- SITARAM JINDAL FOUNDATION

Scholarship Application Form

I. Student Profile

1. Aadhar No:

2. Name :

3. Gender:

4. Email Id:

5. Mobile No:

6. Date of Birth:

7. Country:

8. Nationality:

9. Permanent Address:

10. Permanent Pin Code:

11. Permanent City:

12. Permanent Post Office:

13. Permanent State:

14. Present Address:

Same as Permanent Address

15. Present Pin Code:

16. Present City:

17. Present Post Office:

18. Present State:

19. Physically Handicapped

20. Ward of Ex-Serviceman

21. Belong to BPL Family

22. Single Parent

23. Orphan

II. EDUCATIONAL INSTITUTION DETAILS

1. Country:

2. Pin Code:

3. City:

4. College Post Office:

5. State:

6. Present Institute/College/School name:

7. College Email:

8. College Phone No.(With Std. Code):

9. Previous Exam:

b) Previous Year:

10. Obtained Marks in Previous Exam:

11. Total Marks in Previous Exam:

12. Percerntage (%) in Previous Exam:

13. Current Course:

14. Course Duration (In Years):

15. Choose your Preference:

Regular

Part-time

Correspondence

Evening College

16. Annual Fee:

17. Course Started From:

(Enter the month and year when your current course began (e.g.,01-07- 20XX))

18. Final Exam:

19. Required Scholarship Amount (Per month):

20. Have You Applied Before S.R.Jindal Scholarship Scheme:

21. Are you getting any stipend/Fee reimbursement/scholarship from any other source?
:

22. Have you applied / or getting any scholarship from Minorities Welfare dept / SC / ST / OBC in your state

23. Current Stay:

III Parents/ Guardians Information

1. Name:

2. Relation:

3. Mobile No:

4. Alternate No (Optional):

5. Email Id (Optional):

6. Occupation:

7. Annual Family Income:

IV Bank Details

1. IFSC:

2. Bank Name:

3. Account Number:

4. Beneficiary Name:

5. Branch Address:

6. Upload Bank Document

Only PDF files allowed (e.g., Bank_Passbook.pdf)

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