APPLICATION FORM FOR "M.L.

SOOD MEMORIAL SCHOLARSHIP"

FOR THE YEAR 2019-2020
Passport Size Photo

1 Name of the candidate:

2 Father's Name:

3 Date of Birth

4 Nationality

Address of candidate for

communication along with Contact No
5 & Email ID.

6 University Enrolment Number

7 Branch

8 Name of college of study

9 Name of University RGPV-Bhopal

10 Educational Qualifications

School/College/
Month & Year of Whether passed Board/Universit Medium of Total Marks obtained in
S.No Examination Passed passing in 1 st attempt y Instruction Theory

X th Class Yes/No

XII th class Yes/No

BE 1 st Sem/BE 2 nd Sem Yes/No

Diploma Certificate (For TC Student) Yes/No

11 Occupation of Father:

12 Occupation of Mother:

13 No.of Brothers & their occupation

14 No.of Sisters & their occupation

15 Gross Annual Income of Family

Why this Scholarship should be given Please attach separate sheet ,Write your name and college name on top of this write-up
16 to you ? Give a write-up in 150 words. sheet and sign it with date.

17 Declaration by the Candidate:

This is to certify that the information provided in para (1) to (16) above is correct to the best of my knowledge and belief.

Place: Date: Signature of Candidate with Name:

18. Certificate from the principal/competent Authority of College of study

 This is to certify that Mr./Miss/Mrs……………………………………………………...............University Enrolment
No………………………………….............is a Reular student of this college is approved by AICTE ,New Delhi and affliated to
RGPV,Bhopal.The information provided above has been verified from the records and has been found correct.The student bears a
good moral character.

Place: Date: Signature & Seal of Authority:

Note:-The Candidate should enclose attested copies of Documents and all the marks sheet in Support of above.