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 SVMCM SCHOLARSHIP 2024-25
Application ID: SSP2023050801510909 Application Date: 03-01-2025
BASIC INFORMATION
Student's Name: MISBAHUL ISLAM MIDDHYA Father's Name: ZIARUL ISLAM MIDDHYA
Date of Birth: 25-12-2003 Mother's Name: DILAFROZA BEGUM
Gender: Male Annual Family Income: 70000
Marital Status: Unmarried Guardian's / Husband's Name: ZIARUL ISLAM MIDDHYA
E-mail Id: misbahulislammiddhya@gmail.com Religion: Islam
Mobile No: 9564869503 Aadhaar No: XXXXXXXX7232
Class X Registration No: 4191-065537
ADDRESS INFORMATION
Permanent Address Present Address
Domicile State: WEST BENGAL State: WEST BENGAL
Domicile District: BIRBHUM District:BIRBHUM
Block/Municipality:Labhpur(BLOCK) Block/ Municipality:Labhpur(BLOCK)
Permanent Address: HATIA
Present Address: HATIA
Post Office: HATIA
Post Office: HATIA
Police Station: LABPUR
Pin: 731201 Police Station: LABPUR
Sub Division: Bolpur
Pin: 731201
ACADEMIC INFORMATION
Previous Academic Information Present Academic Information
Previous Institute Name: SEACOM SKILLS Institution District :BIRBHUM
UNIVERSITY Institution Name: SEACOM SKILLS UNIVERSITY
Previous Class / Course Name: BACHELOR OF Current Class / Course Name : BACHELOR OF TECHNOLOGY
TECHNOLOGY (MECHANICAL ENGINEERING)
(MECHANICAL ENGINEERING)
Previous Year of Study: 2nd Year
Current year of Study :3rd Year
Name of the Board of
last Exam Passed: SEACOM SKILLS UNIVERSITY Sub Division: Bolpur ( Bolpur - Sriniketan(BLOCK) )
Year of Passing Last Exam: 2024 Are you a Hosteller: No
% of Marks Obtained Name of the Board / Council / University : SEACOM SKILLS
in Last Examination: 76.80 UNIVERSITY
Course Duration : 4 Year
BANK ACCOUNT DETAILS
IFSC: SBIN0002002
Savings bank account no.: XXXXXXXX9408
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.70000 . 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 MISBAHUL ISLAM MIDDHYA 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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