Pre-Matric Scholarship Application Form (2023-24)
for SC,ST,BC,PWD Students

Student Particulars
Student Name :*
Father's Name :* Mother's Name :*
Gender :* MALE    FEMALE Student Date Of Birth (DOB) :* DATE OF BIRTH FORMAT SHOULD BE (MM / DD / YYYY)
Ration Card No. : Student UID (Aadhar) No:
Profession of Parents :* Whether Disabled or Not:* Yes No
Community / Religion :* Caste Category :*
Sub Caste :*


School Particulars
School District : School Mandal :*
School :*
Present Studying Class :* Medium :*
Admission No. :* Admission Date :* DATE OF BIRTH FORMAT SHOULD BE (MM / DD / YYYY)
Hostelar / DayScholar :
Previous Class :* Grade/Percentage of Previous Class :*


Student Bank Account Details
Bank District :* Bank Name :*
Branch Name & IFSC Code :*
Name of the Account Holder :*
Student Bank Account No :* Re-Enter Student Bank Account No :*


Address
District :* Mandal :*
Village :* Care Of :*
Building :* Street :*
Land Mark :* Locality :*
PIN Code :* Mobile No :*
Re Enter Mobile No :* Mobile No. Belongs to :*


Income Certificate Details
MEE SEVA No. :*  
Applicant Name : *
Father Name : *
District : *
Mandal : *
MRO Name : *
Total Income : *
 


Caste Certificate Details
MEE SEVA No.(Caste Certificate) :*
 
Applicant Name : *
Father Name : *
District : *
Mandal : *
MRO Name : *
Caste : *


Scanned Documents
Image of your Passport Photograph :* only jpeg/jpg (Size Should be greater than 20kb and less than 50kb)
Scanned Bank Pass Book (First page) :* only jpeg/jpg (Size Should be greater than 100kb and less than 200kb)
Scanned UID(Aadhar) :* only jpeg/jpg (Size Should be greater than 100kb and less than 200kb)


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Please Enter the code in the image :*



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