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    Manjeet 001

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    subratkumar9087

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    © All Rights Reserved
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    Manjeet 001

    Uploaded by

    subratkumar9087
    9 views4 pages

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    9 views4 pages

    Manjeet 001

    Uploaded by

    subratkumar9087

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    ଓଡ଼ିଆ A- A A+  Screen Reader

    Scholarship Application Form


    ST&SC and MBC Welfare Department
    Academic Year 2024-25 STSC92412147105020
    Government of Odisha

    Basic Information

    Department Scheme Academic Year Application Type


    ST&SC and MBC Welfare Post Matric Scholarship 2024-25 New
    Department

    Applicant Details

    Applicant Name Category Applicant Gender


    ARIYAN PRADHAN OBC/SEBC Male

    Religion Date of Birth Aadhaar No.


    Hindu 06 Jul 2008 (16 Year) XXXXXXXX5484
     Bank account is seeded with Aadhaar when applied by student.

    Mobile No. Alternative Mobile No. e-Mail Id


    7326929111 9938217866 lilimapradhan496@gmail.com

    Father's Name Father Educational Status Father Occupational Status


    Bijay Kumar Pradhan Literate Agriculture

    Mother's Name Mother Educational Status Mother Occupational Status


    Lilima Pradhan Literate House Wife

    Guardian Name Individual/ Family Information


    VIEW
    -- Beneficiary of NFSA

    Address Information

    District Block/ULB GP/Ward


    Deogarh Reamal Nuadihi

    Village Pin Code Address


    Phuljhari 768108 Ariyan Pradhan, C/o- Bijaya Kumar Pradhan,
    Phuljhari, Nuadihi, Kundheigola, Deogarh-
    768108

    Educational Qualification Details

    For : Matric-Annual

    Passing Total Secured Percentage Marksheet/


    Course Board Roll No. Year Mark/CGPA Marks/CGPA (%) Certificate

    X BSE, 184BB0056 2024 600 370 61.67 Uploaded


    Odisha
    Institute / Course Information (Current Education Information)

    Institute Type
    Pvt. Unaided

    Institute District Block/ULB


    NIIS Higher Secondary School, Madanpur Khurdha Bhubaneswar Mc

    Nature of Course Course Branch/Stream/Trade


    Self Financing Plus 2 Science

    Course Year (Current Year of Study) Admission/Registration No. Admission/Readmission Date


    1st Year 2024250188 12 Jul 2024

    Enrollment No. Enrollment Date


    IS24-013 20 Aug 2024

    Any Exam Conducted during current academic year? : No

    Residential Status

    Whether
    Day Scholar

    Details of Last Exam Passed

    Course Passing Year Total Mark/CGPA


    X 2024 600

    Secured Marks/CGPA Percentage (%) Certificate


    370 61.67 Uploaded

    Eligibility Information

    Income Certificate No. Family Income (in Rs.) To Whom the Certificate Issued
    INC/2024/1638120 100000.00 Bijay kumar pradhan

    Issuing Authority Issue Date Income Certificate


    Revenue Officers not below the rank of 10 Jul 2024 Uploaded
    Tahasildar / Additional Tahasildar

    Matriculation Certificate No. Issuing Authority Matriculation Certificate


    124446042 BSE, Odisha (Annual) Uploaded

    Caste Certificate No. To Whom the Certificate Issued Issuing Authority


    OBC/2021/43864 Ariyan pradhan Revenue Officers not below the rank of
    Tahasildar / Additional Tahasildar

    Issue Date Caste Certificate


    07 Apr 2021 Uploaded

    Institute Declaration Certificate


    NA

    Bank Information

    Account Holder Name IFSC Code Account No.


    ARIYAN PRADHAN SBIN0009027 43610912685

    Whether account number tagged /seeded with


    the Aadhaar number?
    Yes

    Bank Name Branch Name


    STATE BANK OF INDIA PRIYADARSHINI MARKET
    Passbook front page
    Uploaded
    Student Declaration

    1. I have read and understood the conditions of award of Scholarship.


    2. I am aware that my application is liable to be rejected, if it is found at any stage, that Aadhaar number provided by me is wrong or Aadhaar number is
    of someone’s else.
    3. I am aware that if more than one application is found, all my applications are liable to be rejected.
    4. I am aware that for any wrong entry or mis-match of the Bank-account details, the State Government will not be responsible for mis-credit and I will
    be held responsible for diversion of public money on this ground.
    Date ........................
    Place ........................

    Full Signature of Applicant

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