Beruflich Dokumente
Kultur Dokumente
Renewal
Temporary ID :
T2014RupM01739
Permanent ID :
P2013upM01851
Admission No :
4140906
Year
Course
Whether approved
Affix a self
attested passport
size photograph
1.Student name
ABDUL MAZ
AKBAR ALI
3.Mother's name
KHATOON BANO
Uttar Pradesh
A.M.U. ALIGARH
District
ALIGARH
State
Uttar Pradesh
Pincode
202002
SITAPUR
State
Uttar Pradesh
Pincode
261131
01-Aug-1994
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: 18-Sep-14
Year
Marks Obtained
Full marks
% of marks
8.6
10
86.0000
Item
Annual fee
1.
Tuition Fee
1100.00
2.
Library Fee
1000.00
3.
Examination Fee
2000.00
4.
30000.00
Total
34100.00
ABDUL MAZ
Full address
AMU ALIGARH
33277351288
SBIN0005555
NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.
Page 2 of 5
Printed Date: 18-Sep-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: 18-Sep-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: 18-Sep-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: 18-Sep-14