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DEVESH

This document contains a renewal application form for the Mukhyamantri Medhavi Vidhyarthi Yojna scholarship scheme in Madhya Pradesh for the 2023-24 academic year. It includes details of the applicant such as name, father's name, date of birth, gender, category, academic details, family income details, contact details, annual fees claimed and declarations signed by the applicant and parent.

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indore xerox
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0% found this document useful (0 votes)
93 views2 pages

DEVESH

This document contains a renewal application form for the Mukhyamantri Medhavi Vidhyarthi Yojna scholarship scheme in Madhya Pradesh for the 2023-24 academic year. It includes details of the applicant such as name, father's name, date of birth, gender, category, academic details, family income details, contact details, annual fees claimed and declarations signed by the applicant and parent.

Uploaded by

indore xerox
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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Ȫ\]ȪȪ_èȡ¡ȰȪ]ǓȡȧèȡȢȨȣȯǔÈ¡ȡƭȡɅȲ[ȯ¡Ȱ)

Department of Technical Education , Skill Development and Employment


Madhya Pradesh Scholarship Portal 2.0
Renewal Application Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year 2023-24

Applicant Unique ID: 4554005 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna


Application ID: 10566942
First Time Lock Date: 16/03/2024
Version No: 1 Verification Code: 7473 Lock Date: 16/03/2024 IPAddress : 182.77.78.165
Instructions for colleges & offices: Please check all information in each section and place a tick mark in on the box. Institute
will use the first Box with I sign and Sanctioning Office will use second box with O sign in it.
Institute : International Institute of Professional Studies, DAVV, Indore Course : B.Com. (Honours) /Management/2nd Year [1247
District: INDORE

Details Application Form Name of Entrance Examination : OTHER


Name DEVESH KHATRI Roll No of Entrance Examination : MP07201509
Father Name JITENDRA Common Rank in(JEE main/NEET/CLAT) : 1980
DOB 17/01/2005

Gender Male [पुरुष]


Category GENERAL [सामान्य]

Religion : Hindu Special Category : No I O

2. Domicile of M.P. : Yes,Student is Domicile of Madhya Pradesh I O

3.Academic Details As Reported by Student : Enrollment No. : DC2200003 Admission Date :11/09/2022 I O

Previous Year Percentage : 70.59

Details As Reported by Student


Admission Mode Centralized Counselling

Institute [20189],International Institute of Professional Studies, DAVV, Indore District: INDORE

Course B.Com. (Honours) /Management/2nd Year [1247]

Academic Year 2023-24


I O
Hostel Admission Non-Hosteler(Day-Scholar)

4. Total Annual Family Income : Rs.396630/-


Father/ Husband Occupation : Own Business/Shop, Income: 396630/-
Mother Occupation : House Wife ,Income: 0/- I O
Other Income : Rs.0/-

5. Contact Details Mobile No : 7225006467 DEVESHKHATRI030[AT]GMAIL[DOT]COM I O


Correspondence Address : 23 BY NORTH RAJMOHALLA INDORE, District :- INDORE

Permanent Address : 23 BY NORTH RAJMOHALLA INDORE, District :- INDORE

6. Total Annual Fees Claimed(Rs.) 63332/- I O

Generated by MP Medhavi Portal as on 16/03/2024


Ȫ\]ȪȪ_èȡ¡ȰȪ]ǓȡȧèȡȢȨȣȯǔÈ¡ȡƭȡɅȲ[ȯ¡Ȱ)

Department of Technical Education , Skill Development and Employment


Madhya Pradesh Scholarship Portal 2.0
Renewal Application Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year 2023-24

Applicant Unique ID: 4554005 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna


Application ID: 10566942
First Time Lock Date: 16/03/2024
Version No: 1 Verification Code: 7473 Lock Date: 16/03/2024 IPAddress : 182.77.78.165
ȡȧȪȡDeclaration From Student and his Parent
]ȯfȲȡȧȪȡ
We, DEVESH KHATRI S/o JITENDRA and JITENDRA hereby declare that 12th Board Roll No, Board Name, Board Year, Aadhaar No, SAMAGRA
ID, Entrance Exam Roll No, Rank, Marks, Domicile, Annual Income and occupation details of father and Mother, Amount Claimed, Hostel
Status, College detils, Course Details, Category and all other information given in the application form is complete and correct. We have not
submitted any other application for Mukhyamantri Medhavi Vidharthi Yojna or any other scheme that offer the reimbursement of fee for current
academic year in any other institution. We also undertake that, if any information given above is found to be false at any stage, entire amount of
scholarship will be recovered and Director, Technical Education , Government of Madhya Pradesh will be free to register FIR and initiate legal penal
action and against us.

¡DEVESH KHATRI S/o JITENDRA kJITENDRA Ȫȡȯ¡ɇ`ȪƠȡȡȣ¡ȣ¡ȰfȲ¢ȡCDȪ[ȣ¢ȡȡ\ǕĐȡȲ


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^ğȯǕÉȲğȢȯȡȢÚȡȸȪȡfȲ\ÛȢ\ÛȪȡȯ\Ȳ[Ȣ\ÛȲèȡɅ]ȯĤèǕ¡ȣȲȡ
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Ǒ¡Øɉȡȡȣȯ]ȡȡğǙǓȯȯ¡ǕȯȡfȯȪ¡ȡȣȡğǙƣǓèȣȡȯȢȡȡğǙƣȧǔȢ
ȣ_¡Ȱ`ȯȡȯȣȡȯȢ)^¡ȯĐȡȡȯǔÛȡȸȪ¡ȯȡȯfȢȢȪȡȯ\Û[Ȣ
ȢȡğǙƣȯǔ[ȢȡǑȡȡȯȡȡȡȸȪȡȣǗȢÞȰèɅȡǑȡȡȯȡȡȡğǙƣèȢǙȡ[
\ȡȣ\ȡ\Û¢\ȡȣ]æȯɅȪ`ȯǽÚȡȢÖȲǑ¡ȡȧȡȡjȲfȲ
ȯ¡f]_][ȡ_ȡÉȡ[ȡ¡ȣȧȡȯȢ)

Date (Signature of Parent / Father/ ȡȡȯ¡èȡ¢(Signature of Student / ]ȯȯ¡èȡ¢

Declaration from Institute Head & Institute Scholarship Nodal Officer


We, hereby, certify that the student is enrolled in the approved course of Govt MP. All the details filled by the student in the above application
form have been verified with the original documents and have been found to be correct and authentic. He/She is eligible for sanction of
scholarship. College has ORIGINAL COPY of his School Leaving Certificate. He is attending regular Classes, as per the instructions of Government
We have verified all details as per the scheme guidelines & instructions and recommend him for sanction of scholarship as per the rules. We also
undertake that, if the above student does not attend the classes regularly or discontinues the course, We will immediately report the matter to the
Director, Technical Education so that his scholarship can be put on hold. In case any information found to be incorrect, Government will be free to
initiate action against the institute.
The institute is accredited by the Government and permission is given to conduct related course.

Date (Signature ) (Signature ) (Signature )


MMVY Scheme Incharge HOD Director/Principal

Generated by MP Medhavi Portal as on 16/03/2024

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