West Bengal Minorities' Development and Finance Corporation

A statutory Corporation under Minority Affairs & Madrasha Education Department, Government of West Bengal
"Amber", DD/27E,Salt Lake City Sector-I, Kolkata-700064, Toll free No:-18001202130

AIKYASHREE (FRESH)
APPLICATION FOR WB SVMCM SCHOLARSHIP 2023-24
Application ID: SSP2023051800621653 Application Date: 22-11-2023
BASIC INFORMATION
Student's Name: TOUSHIK AHAMED MOLLA Father's Name: ABIR HOSSAIN MOLLA
Date of Birth: 21-09-2002 Mother's Name: TAHERA BEGAM MOLLA
Gender: Male Annual Family Income: 60000
Marital Status: Unmarried Guardian's / Husband's Name: ABIR HOSSAIN MOLLA
E-mail Id: toushikmolla09@gmail.com Religion: Muslim
Mobile No: 9339019440 Aadhar No XXXXXXXX6509
Class X Registration No: 6191-097898 Name as per Aadhaar: TOUSHIK AHAMED MOLLA
ADDRESS INFORMATION
Permanent Address Present Address
Domicile State: WEST BENGAL State: WEST BENGAL
Domicile District: SOUTH 24 PARGANAS District:SOUTH 24 PARGANAS
Block/Municipality:Magrahat - II(BLOCK) Block/ Municipality:Magrahat - II(BLOCK)
Permanent Address: NAINAN, KULDIA, MAGRAHAT, Present Address: NAINAN, KULDIA, MAGRAHAT, DIAMOND HARBOUR,
DIAMOND HARBOUR, SOUTH 24 PARGANAS SOUTH 24 PARGANAS
Post Office: KULDIA Post Office: KULDIA
Police Station: MAGRAHAT Police Station: MAGRAHAT
Pin: 743609 Pin: 743609
ACADEMIC INFORMATION
Previous Academic Information Present Academic Information
Previous Institute Name: SN BOSE GOVERNMENT Institution District :KOLKATA
POLYTECHNIC Institution Name: ALIAH UNIVERSITY KOLKATA
Previous Class / Course Name: DIPLOMA IN CIVIL Institution UDISE/AISHE/NCVT Code : U-0567
ENGINEERING Current Class / Course Name : BACHELOR OF TECHNOLOGY (CIVIL
Previous Year of Study: 3rd Year ENGINEERING)
Name of the Board of Current year of Study :2nd Year
last Exam Passed: West Bengal State Council of Technical & Are you a Hosteller: No
Vocational Education & Skill Development Name of the Board / Council / University : ALIAH UNIVERSITY
Year of Passing Last Exam: 2023 Course Duration : 3 Year
% of Marks Obtained
in Last Examination: 76.90
BANK ACCOUNT DETAILS
IFSC: KKBK0006575
Savings bank account no.: XXXXXXX1699
Name as per bank Account: TOUSHIK AHAMED MOLLA (Self)
Declaration:I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I
have not applied for any other scholarship/stipend, etc. from any other government sources(one-student-one-
scholarship).NB:The application of student applying for more than one scholarship application/scheme is liable to be rejected.

___________________
Signature of Student
DECLARATION OF INCOME
(To be given by the parents/ guardians)

Certified that the gross annual income from all sources in respect of my family is Rs.60000 . I further undertake that in the
event of the particulars given in the declaration being found false, I shall refund the whole amount of the Scholarship paid to
the said Scholarship holder TOUSHIK AHAMED MOLLA and the Government's decision in this regard shall be final and
binding on me.

__________________________
Signature of the parents/ guardian
Instruction
Student is to submit this ***computer-generated filled-in application form (duly signed) to the educational
institution along with following supporting document within 7 days:

1. Photocopy of the bank-passbook where the details of bank a/c number,IFSC are mentioned clearly.

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