Nathani Charitable Form - SECAB

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Current School/ college/ Institute Details Current School /College/ Institute Currently studying in Std/Level of Course: _____________Degree: _________ Duration of the course: __________ Medium of Instruction: ______________________Pattern of the course Semester/Annual: ____________________ Name of the School/Institutions: __________________________________________________________________ Name of the Board/University: _________________________________________Aided/Unaided: ______________ Accreditation /Rating of Institution (applicable only for 12 th onwards): ____________________________________ Address: _____________________________________________________________________________________ _____________________________________________________________________________________ City: ________________ State: __________________ Country: _____________________ Contact No: ____________________ Email Id: ___________________________Website:____________________ Fees Information: Exempted From Term & Annual Fees Yes/No__________ Sr No Particulars of Fees Amount (in Rs.) Other Expenses “C” Amount (in Rs.) A. Term Fees Hostel Fees Annual Fees Total fees Mess Fees Conveyance B. Tuition/coaching classes fees Books & Stationary Project & Instrument Total Fees(A+B+C) Own Contribution Any other(please specify)__________ Total Expenses Note: Hostel & Mess fees will be provided only for special category cases on case to case basis. Education aid is subject to decision of committee members. Details of Other Trust Support Sr No Name & Address of the Trust Amount Received Current Year Amount Received Last Year Sr No Contribution from other sources Amount Received Current Year Amount Received Last Year
Govt. Scholarship Are you eligible for Govt. scholarship: Yes/No _________ If yes, did you apply for scholarship Last year, Yes/No _______ Amount Received: _________________ year: __________ Name of the Govt. Scholarship: __________________________ NCT Information Have you ever Received Fees from our organization Yes/No________ If Yes, ID No. Course Applied For Scholarship Amount Received Year In Which Amount Received By Cheque/DD/Cash NCT Support to Family Members Support receiving/ received by your siblings in past/current from NCT Yes/ No If Yes Sr. No 1 Name Of The Brother/Sister ID No. Course Amount Received Financial Year Last How Many Years Have They Been Receiving Support 2 3 4 5 6 Did you/your family members have received help from NCT under any other scheme other than Education Support: Yes/No_________ If yes Sr. No Name Of The Family Member ID No. Scheme Amount Received Financial Year Do you have bank account Yes /No _____________________ Bank Name: _________________________ Branch___________________ A/C No: _____________________ Name as appearing in Passbook (all in capital letter): ______________________________________________ (Note: If student doesn’t have a bank A/C please write down guardian/parent bank a/c details, photocopy of first Page of passbook (name, bank a/c no & address details to be attached.)
Page 1 and 2: Financial Aid for Education From Za
Page 3 and 4: Basic Information To Be Filled By S
Page 5: Memon Jamat Information / Local Rep

Nathani Charitable Form - SECAB

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