Reliance Foundation Scholarships

APPLICATION NUMBER : RFSCH230200138076

PERSONAL DETAILS
Name Ashwarya Surname Thakur
Email ID ashwarythakur712@gmail.com Gender Male
Mobile Number 9399016246 Telephone Number
Date of birth 09/06/2002 Place of Birth Chhatisgarh
Religion Hindu Mother Toungue chhatisgarhi
Nationality India Disability

ADDRESS DETAILS
Current Address Village:-govindpur ,district:- Kanker, Kanker, Chattisgarh, 494334, India
Permanent Address Village:-govindpur, District:- Kanker Chhatisgarh, Kanker, Chattisgarh, 494334, India

FAMILY DETAILS
No of members in the family 2 Annual Family Income(in Rs.) 11,07,410.00
No. of children studying in family 2 Are you child of a single parent? Yes
Are both your parent’s deceased? Mother

FAMILY MEMBERS
Relationship Name Education Occupation
Brother Abhishek Thakur 10th Grade Student
Father Jiwan Lal Thakur 12th Grade Government Employee

ALTERNATE CONTACT DETAILS

Name Jiwan Lal Surname Thakur
Mobile Number 8517922484 Email ID jiwanthakur742@gmail.com
Relationship Father Address Village:- Govindpur District:- Kanker
Pin Code 494334 District Bastar
State Chattisgarh Country India

SECONDARY EDUCATION
Medium
Passing Max Obtained
Education Board Institute Name Of State City %
Year Marks Marks
Instruction
Govt. Higher
Secondary School
12th 2019 Chhattisgarh Board Hindi Chattisgarh Kanker 500.00 377.00 75.4
Potgaon Kanker
Chhatisgarh
Maharshi Dayanand
Anglovedic Higher
10th 2017 Chhattisgarh Board English Chattisgarh Kanker 600.00 351.00 58.5
Secondary School
Kanker

GRADUATION
Institute Duration Passing Max Obtained
Education Degree Type Degree Program Name/Uni State City (Years) Year Marks Marks
versity
JNM
MBBS (Bachelor of Medical
UG Medicine, Bachelor Medicine & Surgery Chattisgarh Raipur 4 2026
College
of Surgery) Raipur

EXTRACURRICULAR ACTIVITIES/ COMMUNITY ENGAGEMENT ACTIVITIES

Activity Type Activity Description Role Responsibilities
No records found

SPECIAL RECOGNITIONS, ACADEMIC HONOURS & AWARDS

Award Name Awarded Year Description
No records found

CURRENT AND PRIOR SCHOLARSHIPS, GRANTS, OR FELLOWSHIPS

Total Value of Scholarship
Name of Scholarship Duration Awarded Year (INR)
No records found

DOCUMENTS
Document Document Name
Photo ID Proof Web capture_6-2-2023_232855_.pdf
Passport Photograph IMG_20200318_174408.jpg
Family income proof income certificate (2).pdf
Marksheet of 10th Class Board Examination 10th marksheet ASHWARYA THAKUR.pdf
Marksheet of 12th Class Board Examination 12th marksheet ashwary thakur.pdf
Proof of enrollment in current institution university examination form.pdf
By signing my name in the box below:
1.I confirm that all information I have provided in this application is accurate and truthful, and is a wholly accurate and fair
representation of my achievements.
2. I understand that any material misrepresentation by me in this application will result in disqualification of my application and,
where appropriate, the rescinding of a scholarship.
3. I understand that this application and supporting materials will be shared with persons involved in the evaluation process and
others who are responsible for administering the Reliance Foundation Scholarship and involved in the selection process.
4. I understand that in case I fail to maintain a satisfactory record, or in case my conduct is considered prejudicial to the best
interest of the program, my award may be withdrawn, and payments terminated.
5. I understand that all Reliance Foundation Scholarships are subject to the policies of Reliance Foundation.
6. I agree that my information may be used for marketing and promotional purposes in the future. In the event I no longer wish for
my information to be used for such purposes, I shall intimate the same to Reliance Foundation at
rf.scholarships@reliancefoundation.org.
7. Once submitted, I will no longer have access to any part of the application or supporting materials, including any references or
evaluations.
8. I confirm that as of the date that this application, (i) there have never been any proceedings in respect of an offence alleged to
have been committed by me instituted against me before a criminal court in India, (ii) no warrant or summons for my appearance
has ever been issued under any law for the time being in force, (iii) no warrant for my arrest has ever been issued by a court under
any law for the time being in force, (4) no court has ever passed an order prohibiting my departure from India, or (4) I have not, at
any time, ever been convicted by a court in India for any offence under any law.
9. I confirm that I have not (i) been subject to any disciplinary measure, (ii) resigned from a professional or academic appointment,
or (iii) entered into a settlement for, or in connection to, any misconduct, including but not limited to unethical practices,
harassment, sexual harassment or abuse.

Note to Applicant: If you are arrested for, charged with, or convicted of an offence, or any proceedings are instituted or pending
against you, or any warrant or summons issued for your arrest or appearance, or if there is any change in your misconduct status
after the submission of this application, you must PROMPTLY (within 30 days of the arrest, charge, misconduct report, etc.) inform
the Reliance Foundation Scholarships team at rf.scholarships@reliancefoundation.org

Is this application has been filled on your behalf by someone else No

How did you hear about the Reliance Foundation Scholarships? Web search
In place of your signature, please type your full legal name (applicant) Ashwarya Thakur
Aptitude Test Slot 18/02/2023 5:00pm-6:00pm
Date 11/02/2023