Applicant Full Name

Application Date

Gender
FemaleMale

Religion
HinduChristianMuslim

Last Year Marks obtained in percentage/grade

Contact No

Email Id

Address

Father’s / Mother’s Name

Father’s / Mother’s Occupation

No. of Children in Family

Annual Income of Both the Parents

Course of Study

Estimated Yearly Fees

Have you received scholarship before? if yes
YesNo

Copy of BPL Card (If applicable)

Copy of Your Last Passed Academic certificate

Your recent passport size photograph