Inter R.

No:_______________________ Group :___________,Marks: _____

RENEWAL

APPLICATION
- 20 (CSSS for College & University students) % of Remarks Attend- Regarding ance discipline of the student, including ragging, etc.,

Name of Degree / PG Course:.. II Year P.G. III Year IV Year / I Year

MHRD, Department of Higher Education, Govt of India, New Dehli. Form for Renewal of Scholarship for the year 20

Schp. IDNo.____________________
Name of the student with Fathers name & e-mail-ID

IV Year / II Year P.G.

On line facility Bank A/c particulars

Name(as on sign board) & Postal Address of the College, where Candidate is studying now. Degree College:______________________ ___________________________________ Address: ____________________________ ___________________________________ Dist._________ State________ Pin_______ ___________________________________ If studying PG: Name of the PG Course:________________ Admission No. _______________________ Date:____________ Name of the PG College:_______________ ___________________________________ Address: ____________________________ ___________________________________ Dist.________ State_________ Pin_______ ___________________________________ Telephone No. ____________________ Mobile No.

Name of the Bachelor Degree course, whether promoted to the next class and percentage of marks obtained in annual / semester exams in the relevant year

a) Name of the Bachelor Degree / PG Degree Course:______________ b) whether promoted to next class : - Yes / No c) I year % of marks:_________ d) II year % of marks:_________ e) III year % of marks:_________ f) IV year / I year P.G. % of marks:__________
Note: Convert the CGPA into % of Marks & Furnish Year Wise in % of Marks.

State and Board from which class 12 exams appeared, year of passing and Roll.No., group, marks, Shp ID.No. as given in the fresh final selection list. A.P., BIE, A.P., Hyderabad IPE March 20 Roll.No:________________ Group in Inter:___________ Marks in Inter:___________ Schp.ID NO: ___________ (as provided in the final selection list)

Bank Name:_____________________ ______________________________ Branch :_____________________

Branch Code:____________________ Bank S.B A/c No.: _______________________________ IFSC code:______________________ (Above particulars must be furnished)

Telephone No. _______________ Mobile No. _______________

Certified that the particulars given above are true. 1) Scholarship ID No. as provided in final selection list is to be filled compulsorily without which renewal scholarships can not be sanctioned. Signature of the Principal (Bachelor Degree Course) / PG 2) This form has to be sent as early as possible (on or before 15th July of Every Year (OR) as stated in covering letter) Course, Head of the Institute with College Seal. 3) Incomplete and late received forms will be rejected. 4) Further information on MHRD CSS Scholarship is available at BIE Website: www.bieap.gov.in And Enclose: a. Attested copy of Degree Marks Sheet. b. Xerox copy of Bank pass book page where Bank Account Number (having on line facility) and students name as mentioned in the Intermediate Pass Certificate are reflected. To be sent to: 1.The Director (National Scholarship ) Ministry of Human Resource Development, Government of India, Department of Higher Education, West Block 1, Wing 6, 2nd Floor, Ramakrishnapuram, New Delhi 110066. 2. A copy of the same may be sent to the Secretary, Board of Intermediate Education, A.P., Vidya Bhavan, Nampally, Hyderabad -500001.