Scholarship of Help the Blind Foundation for college students for the academic year 2017-18
Below reproduced is application form to apply for scholarship of Help the Blind foundation for college education for the academic year 2017-18
Students are advised to dully fill up the application and e-mail it to the foundation at below mentioned mail ID.
After receipt of the soft copy of application, the functionary of the foundation will come to your concerned college for your interview and seeking signature of your college principal,
You are also advised to retain the hard copy of the application with you and submit the same to the foundation after completion of the verification process in accordance with the satisfaction of the foundation
Last date to apply – 31st August 2017
Contact details: Phone: +91 9003330197 - email – sekar@helptheblind.in
APPLICATION FOR SCHOLARSHIP - NEW / CONTINUATION
STATE / CITY ______________________
NAME OF COLLEGE: __________________________
COLLEGE HOSTEL |
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OTHERS |
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NAME : ________________________________________
DATE OF BIRTH / AGE : ______________________ MALE / FEMALE
% OF VISUAL IMPAIRMENT : __________ (ATTACH CERTIFICATE)
PRESENT ADDRESS & TEL No : ________________________________________
________________________________________
PERMANENT ADDRESS : ________________________________________
________________________________________
CONTACT PHONE NO. _____________________ EMAIL ID _______________________________
NAME AND OCCUPATION OF FATHER / MOTHER ________________________________________
ANNUAL INCOME OF FAMILY ________________________________________
DO YOU OWN COMPUTER / LAPTOP / ANGEL READER / OTHERS
AMOUNT OF SCHOLARSHIP RECEIVED FROM US LAST YEAR : ____________________________________
ANY OTHER FINANCIAL ASSISTANCE APPLIED / RECEIVED Rs._____________ FROM ________________
ACHIEVEMENTS IN EXTRA CURRICULAR ACTIVITIES ___________________________________________
COURSE STUDYING: _____________________ YEAR OF STUDY: YEAR 1 / YEAR 2 / YEAR 3
% OF MARKS : (ATTESTED COPY OF MARK SHEET TO BE ATTACHED)
10TH __________ 12TH__________ I YEAR _________ II YEAR _________ III YEAR ___________
Certified that the applicant is bonafide student of the college
SIGNATURE OF STUDENT.
SIGNATURE OF THE PARENT/ LOCAL GUARDIAN/HOSTEL MANAGER SIGNATURE OF PRINCIPAL / HOD WITH COLLEGE SEAL
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APPROVED : AMOUNT ____________________