Nothing Special   »   [go: up one dir, main page]

AkbarPrint - Application

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

Government of Andhra Pradesh

Department of Minority
Student Application cum Verification Report for Post-Matric Scholarship Renewal 2012-13

1. Application No: 2012 0548 8373 4. Student Name : MOHAMMAD AKBAR ALI 6. Father / Mother Name : MOHAMMAD VALLI

2. Application Date: 24-01-2013

3. Caste / Sub Caste: BC-E / BC-E 5. Gender : Male

7. Address & Mobile No : ,Kakinada (Urban) , Ramarao Pet ,East Godavari & 9666545260 8. SSC HT No : 0236658 11.Family Annual Income (in Rs.): 48000 13. Income Certificate Details: 9. Pass Year -Pass Type : 2006-Regular 10. Date of Birth: 13-12-1990

12. Ration Card : PAP04830150036

14.College Details : GODAVARI INSTITUTE OF ENGINEERING AND TECHNOLOGY VELUGUBANDA , Rajanagaram,East Godavari , Private College ,JNT UNIVERSITY KAKINADA
15. Course Name /Course Year /Duration of Course : BTECH (EEE) / III Yr / 4Yrs 16. College Admission No / Admission Date(of this year): / 14-06-2012 18. Scholarship Type : Student Managed Hostel 20. Bank Name / IFSC Code: SBHY-ZP COMPLEX KAKINADA /SBHY0020975 17. Distance (in Kms.) : 60 19. DAH Name : 21. Bank A/c No : 62031340280

I.Declaration
I hereby certify that that above information furnished is true. I have not availed any other scholarship for this purpose from any other sources. I shall abide by the terms and conditions of the sanction of the scholarship. If any discrepancies are found later, I hereby abide for refund of the scholarship amounts claimedand also am liable for action by the Department. .

Date :

Signature of the Student

August 14, 2013 07:51:57 PM

You might also like