Student Location

State* Select State Andaman and Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli Daman and Diu Delhi Goa Gujrat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Lakshadweep Madhya Pradesh Madhya Pradesh (MP) Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Puducherry Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal

District*

City *

Block*

Centre*

Phone Number*

Pin Code*

Email*

Student Information

Name*

Father's Occupation*

Annual Income *

Mother's Name*

Religion*

Email*

Caste*

Address*

Scholarship Name*

Scholarship Amount*

District*

Block *

Pin*

Father's Name*

Gender* Male Female

Financial Year

Qualification*

Course Name*

Phone Number*

Religion* Select a religion Indian Others

Source*

Date of birth*

Referance ID*

Photo Upload*

Upload Signature*

Reference Proposal*

Income Certificate*

Declaration
I do hereby declare that the above information or statement given by me is true to the best of my knowledge, if any statement showing false so my candidature will be cancelled without any notification.

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