<p> Last date to apply : 10.08.2017 SATNAM SARAB KALYAN TRUST (Regd.) 1078/2, Sector 39-B, Chandigarh. PH. +91 172 269 1922. Email: [email protected] www.satnamsarabkalyantrust.org PASTE YOUR LATEST APPLICATION FOR BHAI SAHIB BHAI JIWAN SINGH JI COLOURED PASSPORT SIZE EDUCATIONAL SCHOLARSHIP FOR THE YEAR 2017-18 PHOTOGRAPH (TO BE FILLED IN BLOCK LETTERS)</p><p>1. NAME OF THE STUDENT : </p><p>………………………………………………………………………………………………………</p><p>2. DATE OF BIRTH : ……………………………………………………………………………………………</p><p>3. RELIGION : ………………………………………… SABAT SURAT : YES/NO</p><p>4. PRESENT / PROPOSED CLASS / COURSE …………………………………… YEAR ………… SEMESTER……………… DURATION OF THE COURSE……………………………………………………………. 5. NAME OF THE INSTITUTION: </p><p>…………………………………………………………………………………………………………</p><p>WITH ADDRESS : </p><p>………………………………………………………………………………………………………………….</p><p>6. FATHER'S NAME & QUALIFICATION : ………………………………………………………………………………………………..</p><p>PROFESSION & ANNUAL INCOME : …………………………………………………………………………………………..</p><p>7. MOTHER'S NAME & QUALIFICATION: ……………………………………………………………………………………………… PROFESSION & ANNUAL INCOME: …………………………………………………………………………………………..</p><p>8. NAME & QUALIFICATION OF BROTHERS / SISTERS: ………………………………………………………………………………….</p><p>…………………………………………………………………………………………………….</p><p>9. P ERMANENT ADDRESS : ……………………………………………………………………………………………………</p><p>……………………………………………………………………………………………………… 10. CORRESPONDENCE ADDRESS : ……………………………………………………………………………………………………… ………………………………………………………………………………………………………………… CONTACT NO. : (L) ……………………………… (M) ………………………………………..</p><p>EMAIL (Compulsory) : ………………………………………………….</p><p>11. LAST EXAMINATION PASSED : ……………………… Year ……………..Marks obtained……………… out of …………… Percentage...... 12. DETAIL OF EXAMINATION PASSED : Class Year Of Marks Total %age Name of Board/ Marks obtained Passing Obtaine Marks University in Gurmat d 10th 12th</p><p>(Note : Attach photocopies of the certificates)</p><p>13. Any other extra curricular activities/information whi ch you may like to mention here : </p><p>…………………………………. …………………… </p><p>……………………………………………………………………………………………………………………………………</p><p>……………</p><p>14. Name the classes & last school in which you have studied gurmat : </p><p>………………………………………………………… </p><p>……………………………………………………………………………………………………………………………</p><p>…………..</p><p>15. Are you getting/expecting scholarship from any other source? If so, give details.: ……………… </p><p>……………… ……… </p><p>……………………………………………………………………………………………………………………………</p><p>…………</p><p>16. Have you availed any financial assistance from this trust last year? : </p><p>……………………………………………………..</p><p>17. Detail of annual/semester expenses on studies :</p><p>Particulars Annual Semester Admission Fee Tuition fee</p><p>Other expenses (Books, transport, uniform etc.) Total</p><p>18. Detail of Bank Account</p><p> a) Name of the payee as in bank passbook : b) Bank a/c no. : c) Name of the bank & address : d) IFSC code no. (Compulsory) :</p><p>19. Exceptional/compassionate ground if any :</p><p>______</p><p>Signature of father/guardian Signature of Student</p><p>Name : Address:</p><p>PLACE : DATE :</p><p>List of enclosures: 1. Photocopies of all educational certificates 2. 2 passport size coloured photograph. 3. Fee deposit receipts if any. 4. Income proof (Affidavit etc.)</p>