APPLICATION FOR GP BIRLA SCHOLARSHIP (SO 2025)
Please tick (√) the following category for which you want to apply. The students may apply for more than one
category subject to eligibility as laid down in the guideline of GP Birla Scholarship. However, they will be
considered for a single category only depending on their eligibility. The students are advised to go through
the guidelines carefully before filling in the application form.
1. GP Birla Scholarship based on Merit
2. GP Birla Scholarship based on Merit-cum Means to the Economically Weaker Section (EWS)
3. GP Birla Scholarship to the Economically and Socially Challenged Students (ESCS)
Details of the Student:
Name of the Student : …………………………………....... Roll No. : ……………………………
Campus : …………………………………....... Program : ……………………………
Batch : …………………………………....... Semester : ……………………………
Rank in JEE (Main) / : ………………………....... SGPA (MO 2024) : ……………………………
Equivalent Entrance
Exams
Caste : GEN/EWS/SC/ST/OBC/EBC/NCL Gender : ……………………………
Parents Annual Income : Rs……...…………. Income from other sources (if any) : Rs…………………………
Mobile No. : …………………………………....... Email Id : ……………………………
Father’s Name : …………………………………....... Occupation : ……………………………
Mobile No. : …………………………………....... Email : ……………………………
Mother’s Name : …………………………………....... Occupation : ……………………………
Mobile No. : …………………………………....... Email Id : ……………………………
Permanent Address : …………………………………...............................................................................................
Name, Address with Mobile No and Email ID and Profession of Guardian (if parents are not alive):
………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………...
Enclosures:
i) Students applying for Category - 2 [Merit-cum-Means (EWS)] must submit the Latest Income Certificate and EWS
Certificate issued by a Gazetted Officer not below the rank of CO/SDO/Tehsildar. No other document related to income will
be entertained.
ii) Students applying for Category - 3 [ESCS] must submit the Latest Income Certificate and Caste Certificate issued
by a Gazetted Officer not below the rank of CO/SDO/Tehsildar. No other document related to income will be entertained.
Signature of the Student with Date Countersigned by the Parents/Guardian with Date
UNDERTAKING FOR GP BIRLA SCHOLARSHIP
SPRING (SP) 2025
I……………………………………...………………… Roll No…………………………………………………
S/o / D/o…………...……………..…………… am a student of BIT………………. (Campus) hereby
undertake that:
1. I am applying for GP Birla Scholarship for SP 2025 based on my results of MO 2024.
2. I am fulfilling the eligibility criteria as laid down in the guidelines for GP Birla Scholarship.
3. I have not received any other scholarship/freeship/financial aid from other agencies during
SP 2025
I hereby declare that the information furnished by me in this application is true and correct to the best of
my knowledge. I shall abide by the decision of the Competent Authority. If the institute finds that I have
availed scholarship from any other source for the same period, then the Institute reserves the right to take
disciplinary action against me including the recovery of the amount of scholarship availed.
Signature of the Student Countersigned by the Parents/Guardian
Mobile No……………………… Mobile No………………………
Date: ………………………………
Place: ……………………………..
