Ref. No.__________ Form Valid for Academic Year 2025-26 only Sr. No.

_____
Issued on ________________ Received On _________________ Received, Checked & Entered _______________________

ALIMAAN CHARITABLE TRUST (Registered)

Najafi House, 159, Nishanpada Road, Off Hazrat Imam Husain (A.S.) Chowk, Dongri, Mumbai - 400 009. Tel.: 91 22 23403295
Patron :Naeb e Imam HazratAyatullah Al uzmaAqaeSaiyed Ali Al Husaini As Seestani (DZ)
Founder:AllamaSayed Mohammed MusawiSaheb (DZ)
Paste Recent Passport
Sized Coloured Photo
APPLICATION FOR SCHOLARSHIP (Baligh Girls
Note: Before filling the form read instructions given on the back side of the form. with Hijab
& Baligh Boys with
INCOMPLETE FORM WILL NOT BE CONSIDERED
Beard)

1. Name of Student: Miss/Mr. __________ ___________________________________________

Adhar Card Number of Students Attach Copy

Father's / Guardian’s Name _______________ ______________________________ Occupation _____________________

Mother's Name _______________________________________________________ Occupation _____________________
Date of Birth of Student: Age : ______ years. Sadaat:  / Non-Sadaat: (in appropriate box)
D D M M Y Y Y Y
2. Postal Address:
______________________________________________________________________________
Village / Town : Post Office:

District: State: PIN -- -- -- -- -- --

Mobile No. (1) (2) Email id:

3. Annual Family Income of ` ____ ________ ` ____________ ` ____________

4. Amount received from this Trust in the last Academic Year `_________________________________________
5. School Fees Monthly ` ______________ Term Fees: `___________________
6. Has any application for FEES been made to any other Trust / Organisation?  YES  NO (in appropriate box)
If YES, Name of the Trust ________________________________ Amount Applied / Received `_____________
7. Result (Attach Copy of Mark Sheet of Last Examination Passed)
Last Class / Examination Passed Marks Obtained Total Marks Percentage / Grade

8. Institution Joined in the Current Academic Year (Attach original fee receipt of current Academic Year)
Name of School / College Class / Course Medium of Instruction

9. Certificate from School / College:

This is to certify that Miss / Mr. _____________________________________________________________ is a bonafide student of
this Institution for the current Academic Year, studying in Class _________ Div. ______ Roll No. _______. The details furnished by her
/ him in this form are correct. The TUITION FEES ONLY for the class / course opted by her / him is `. ___________________ per
month Academic Year of our institute is from month of ______________________ 2025 to month of _____________________ 2026.
Name of Account (Favouring) of School / College for sending cheque:
_________________________________________________________________________________________________________

Date: ______________ Seal of Institute Signature of Head of the Institute

9. Details of Family Members: (Mother, Father and Children only)
Sr.No. Name Relationship Age Occupation Income .
1 Father / Guardian
2 Mother
3 Son / Daughter
4 Son / Daughter
5 Son / Daughter
6 Son / Daughter
7 Son / Daughter
8 Son / Daughter

Date: ________________ ____________________________ ________________________________

Signature of Student Signature of Father / Mother / Guardian

Verification from Aalim e Deen / आ लमे द न से त द क़

I certify that म त द क़ करता हूं $क %ी %ीमती is known to me. The family
observes and practice religious activities and deserves financial assistance / को म जानता हूं, खानवादा द नदार और मु तहके इमदाद है ।

Name of Aalim-e-Deen आ4लमे द न का नाम

Address पता

Mobile No. /मोबाईलन. Signature with Date द तख़त Stamp/मोहर

IMPORTANT INSTRUCTIONS आव यक नदश
Read the following instructions before filling the scholarship form. छा व ृ फाम भरने से पहले न!न ल"खत नदश पढ़% ।
1. This application should not be considered as any commitment 1. इस आवेदन को इस ) ट +वारा छा व ृ क, मंजूर के लए कोई 2 तब+धता
for sanction of scholarship by this Trust. नह ं माना जाना चा6हए।
2. Incomplete form or form without attachments 4, 5, 6, 7, 8 2. न!न ल"खत संल7नक 4, 5, 6, 7, 8 और 9 के 9बना / अ भभावक के ह ता<र
& 9 below or without the signature of student and parent के 9बना / अपूण फाम अ वीकार कर 6दया जाएगा और सुधार के लए वापस
will be rejected and will not be send back for correction.
3. Form must be duly filled in English in BIOCK letters, don't नह ं भेजा जाएगा।
leave any information incomplete or blank. Xerox copy of the 3. फॉम को केवल अंBेजी के BLOCK LETTERS म% वCधवत भरा होना चा6हए,
Form will not be accepted. Dकसी भी सूच ना को अधूरा या खाल न छोड़%। फोम क, झेरोGस कापी नह ं कबूल
4. A hand written application from the parent/guardian क, जाएगी।
addressing to the Trust for aid is compulsorily to be attached 4. ) ट से सहायता के लए माता- पता / अ भभावक के हाथ क, लखी हुई दरJवा त
with the form. फॉम के साथ संल7न होना अ नवाय है ।
5. Paste (don't staple) colored and recent photograph. 5. वतमान क, रं गीन त वीर Cचपकाएं ( टै पल न कर% )।
6. Attach copy of Mark Sheet of the last examination passed. 6. अं तम पर <ा के माकशीट क, ज़ेराGस कापी संल7न कर% ।
7. Attach original fee receipt / Fees Structure of the Current 7. वतमान शै<"णक वष क, मूल शुPक रसीद / संरचना संल7न कर% ।
Academic Year.
8. Attach copy of Aadhaar Card of the Student. 8. छा य छा ा के आधार काट क, कापी संल7न कर% .
9. Certificate from the Institute must be duly signed and sealed 9. सं थान का 2माणप बँक खाते के ववरण के साथ सं थान के 2मुख +वारा
by the head of institute, along with details of bank account. वCधवत ह ता<Sरत और मुह र के साथ होना चा6हए।
10. Verification from Aalim-e-Deen is compulsory on the form. 10. आ लमे द न का सTयापन फॉम पर अ नवाय है ।
11. Please be informed that as per the present policy of the Trust, 11. कृपया सूCचत हU Dक ) ट क, मौजूदा नी त के अनुसार एवंम ) ट के मानदं डU
payments towards fees will be made directly to the institute; के Xप म% वीकृत क, गई रा श, फ,स के 2 त भुगतान सीधे सं थान को Dकया
when sanctioned as per the norms of the Trust. जाएगा। माता- पता / छा U से अनु रोध है Dक शेष रा श य6द कोई हो तो सीधे
Parents/Students are requested to make the balance सं थान को भुगतान करे । ) ट का इस नी त को पालन करने का सदै व 2यास
payment if any, directly to the institute. It will be our endeavor रहे गा।
to adhere to this policy in the best possible manner.
12. Last date for receiving completed form at our office is 12. हमारे कायालय म% पूर तरह भरा हुआ फॉम 2ाYत करने क, अं तम तCथ
31st July. Forms received after due date will not be 31 जुलाई है । नयत तCथ के बाद 2ाYत फाम\ पर वचार नह ं Dकया जाएगा।
considered. 13. अ तSरGत जानकार के लए माता- पता इन फोन नंबरU 022-23403295 /
13. In case of any query parents may contact us on 022-23406353 पर सां य 4 से 5 बजे के बीच म% ह हमसे संपक कर सकते
022-23403295 / 022-23406353 between 4 and 5 p.m. only. ह]।

FOR OFFICE USE ONLY

(DON’T WRITE ANYTHING OR SIGN IN THE SPACE BELOW/नीचे द हुई जगह पर कुछ न लख% या द तखत न कर% )
Details are Complete / Incomplete _________________________________________________________________________

Amount Sanctioned ` _______________ Paid ` ___________ ByCheque / NEFT ___________________ Date: ___________
Signature of Dealing Clerk with Date: _______________ Authorized Signatory:_____________________________________