APPLICATION (Post Matric Scholarship) Eligible students are advised to submit their application the prescribed format to their respective schools/colleges/institutes Heads or latest by 15 Jan. 07 along with the following documents Individual applications or students will not be entertained. 1. One copy of the passport size photograph with signature of the students thereon. 2. One attested copy of certificates, diploma, degree etc. in respect of the last examination pas 3. A certificate of caste of the students should issued by the SDM of Govt. of NCT of Delhi. 4. Income certificate from S.D.M. of Govt. of NCT of Delhi. Paste 5. Hostellers certificate from competent authority. (if hosteller) photograph 6. Fee receipt & fee structure from college. APPLICATION FORM : Name & Roll No. of student : _____________________________________________ Address & Phone No. :____________________________________________________ Name of Father/guardian :_________________________________________________ Yearly Family Income : ___________________________________________________ Class in which he/she studying _____________________________________________ Hosteller/Day Scholar :___________________________________________________ Whether Belongs to SC/ST/OBC/Min. ______________________________________ Nature of disability in the cased of handicapped students ____________________________ In case of handicapped students, particulars of additional allowance (i) _________________ As per eligibility should be filled in and photocopies of supporting (ii) __________________ Documents/vouchers should be attached to the application form in an (iii) _______________ Envelope. (iv) ________________ Certified that the information given above is true to the best of my knowledge & belief. Signature of the student The concerned College/Institute Heads may forward all the applications received from the eligible students before 29th January, 2007 along with the consolidated statement prescribed below. ( f o r w a r d e d t h e a p p l i c a t i o n s w i t h d o c u m e n t s : - D y . D i r e c t o r , D e p t t . f o r t h e w e l f a r e o f S C / S T / O B C / M i n , B - B l o c k , I I n d f l o o r , V i k a s B h a w a n , I . P . E s t a t e , N e w D e l h i - 1 1 0 0 0 2 ) Consolidated Statement 1. Name & address of the School/College/Institute_________________________________ 2. Name of the Scheme :-Post Matric Scholarship (2006-07) S.No. Name & Roll No. Class in which presently Father's/Guardian's Family Income of the student studying (2006-07) Name (per annum) 1 2 3 4 5 Hostellers/Day Scholars Rate of Scholarship Category Date of Admission Remarks 6 78 910 Certified that the above information particularly in respect of income of family and caste status of the students have been verified on the basis of supporting documents produced by the parents/guardians of the student. NOTE : 1. Certified that the above particulars have been checked with the office record and found cored. 2. Certified that no eligible student studying in the school is left out for grant of scholarship and this list may be treated as final. 3. Certified that the SC/ST/OBC/ certificates in respect of all the students have been issued by the competent authority/Dy. Commissioner, Delhi. 4. Certified that the scholarship or the stipend holders named above have been regular in attendance and have confirmed to the rules under which their scholarship or their stipends are granted. 5. This list may be treated as final. 6. Certified that the eligibility of the student have been rechecked once again before disbursement of the amount and no discrepancy is noticed/discrepancy noticed has been reported to the department vide letter no. _______ dated _______. Signature with seal of the Principal/Head of the Institution.
