Application form for the grant of State Sports Talent Search Scholarship 2019-20

GAME : Football Level : Jr. Application ID : SC/2020/2528 Amount Rs. 2500.00

Position - 2nd

Name of the Candidate Harshit Rawat

Father's Name Mahipal Singh

Mother's Name Anjali Rawat

Gender male

Date of Birth 16-Jan-2004

Email harshitrawat413@gmail.com

Class in Which Studying (At the time of 10th

participation)

Applicant Mobile No. 9814401413

Is Applied for another Scholarship? No

Landline/Alternate Mobile No. 9878704759

Full Residential Address #413, sector 8 panchkula #413, sector 8 , Panchkula , Haryana #413 , sector
8 , Panchkula , Haryana PANCHKULA HARYANA 134109 INDIA

Bank Details

Bank Name IFSC Code Account No. Aadhaar No

Kotak Mahindra Bank KKBK0000283 2513266058 576137909748

Achievement for the year

Institute / Competition Name Game Competition Level Position Date(s)

Association Name
Strawberry feilds Inter School Football Jr. 2nd 2019-10-
high school Tournament 04 To 2019-10-22

VERIFICATION :-

I hereby solemnly declare and affirm that information containing are true to the best of my knowledge and nothing has been
concealed therein.

Dated: 31-Oct-2020 Signature of Application

 VERIFICATION FROM INSTITUTION :-

Verified that Mr/Ms. Harshit Rawat Son/Daughter of Mahipal Singh is / was bonafied / regular student of this institute for the academic

year ______________ and has participated in Inter School Tournament held at Chandigarh from 2019-10-04 to 2019-10-22

Signature

Head of Institution (With Seal)

FOR OFFICE USE ONLY

Recommendation of Committee:-

We have verified the content of this application and recommend / not recommend the scholarship.

Signatures of Committee Members.

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