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SSP2022011501300325 20231022

This document is an application form for the West Bengal Pre-Matric Scholarship 2023-24 submitted by Nazia Parween. It contains her personal details like name, father's name, date of birth, annual family income, address, academic details of previous and current institutions, bank account details, and declarations signed by the student and parent. The instructions at the bottom indicate the student must submit this computer-generated filled form to their educational institution along with a photocopy of their bank passbook within 7 days.

Uploaded by

Babu Salam
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96 views1 page

SSP2022011501300325 20231022

This document is an application form for the West Bengal Pre-Matric Scholarship 2023-24 submitted by Nazia Parween. It contains her personal details like name, father's name, date of birth, annual family income, address, academic details of previous and current institutions, bank account details, and declarations signed by the student and parent. The instructions at the bottom indicate the student must submit this computer-generated filled form to their educational institution along with a photocopy of their bank passbook within 7 days.

Uploaded by

Babu Salam
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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West Bengal Minorities' Development and Finance Corporation

A statutory Corporation under Minority Affairs & Madrasha Education Department, Government of West Bengal
"Amber", DD/27E,Salt Lake City Sector-I, Kolkata-700064, Toll free No:-18001202130

AIKYASHREE (RENEW)
APPLICATION FOR WB PRE MATRIC SCHOLARSHIP 2023-24
Application ID: SSP2022011501300325 Application Date: 31-08-2023
BASIC INFORMATION
Student's Name: NAZIA PARWEEN Father's Name: DABIRUL
Date of Birth: 07-05-2008 Mother's Name: SANWARA BEGUM
Gender: Female Annual Family Income: 42000
Marital Status: Unmarried Guardian's / Husband's Name: DABIRUL
E-mail Id: Religion: Muslim
Mobile No: 8337870243 Aadhar No XXXXXXXX2992

Bangla shiksha ID: 07493219000106


ADDRESS INFORMATION
Permanent Address Present Address
Domicile State: WEST BENGAL State: WEST BENGAL
Domicile District: UTTAR DINAJPUR District:
Block/Municipality:Goalpokhar - I(BLOCK) Block/ Municipality:
Permanent Address: DUDHKUMAR Present Address: DUDHKUMAR
Post Office: BABHANBARI Post Office: BABHANBARI
Police Station: GOALPOKHER Police Station: GOALPOKHER
Pin: 733210 Pin: 733210
ACADEMIC INFORMATION
Previous Academic Information Present Academic Information
Previous Institute Name: BHULKABARI HIGH SCHOOL Institution District :UTTAR DINAJPUR
Previous Class / Course Name: VIII Institution Name: BHULKABARI HIGH SCHOOL
Previous Year of Study: VIII Institution UDISE/AISHE/NCVT Code : 19040510902
Name of the Board of Current Class / Course Name : IX
last Exam Passed: West Bengal Board of Secondary Education Current year of Study :IX
Year of Passing Last Exam: 2022 Are you a Hosteller: No
% of Marks Obtained Name of the Board / Council / University : West Bengal Board of Secondary
in Last Examination: 66.55 Education
Course Duration : 1 Year
BANK ACCOUNT DETAILS
IFSC: PUNB0RRBBGB
Savings bank account no.: XXXXXXX2256

Declaration:I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I
have not applied for any other scholarship/stipend, etc. from any other government sources(one-student-one-
scholarship).NB:The application of student applying for more than one scholarship application/scheme is liable to be rejected.

___________________
Signature of Student
DECLARATION OF INCOME
(To be given by the parents/ guardians)

Certified that the gross annual income from all sources in respect of my family is Rs.42000 . I further undertake that in the
event of the particulars given in the declaration being found false, I shall refund the whole amount of the Scholarship paid to
the said Scholarship holder NAZIA PARWEEN and the Government's decision in this regard shall be final and binding on me.

__________________________
Signature of the parents/ guardian
Instruction
Student is to submit this ***computer-generated filled-in application form (duly signed) to the educational
institution along with following supporting document within 7 days:

1. Photocopy of the bank-passbook where the details of bank a/c number,IFSC are mentioned clearly.

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