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Name: *

Email: *

Address: *

Gender: *

Religion: *

Caste Category: *

Photo *

Date of Birth: *

Siblings *

State of Origin *

Languages(s) spoken at home: *

House Type: *

Contact Number: *

Whatsapp Number: *

Aadhaar Number: *

Father's Name: *

Father's Educational Qualification: *

Father's Occupation: *

Father's Monthly Income: *

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Mother's Name: *

Mother's Educational Qualification: *

Mother's Occupation: *

Mother's Monthly Income: *

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Total Family Members: *

Total Earning Members: *

Monthly Family Income: *

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Why you need scholarship: *

Scholarship Amount: *

Current School/College Name: *

School ID: *

Class/Stream: *

Roll: *

Madhyamik Board Name: *

Marks obtained in Madhyamik Exam: *

Madhyamik Grade: *

HS Board Name: *

Stream Name: *

Marks obtained in HS Exam: *

HS Grade: *

Highest Qualification: *

Passing Year: *

Upload Result or Certificate: *

Beneficiary Name: *

Bank Name: *

Bank Account Number: *

Bank IFSC Code: *

Upload Aadhaar Card: *

Upload School ID Card: *

Upload Bank Passbook: *

I hereby certify that the information given in the Form is complete and accurate. I do hereby consent to abide by the rules & regulations of the organization.

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