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CERTIFICATE

Application No: 40180000024368

1. Name of School/College/Institution: RAJKIYA PRATIBHA VIKAS VIDYALAYA

2. Affiliation No/School Id/Dise No/Recognition No: 1106252

3. School/College/Institution Address: D-BLOCK, NAND NAGARI DELHI

1. Certified that the above particulars in respect of KABIR (DOB:13/10/2006) S/o ASHOK KUMAR,
R/O D-27/2 GALI NO-3 ASHOK NAGAR ASHOK NAGAR D1- BLOCK Delhi 110093 India studying
in class 12th in our School/College/Institution are verified from the office record of this
School/College/Institution.
2. Certified that the above student is not a repeater in the same class and his attendance in the
previous year was 85% wherever applicable.
3. Certified that the above student is not covered under 20% quota meant for poor families as per
latest prescribed regulations set by the Directorate of Education, Govt. of NCT of Delhi in this regard.

Signature with seal of the Principal/Head of School/College/Institution

Dated:

GOVERNMENT OF NCT OF DELHI


DEPTT. FOR THE WELFARE OF SC/ST/OBC
B-BLOCK, 2ND FLOOR, VIKAS BHAWAN, I.P. ESTATE, NEW DELHI-110002
Website: www.scstwelfare.delhigovt.nic.in

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APPLICATION FORM OF POST MATRIC SCHOLARSHIP SCHEMES FOR SC FOR THE YEAR 2023-2024

Application No: 40180000024368

Name of the School/College/Institution: RAJKIYA PRATIBHA VIKAS


VIDYALAYA
Address of the School/College/Institution: D-Block, Nand Nagari Delhi, ,
Delhi

Particulars of the students:

Name of the DOB of the Father/Guardian’ Whether Yearly Family


SL. No.
student student s Name SC/ST/OBC/MIN Income

1. KABIR 13/10/2006 ASHOK KUMAR SC/ 140000

Mobile/Phone Number: ******5634


Address : D-27/2 GALI NO-3 ASHOK NAGAR ASHOK NAGAR D1- BLOCK Delhi 110093 India
Whether Hostler:No

Class in which % of marks in the previous class % of attendance in the previous


Previous class
presently passed(Copy of Report Card to be class passed (for students of class
passed/year
studying attached) 6 onwards)

12th 11th 85

Declaration: I hereby declare that the particulars given above are true and correct. There is no false
and fabricated document/information. If any false or fabricated information provided by me it may be
prosecuted as per law

Signature of Parent/Guardian

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