APPLICTION FORM (Free supply of Stationary) Eligible students are advised to submit their application in the prescribed format to their respective school Heads along with the following documents. (i) One copy of the passport size photograph with signatures of the student thereon (ii) One attested copy of last examination passed. (iii) A certificate of Caste of student should be issued by the S.D.M. of Govt. of NCT of Delhi. (iv) Proof the family income. (v) Proof of attendance. APPLICATION FORM: Name & Roll No. of student _________________________________________________________ Name of Father/guardian ____________________________________________________________ Class in which he/she studying _______________________________________________________ Yearly family income ______________________________________________________________ Whether belongs to SC/ST/OBC/Min. _________________________________________________ Certified that the information given above is true to the best of my knowledge & belief. Signature of the student Consolidated Statement (FREE SUPPLY OF STATIONARY) For use of School only 1. Name & address of the School_________________________________________________ 2. Name of the Scheme :-Free supply of stationary (2006-07) S.No. Name & Roll No. Father's/Guardian's Present Class Attendance of the student Name previous class 1 2 3 4 5 Yearly family income Amount Category Remarks 6 789 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 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. Five years residence proof in Delhi for Minority Students. 4. Certified that the students named above have been regular in attendance and have confirmed to the rules under which their amount is 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.
