Professional Documents
Culture Documents
Renewal
Temporary ID :
T2014RjkM01923
Permanent ID :
P2013jkM00525
Admission No :
1204
Year
Course
Whether approved
Affix a self
attested passport
size photograph
1.Student name
3.Mother's name
shameema
SRINAGAR
State
Pincode
190003
SRINAGAR
State
Pincode
190003
03-Mar-1989
Male
9. Religion
Muslim
10. Nationality
Indian
NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.
Page 1 of 5
Printed Date: 29-Nov-14
Year
Marks Obtained
Full marks
% of marks
478
650
73.5384
Item
Annual fee
1.
Tuition Fee
8595.00
2.
Library Fee
800.00
3.
Examination Fee
4.
1150.00
0.00
Total
10545.00
Full address
khanyar
91822
JAKA0SHIRAZ
NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.
Page 2 of 5
Printed Date: 29-Nov-14
In case the information filled in these columns is not correct, then the institute should indicate that
separately.
NOTE :
NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.
Page 3 of 5
Printed Date: 29-Nov-14
Signature
Residential Address
Date:
(Father/Mother/Guardian)
NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.
Page 4 of 5
Printed Date: 29-Nov-14
(i) I hereby declare that the information given in my application form (From 1 15) is correct.
(ii) I am not availing any other Scholarship for this purpose from Central Govt./State Govt.
sources.
(iii) I shall abide by the terms and conditions for sanction of the Merit cum Means based
Scholarship.
(iv) I have uploaded the desired documents in support of my claim.
(v) I undertake, that if at any stage, it is found to the satisfaction of the sanctioning authority in
the Ministry of Minority Affairs that the information given by me is false or if I violate the terms
and conditions of the scholarship, the scholarship sanctioned to me, may be cancelled and the
entire amount of scholarship will be refunded by me or recovered from me, apart from liability for
such penal action as warranted by law.
Date :
NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.
Page 5 of 5
Printed Date: 29-Nov-14