Hindi Scholarship 2014-15

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Government Institution
Registration ID
010010787112
1) Full Name
VIJAYASREE.M
2) Name of Father/Husband/Guardian
PREMA.K.T
3) Name of Mother
PREMA.K.T
4) State/UT of domicile
Kerala
5) Aadhhar Number
284421784378
6) Permanent Address
i) House No/Name
DELI KUNNUPARA
ii) Street/Locality
DELI
iii) Name of City/Town/Village
CHEMNAD
iv) Post Office
PARAVANADUKKAM
v) District
Kasaragod
vi) State
Kerala
vii)Pincode
671317
viii)Phone Number
7) Address for Correspondence
i) House No/Name
DELI KUNNUPARA
ii) Street/Locality
DELI
iii) Name of City/Town/Village
CHEMNAD
iv) Post Office
PARAVANADUKKAM
v) District
Kasaragod
vi) State
Kerala
vii)Pincode
671317
8) Date of Birth
26/05/1997
9) Whether male or female
Female
10) Nationality
Indian
11) Details of educational qualifications from
To be Verified by the head of the
Verified Signature
matriculation/SSLC/SSC onwards
Institution
12) Details of course based on which scholarship is being sought:
i) Examination Passed
HSC,Business Studies, Accountancy, Economics,Statistics
ii) Year of Passing
2013 - 14
iii) Percentage of marks obtained in aggregate
96.25%
13) Details of Present Course and Institutions
i) Name of the Course Joined
UG,B.Com Computer Application
ii) Name of the Institution
GOVERNMENT COLLEGE, KASARAGOD
14) Details of Bank Account
i) Account Number
67118001641
ii)Name of the Bank
STATE BANK OF TRAVANCORE
iii)Branch Code and Address
201,P.B.NO.27, MANSOOR MANSION, RAILWAY STATION
ROAD, KASARAGOD P.O. KASARAGOD DISTRICT.

IT Services:National Informatics Center(NIC),Kerala

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Printed On: 26/09/2014 13:59

Hindi Scholarship 2014-15

Registration ID
010010787112
Full Name
VIJAYASREE.M
15) Whether the student is in receipt any
No
scholarship
16) Course starting date for single year course
00/00/0000
17) Is Studying hindi as a language?
18) Percentage of mark in hindi
0
19) Documents enclosed with the application
i.One copy of passport size photograph pasted on the registration Printout.
ii. Attested certificate of matriculation examination.
iii. Proof of permanent residence/Nativity Certificate.
iv. Attested copy of first page of bank pass book in the name of the student., showing the Account Number, Name,
Code.
v. Copy of Certificate of Qualifying Examination attested by a Gazetted Officer.
vi Copy of Adhaar/Enrollment document.
20) Declaration
i) I hereby declare that the information furnished above is correct to the best of my knowledge and belief.
ii) I shall abide by the terms and conditions for sanctioning of the scholarship..
iii) I understand that if at any stage, it is found to the satisfaction of the sanctioning authority that the information given
by me is false or I have violated 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, apart from liability for such penal actions
warranted by the law.

Place:
Date:

Signature of Candidate

20) Remarks by Verifying Officer

Verified online the details given by the candidate with supporting documents and found
Correct/ Incorrect (Specify)

Place:
Date:

Signature of Verifying Officer

name:
Designation:

21) Certificate by the Head of the Institution

It is certified that the information filled in the above mentioned columns by shri/smt/kumari....VIJAYASREE.M......... S/O
D/O W/o Shri..........PREMA.K.T........... who is admitted for .....B.Com Computer Application .....Course in
..........GOVERNMENT COLLEGE, KASARAGOD.............college is correct. He/She/ is a student of this college..

Place:
Date:

IT Services:National Informatics Center(NIC),Kerala

Signature of head of the institution/college with official Seal

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Printed On: 26/09/2014 13:59