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II. SCOPE
after B.A. or M.A. in a subject after M.A in another subject will not be
eligible.
(v) Students who, after having completed their educational career in one
(viii) Students who pursue their studies through correspondence courses will
be eligible towards reimbursement of non-refundable fee. The term
applicable.
(ix) Only two boys of the same parents/guardian will be entitled to receive
(x) A scholarship holder under this Scheme will not hold any other
i) Maintenance Allowance
Group A
(i) Degree and Post Graduate level
courses including M.Phil., Ph.D. and
Post Doctoral research
in Medicine (Allopathic, Indian and
other recognized systems of
medicines), Engineering,
Technology, Planning, Architecture,
Design, Fashion
Technology, Agriculture, Veterinary
& Allied Sciences, Management,
Business Finance/ 350
750
Administration, Computer
Science/Applications.
(ii) Post Graduate Diploma courses
in various branches of management
& medicine.
(iii) C.A./ I.C.W.A./ C.S./ I.C.F.A.
etc.
(iv) M. Phil., Ph.D. and Post-Doctoral
Programmes (D.
Litt., D.Sc. etc.).
(v) L.L.M.
Group B
(i) Graduate/Post/Graduate courses
leading to Degree, Diploma,
Certificate in areas like Pharmacy
(B. Pharma), Nursing (B Nursing),
LLB, BFS, other para-medial
branches like rehabilitation
diagnostics etc., Mass
Communication, Hotel Management
& Catering,
Travel/Tourism/Hospitality
Management, Interior Decoration, 510 335
Nutrition & Dietetics, Commercial
Art, Financial Services (e.g. Banking,
Insurance,
Taxation etc.) for which entrance
qualification is minimum Sr.
Secondary (10+2), except aviation
related courses.
(ii) Post Graduate courses not
covered under Group A
e.g. MA/ M.Sc./ M.Com/ M.Ed./
M.Pharma etc.
Group C
All other courses leading to a
400
graduate degree not covered under 210
Group A & B e.g. BA/B.Sc./B.Com
etc.
Group D
All post-matriculation level non-
degree courses for which entrance
qualification is High School (Class
X),
260 160
e.g. senior secondary certificate (class
XI and XII);
both general and vocational stream,
ITI courses, 3 year diploma courses
in Polytechnics, etc.
ii) Reader Charges for blind students (Blind Scholars)
Group C 130
Group D 90
iii) Fees
Study tour charges upto a maximum of Rs. 900/- per annum limited to the
actual expenditure incurred by the student on transportation charges etc., will
be paid to the scholars studying professional and technical courses, provided
that the head of the institution certifies that the study tour is essential for the
scholar for completion of his/her course of study.
b. One copy of the passport size photograph with signatures of the student
thereon.
ii) Application complete in all respect shall be submitted to the Head of the
Institution being attended or last attended by the candidates and shall be
addressed to the Managing Director, KSWCFC.
Duly filled applications along with the mandatory/ relevant documents should be sent to
the following address.
Application Form
Dr. Ambedkar Post Matric Scholarship for the Economically Backward Class
(EBC)
Applicant must
To affix his/her
The Managing Director, recent passport
size photograph
Kerala State Welfare Corporation
with his/her
for Forward Communities Limited. signature
L2, Kuleena, Jawahar Nagar, Kowdiar. P.O, thereon.
Thiruvananthapuram – 695003.
Sir,
I wish to offer myself as a candidate for the award of a scholarship for the year 2019-20
under the above noted scheme.
I belong to …………………………… (Religion) & ……………………………….. (caste) and the other
particulars are given below:
Name of Student
Father’s Name
Mother’s Name
Guardian’s
Name
Student’s
Aadhaar No
2. Address
Name
House No
House Name
Street
Post Office
District
State
Pin Code
Student Mobile
No
Parent Mobile
No
3. Date of Birth D D M M Y Y Y Y
Religion
Nationality
Category
(General/SC/ST/OBC)
Whether Differently
abled (PH) (Yes/No)
Category of disability (if
applicable)
% Disability (if
applicable
Disability certificate
issue authority (if
applicable)
University/ % marks
Division/
Sl. Examination Board/Institution/ Year of Marks Marks obtained
Class/
No Passed Council of Passing obtained out of in Board/
Grade
Examination University
4
8. Details of course in which the student is admitted and scholarship is being
sought
1 Name of course
2 Duration of Course
Part Time/Full Time/
3
Correspondence
4 Day Scholar/ Hosteller
5 Academic Year
Date of admission of the course
6
in the current academic year
Class last attended Academic
7
(Xth/ XII th/ any other) Year
10. Annual family income of parents of the student : Rs. ……………. in words
…………………………………………………………………… (Certificate of annual family
income is to be given only in the prescribed format enclosed as Annexure – III along with
the application)
11. Declaration by the student
a. I hereby declare that the information given above is correct.
b. I have taken admission in _________________ course _______________ year during
academic session _________________ by securing ____________ marks out of
_____________. Percentage/ CGPA _______________ in the previous year examination.
c. I am not availing any other scholarship for this purpose from any other source.
d. I shall abide by the terms and conditions for sanction of the scholarship.
e. I undertake, that if at any stage. It is found that the information given by me is false or
if I violate the terms and conditions of the scholarship, the scholarship sanctioned to
me, will be cancelled and the entire amount of scholarship will be refunded by me or
recovered from me, apart from liability of penal action as warranted by law.
Place:
(To be filled in by the Head of the Institution, where the applicant is studying)
12. Details of the Institution to which the student is admitted for the current academic
year
1 Name of the Institution
2 Address of the Institution
3 District
4 State
5 Pin Code
Name of the Principal/Director/
6
Head of the Institution
Annexure - I
Certificate
(to be issued by Director/Principal/Head of the Institution)
PARENTS/GUARDIANS DECLARATION
I certify that the particulars given in the application are correct and if any of them is
found to be incorrect, the Government’s decision shall be final and binding on me. I
undertake to refund the entire amount of the scholarship paid to my
son/daughter/wife failing which the Government may recover the amount from me
through whatever means it deems proper.
Place: Signature_____________
Annexure-III
As per the records, his/her annual family income from all the sources is
Rs………………… (in words) …………………………………………………………
………………….Only.
Office Seal
14. Document enclosed with the application(Attach following attested documents
along with the application)
Sl Attested Attached
Name of the document
No. (Yes/No) (Yes/No)
Copies of mark sheet of standard Xth/XII th/
1*
others as applicable and as filled up in Sl.No. 08
Copy of annual family income certificate for the
2* current financial year in the prescribed format
issued by Village Officer/ Tahasildar.
Copy of certificate issued by Competent
3 authority in case of differentially abled
candidate (PH candidate) (if applicable)
Copy of Annual charges / All non refundable
4
fee receipt
Copy of Bank Pass book showing name of the
5*
student, account number, IFSC and photograph
6 Copy of student’s AADHAAR card
Certificate issued by the Director/ Principal/
7*
Head of the Institute (Annexure – I)
8* Declaration by Parents (Annexure – II)
*Mandatory document
Sl.
Component YES/No
No
1 Maintenance Allowance
Reader Charge
2
(Only for blind Student) as sl no. IV (ii)
3 Fee as per sl.no. IV (iii)
Note : All the above assistance except maintenance allowance will only be sanctioned
based on the recommendation of head of the institution where the candidate
studies.
Details should be filled by the applicant correctly (In capital letters)
1 Category
2 Fresh/ Renewal
4 Father’s Name
5 Gender
6 Address
7 Student’s Mobile No
8 Parent’s Mobile No
9 Day_scholar/ Hosteller
10 Bank Name
11 Bank Address
12 IFSC
13 Account No
14 Aadhaar No
17 Sub caste