 5

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