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Nathani Charitable Form - SECAB

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Govt. Scholarship<br />

Are you eligible for Govt. scholarship: Yes/No _________ If yes, did you apply for scholarship Last year, Yes/No _______<br />

Amount Received: _________________ year: __________ Name of the Govt. Scholarship: __________________________<br />

NCT Information<br />

Have you ever Received Fees from our organization Yes/No________ If Yes,<br />

ID No.<br />

Course<br />

Applied For<br />

Scholarship<br />

Amount<br />

Received<br />

Year In Which<br />

Amount Received<br />

By<br />

Cheque/DD/Cash<br />

NCT Support to Family Members<br />

Support receiving/ received by your siblings in past/current from NCT Yes/ No<br />

If Yes<br />

Sr.<br />

No<br />

1<br />

Name Of The<br />

Brother/Sister<br />

ID No.<br />

Course<br />

Amount<br />

Received<br />

Financial<br />

Year<br />

Last How Many<br />

Years Have They<br />

Been Receiving<br />

Support<br />

2<br />

3<br />

4<br />

5<br />

6<br />

Did you/your family members have received help from NCT under any other scheme other than Education Support:<br />

Yes/No_________ If yes<br />

Sr.<br />

No<br />

Name Of The Family<br />

Member<br />

ID No. Scheme Amount Received Financial Year<br />

Do you have bank account Yes /No _____________________<br />

Bank Name: _________________________ Branch___________________ A/C No: _____________________<br />

Name as appearing in Passbook (all in capital letter): ______________________________________________<br />

(Note: If student doesn’t have a bank A/C please write down guardian/parent bank a/c details, photocopy of first<br />

Page of passbook (name, bank a/c no & address details to be attached.)

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