GOVERNMENT OF ANDHRA PRADESH (DEPARTMENT OF COLLEGIATE EDUCATION) APPLICATION FOR AWARD OF " PRATHIBA" SCHOLARSHIP NOTE : Please read the Instructions given in the enclosure carefully before filling up the form Passport size photo of the candidate shall be affixed and shall duly be attested by the Institution/Authorised Officer on his behalf 1. NAME OF THE APPLICANT IN FULL (As given in SSC Certificate or equivalent, : in block letters) 2. NAME OF THE FATHER /GUARDIAN IN FULL (Guardian in case father is n ot alive, in block letters) : 3. ADDRESS FOR CORRESPONDENCE : (with pin code) 4. WHETHER SELECTED FOR LAWCET : I or II ( Please specify) 5. STATE THE YEAR IN WHICH THE APPLICANT : HS BEEN SELECTED FOR THE AWARD 6. STATE THE CATEGORY IN WHICH THE APPLICANT : OC(Boys)/Woman/SC/ST/BC/ HAS BEEN SELECTED FOR AWARD(Tick) Minorities/PH 7. MENTION THE RANK OBTAINED AT THE ENTRANCE : EXAMINATION 8. NAME OF THE COURSE AND ADDRESS OF INSTITUTION IN WHICH THE CANDIDATE HAS TAKEN ADMISSION/HAS HE OBTAINED THE ADMISSION BASED ON THE RANK : SECURED BY HIM AT THE CORRESPONDING ENTRANCE EXAMINATION 9. DURATION OF THE COURSE : 10. IS THE APPLICATION SUBMITTED FOR SANCTION OF A FRESH OR RENEWAL OF SCHOLARSHIP ?(Tick) : FRESH/RENEWAL 11. IN CASE OF RENEWAL OF SCHOLARSHIP WHAT IS THE PERCENTAGE OF MARKS OBTAINED BY THE CANDIDATE IN THE PREVIOUS YEAR OF EXAMINATION ? (Xerox copy of marks sheet shall be enclosed) 12. IS THE CANDIDATE IN RECEIPT OF ANY OTHER SCHOLARSHIIP? OF YES, GIVE DETAILS INCLUDING NAME OF THE SCHOLARSHIPS AMOUNT , PERIOD ETC., 13. DOES THE CANDIDATE WANT TO OPT FOR PRATIBHA SCHOLARSHIP OR THE OTHER SCHOLARSHIP MENTI-ONED ABOVE 14. IS THE CANDIDATE EMPLOYED ANY WHERE (If yes, give full detail and also salary Certification) DECLARATION TO BE SIGNED BY THE CANDIDATE AND HIS/HER PARENT/ GUARDIAN Certified that the particulars furnished by me in this application form are true and correct. Further, I declare that In case at any time, it is proved that the information furnished is false or information has been suppressed, I shall refund the entire amount received as Scholarship to the Govenment of Andhra Pradesh together with the interest that may be levied. SIGNATURE OF THE SIGNATURE OF THE CANDIDATE CANDIDATE'S PARENT/GUARDIAN DECLARATION TO BE SIGNED BY THE HEAD OF THE INSTITUTION/ AUTHORISED OFFICER ON HIS BEHALF. Certified that Sri/Kum__________________________________ S/o/D/o ____________ was admitted into the institution _________________________________ as regular full time student or part time student in ___________________ Course on ____________. His/ her admission No. is ___________ The particulars furnished by the candidate in the application form are correct as per records available in this office. Place: SIGNATURE OF THE HEAD OF THE Date: INSTITUTION WITH NAME DESIGNATION & OFFICIAL SEAL. INSTRUCTIONS TO CANDIDATES FOR FILLING APPLICATION FORM FOR AWARD OF "PRATHIBA " SCHOLARSHIP. Candidates should affix his/her passport size photograph in the space provided at the top right head of the application form. The photograph should be duly attested by the Head of the Institution where the candidate is studying at present or by any authorized Officer on his behalf. The stamp of the Officer attesting the photograph along with designation must be clearly legible. 2. Candidate should enter his name and his father's name as recorded in S.S.C or equivalent certificate, in BOLD letters, against Sl. No. 1 and 2 of the application form. 3. Candidate should enter his address, against Sl. No. 3 of the application form. Full and complete address, like house No./ Room No. Flat No., Name of the building, name of the street/ in number, name of the Locality/ Village/Mandal., name of the Town City along with correct PIN code must be entered for prompt correspon dence and for quicker delivery of mail. 4. Against Sl. No. 4 candidate should clearly specify whether selected for LAWCET I or II. 5. Against item 5, candidate should clearly specify the year in which they have been selected for the Award. 6. Against item 6, candidate should clearly specify the category under which they have been selected for the Award, by marking (tick) against the appropriate category and scoring out the irrelevant category. 7. Candidate should mention clearly the Rank secured at the entrance examination against item No. 7 of the application. 8. Candidates should mention the duration of the LAW course, viz., 3 or 5 years against item No.9 of the application form. 9. Candidate should mention clearly whether the application is for sanction of a fresh scholarship or renewal of an existing scholarship, by striking at inapplicable portion, against item No 10 of the application. form. 10. Candidates should note that scholarship granted under PRATIBHA scheme, shall be renewed for further years, only if the candidate passes all examinations of the previous years/semesters and secured 60% and above marks in aggregate in each year/semester and passes in all subjects in one attempt. Candidates shall enclose attested xerox copy of their marks sheet in support of them claim. 11. Candidates applying for the sanction of PRATIBH Ascholarship for the first time shall enclose attested copy of marks sheet of the qualifying exam, viz., or Intermediate or equivalent or Degree. 12. Candidates should note that they are entitled to only one scholarship, i.e., PRATIBHA or any other merit or Social Welfare scholarship. Hence against item No.12 of the application form, candidate should state clearly the name of the other scholarship, if any, he/she is in receipt of the amount of such scholarship, and the period for which it shall be payable. Against item No. 13, candidate should state clearly whether he/she is opting for PRATHIBA or other scholarship 13 .Against Sl. No. 14 candidate should clearly specify whether he is employed if yes he should give the full address of the employer and also should enclose a salary certified by his/her employer.
