Download Fresh Application Form for Free Studentship to the Students Belonging to the Scheduled Castes/Tribes/and Other Backward Classes for Post-Matric Students.

FRESH APPLICATION FORM FOR FREE STUDENTSHIP TO THE STUDENTS BELONGING TO THE SCHEDULED CASTES/TRIBES/AND OTHER BACKWARD CLASSES OF THE STATE OF MEGHALAYA FOR POST-MATRIC STUDENTS. YEAR______________________________ (To be submitted to the Director of Public Instruction, Meghalaya Shillong through the Head of the Educational Institution concerned). 1. Name of the candidate in full (in block letters)_________________________________________________ (Women candidate should indicated Miss or Mrs). 2. Place of birth including Police Station and District______________________________________________ 3. Present Address_________________________________________________________________________ 4. Age on 1st March of the year of Application___________________________________________________ 5. Are you a citizen of India? If so, how (Copy of citizenship certificate should be enclosed) 6. Community _____________________________________Sub-Caste / Tribes_________________________ 7. Particulars of Examination passed commencing from H.S.L.C Matriculation or any equivalent Examination. (Attested copies of Mark-sheet and certificate to be attached) Serial No. Name of the University / Year of Class or Percentage Examination Board passing Division of marks secured 8. Whether there is break of studies. If so, the year and reasons thereof to be state_______________________________________________________ 9. Names and Address of the Institution where admission has been secured for the current academic year 10. Class in which admission was taken_________________________________________________________ 11. Whether in Day/Night/Morning shift_________________________________________________________ 12. Course of studies and number of year required for completion of the course 13. Whether you are in receipt of any Scholarship or financial assistance from the Government or any other source. If so, particulars to be given.________________________________________________________ 14. Whether you are employed in Government service or any Non-Government organization. If so, state the emoluments and particulars of the __________________________________________________________ 15. (a) Father's name or Mother's name or Guardians_____________________________________________ name (If parents are not alive) (b) Occupation (c) Address - Present__________________________________________________________________________ Pernanent___________________________________________________________________________________ 16. Monthly income of Parents/ Guardian from all sources_________________________________________ I am an applicant for free studentship for studies in the course and Institution mentioned above and the facts stated above are true to the best of my knowledge and belief. In case on any false statement, I am liable to any action Government may deem fit and proper. Signature of applicant CERTIFICATE FROM THE HEAD OF THE INSTITUTION The application is recommended / not recommended Certificate that Shri / Shrimati ________________________________________________whose particulars are given above has been admitted into the________________________________________________ _______________________________________year/class in __________________________________________ course in Day / Night / Morning shift in this College which is affiliated to the _____________________________ _____________________________________ University or recognized by _______________________________ The student has to pay the following fees which are not reimbursed by State Government or from any other source. (a) Admission / Enrolment fees Rs___________________________________________ (b) Registration fees Rs___________________________________________ (c) Tuition fees Rs___________________________________________ (d) Games fees Rs___________________________________________ (e) Union fees Rs___________________________________________ (f) Library fees Rs___________________________________________ (g) Magazine fee Rs___________________________________________ (h) Science Laboratory fees for Science subject with practical. Rs___________________________________________ (i) Medical Examination fees charged by the Institution (i) Charged by Institution Rs___________________________________________ (ii) Charged by the University Rs___________________________________________ Total fees payable during 20 - 20 Rs Signature of the Head of Institution and Seal FOR USE IN THE OFFICE OF THE DIRECTOR OF PUBLIC INSTRUCTION MEGHALAYA, SHILLONG 1. Total amount sanctioned during 20 - 20 ________________Rs. ___________________________ Checked by _________________________________________ Deputy Director of Public Instruction Dealing Assistant Meghalaya Shillong