STUDENT APPLICATIONRenewal(MINORITY WELFARE SCHOLARSHIP SYSTEM)

Affix a selfattested passportsize photograph

2.Father's name/Husband's name :

3.Mother's name :

4. Domicile State/UT (State/UT which thestudent belongs to) :

For official use onlySl No of application Year Course Whether approved

SAJAD AHMAD KAWA

mohd sidiq kawa

5. Address for correspondence:

6. Permanent address(please enclose residential certificate from concerned stategovernment authority):

7. Date of birth (Please enclose certificate) :8. Whether male or female :

City/Town/ Village & P.O.District

StatePincode

House No. & Street Detail

House No. & Street DetailCity/Town/ Village & P.O.District

StatePincode

kaw mohalla khanyar srinagar

SRINAGARJammu and Kashmir190003

03-Mar-1989

Male

Jammu and Kashmir

9. Religion : Muslim

kaw mohalla khanyar srinagar

SRINAGARJammu and Kashmir190003

shameema

10. Nationality : Indian

Temporary ID : T2014RjkM01923

Admission No : 1204

1.Student name :

11. Adhaar No. :

P2013jkM00525Permanent ID :

Page 1 of 529-Nov-14Printed Date:NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.

14. Details of bank account of student:

Name of the payee (as in the bank accounts)

Name of the Bank

Full address

Branch Code number

Bank Account Number

Bank Account Number in words

IFSC code of the Bank

THE JAMMU AND KASHMIR BANK LTD

JAKA0SHIRAZMode of Electronic transfer available in the Bank ECS/RTGS/NEFT/CBS/code number (if any);-15. Annual Income of parent/guardian of the student: Rs. 80000

(specimen form of declaration of annual income is given at Annexure which is to be signed by theparent/guardian of the student and enclosed alongwith the application. In case parent/guardian areemployed, income certificate from the employer may also be enclosed)

91822

12. Last Examination Passed Details:

Name of examination passed Year Marks Obtained Full marks % of marks73.5384478 6502MCA( Master of Computer

khanyar

3. Examination Fee

4. Other Non Refundable Fee

Total

(Break up of course fee such as tuition fee, library fee, examination fee etc. other than refundabledeposits):

Sl.No. Item

1. Tuition Fee

2. Library Fee

Annual fee

13. Total Annual course fee:

10545.00

10545.00

8595.00

800.00

0.00

1150.00

sajad ahmad kawa

Page 2 of 529-Nov-14Printed Date:NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.

INSTITUTION VERIFICATION FORMVerification/information to be furnished by the Head of institution/college:

Details provided in existing print out of form.(last year marks details) .

In case the information filled in these columns is not correct, then the institute should indicate thatseparately.

It is certified that the student has not changed the course of study and/or the institution of the studyfor which the scholarship was originally awarded /has changed the course of study and/or institutionwith prior approval of the state government (Please strike outPlease ensure the information given by you is factually correct. In case of any discrepancy noticedlater, your application is likely to be rejected.

For Renewal of Scholarship:

Details provided in existing print out of form. (Fee details current year).

Date :

Place :

Signature of the head of the

with Official seal

It is certified that the information provided below by SAJAD AHMAD KAWA who is admitted in MCA Master ofComputer Application course for the for the academic session 2014-2015 in Department of Computer SciencesKashmir University college is correct. He/she is a hosteler/day scholar of the college.

NOTE :

The verification by institution is mandatory for consideration of the application.

Page 3 of 529-Nov-14Printed Date:NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.

DECLARATION OF FAMILY INCOME

Signature

Date:

(Father/Mother/Guardian)

Residential Addresskaw mohalla khanyar srinagar

SRINAGARJammu and Kashmir

190003

I mohd sidiq kawa (Father /Mother /Guardian) of SAJAD AHMAD KAWA(Name of student) who is studying in MCA( Master of Computer Application ) IIIyear hereby declare that my annual income from all sources is Rs./ 80000.00 ifat any stage,it is found that the information given by me is false/not true,allbenefits given to the student under the scehme of Merit cum means basedscholarship to the student belonging to minority communities could be with dranand legal action as deemed fit, may be taken against me or my ward.

Page 4 of 529-Nov-14Printed Date:NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.

(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 basedScholarship.

(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 inthe 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.

Signature of the candidate

Declaration of the Student

Date :

Page 5 of 529-Nov-14Printed Date:NOTE: Scan each page of this application as separate PDF Files for upload after Signing from Institute.