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Application Form 2020-21 OUT OF STATE
Application Form 2020-21 OUT OF STATE
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izekf.kr Nk;kizfr;kaA
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5& lEc)rk ls lEcfU/kr izi=ksa dh izekf.kr Nk;k izfr;ka A
uksV& loZizFke Nk=o`fRr iksVZy ls vkuykbu vkosnu lcfeV djsa ¼uohu laLFkku½ ,oa
funs'kd] lekt dY;k.k] 3&izkx ukjk;.k jksM ¼dY;k.k Hkou½ y[kuÅ] mRrj izns'k] fiu
dksM&226001 ds irs ij LihM iksLV@jftLVMZ Mkd }kjk rFkk bZ&esy ds ek/;e ls
dd.dir3.sw@dirsamajkalyan.in ij mDr lwpuk ,oa izi= 2023&24 dh le; lkfj.kh esa
fu/kkZfjr frfFk rd miyC/k djk;saA
YEAR 2023-24 APPLICATION FORM
(FOR INCLUSION OF OUT OF STATE (Govt & Govt Aided Institutes only)
INSTITUTES IN U.P. SCHOLARSHIP MASTER DATA)
1- Name of institute & Address (With Pincode) …………………………….
2- Name of state & District (where institute is situated)
3- Duration of recognition .......................................................
A. Name -& post of competant department/Authority for
recognition .......................................................
B. Letter No.of recognition....................................................... Date……..
4- Type of institute--:-Govt/Aided.......................................................
5- Courses run by institute& its fees Structure
Sr.no. Name of course Type of Fees Letter No. Of
course(regular / Fixed by recognition
self finance Competent letter & date
authority
1
2
3
Other
6- Name & address of university & Institute (where institute
attached)--------------------------------------------------------------------------------------
Letter No and date for affiliation
-----------------------------------------------------------------------------
7- Statement about sanction seat in institute (academic year 2023-24)
SC ST GENRAL TOTAL
Sign
Head of Institution
(Name & designation with seal)
1- Attested copy of recognition Certificates of institute & govt./aided gazette notification
of institute .
2- Attested copies of courses recognition Certificates.
3- Attested copies of fees fixation letters from competent authority.
4- Attested copies of course wise seats approval letters.
5 - Attested copies of affiliation Certificates.
Note:- Please submit your application online at scholarship portal (New Institution) & send
your all information for inclusion in U.P. Scholarship Master data by registered/speed post
to DIRECTOR, SOCIAL WELFARE, 3- PRAG NARAYAN ROAD (KALYAN BHAWAN) LUCKNOW .U.P.
PIN CODE – 226001 & at E-mail address dd.dir3.sw@dirsamajkalyan.in within time limit given
in Time Table 2023-24.