Specimen Copy (For Educational Institution use only)

POSTMATRIC SCHOLARSHIP (RENEWAL) FOR MINORITY STUDENTS FOR THE YEAR 2010-11
List of students recommended by the Educational Institutions to the DBCWO of their respective District
Course fees ( per annum) for Bank D

Degree (Specify year of

physically handicapped
Religion(Christian-C;Muslim-M

Study) during 2010-11

Day Scholar/Hosteler
UG-PG
Fresh 2010-11 the Stu

Whether student is
Sikh-S;Buddhist-B;Parsi-P)

Scholarship Name of the

Other non refundable

fee (Details specify)

Branch Code No.

Gender(F/M)

Name of the Bank

% of marks Annual

(Yes or No)
santioned Students with Name of
secured in Income of

Library Fee
Tuition Fee

Exam Fee
Sl. during contact No. the

D/H
the exam the Parent/
Class/Std/

No. the year (Pl. do not put Parent/ Total

Rs.

Rs.

Rs.

Rs.
held during Guardian
2007-08 Initial of the Guardian Rs.
2009-10 Rs.
2008-09 Student )
2009-10

Grand
Total

Rs…….( in words)
Certificate
I It is Certified that
1 Utlisation Certificate for Postmatric Scholarship(Fresh) and disbursement acquittance for 2009-10 has been sent to TAMCO on …….
2 The above students have secured not lessthan 50% of marks and no arrears in the previous year examinations
3 The annual Income of the student's Parent / Guardian does not exceed Rs.2.00 lakhs
4 The above students have not enjoyed any other scholarships from the Central / State Govt. / Welfare Boards in Tamil Nadu.
5 The course fee mentioned are verified with our record, Bank details furnished by the Institutions are verified and found correct.
6 The above students have satisfactory progress, conduct and character
7 Renewal application received from the student are kept in the Institution's custody and are subject to verification / Audit by the officials concerned.
II Bank account details of the Institution :-
e) MICR Code
a) Name of the Payee : c) Branch Code No. : (9 digit) :
b) Name of the Bank & Branch : d) Bank Account No. (SB/Current) : F) IFSC/RTGS CODE NO.
Institution: Contact No:

Seal of Educational Institution Signature of the Correspondent/Principal/Dea

with Designation Seal
etails of
udents

Bank A/c No.

an/Registrar