Scholarship - Department of Higher Education
Scholarship - Department of Higher Education
Scholarship - Department of Higher Education
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19. Total Refundable amount (Sr. No. 17+18)…………………………………..................………………DeclarationI hereby declare that all statements made in this application are true and correct to the best <strong>of</strong>knowledge and belief. Neither I am in receipt <strong>of</strong> any scholarship from any other source nor am I workinganywhere. I understand that in the event <strong>of</strong> particulars /information given herein being found false orincorrect my claim for award <strong>of</strong> scholarship is liable to be rejected or cancelled and in the event <strong>of</strong>discrepancy being detected after the award <strong>of</strong> scholarship, I shall be liable to refund the entire amount <strong>of</strong>scholarship/fee with interest @ 18% and the department will be free to initiate legal action against me.Signature <strong>of</strong> Parents/GuardianSignature <strong>of</strong> the studentSignature <strong>of</strong> wardenSignature <strong>of</strong> Principal/Head <strong>of</strong> InstitutionWith sealwith seal(In case <strong>of</strong> hostler for PMSS/IRDP)………………………………………………………………………………......………………………………List <strong>of</strong> mandatory enclosures:-* Attach Caste certificate, in original duly signed by the competent authority for Post Matric<strong>Scholarship</strong> Scheme (SC/ST/OBC)/Attach Caste certificate & Bonafide Certificate for all<strong>Scholarship</strong> Schemes.** Attested copy <strong>of</strong> certificate, diploma, degree etc. in respect <strong>of</strong> all/previous examination passed.*** Bank Statement must be attached for verification <strong>of</strong> student A/C No. & Branch name.**** IFSC code is must for online payment <strong>of</strong> scholarship amount in the student's A/C.***** Hostel verification must be verified by the Hostel Warden in the prescribed forms.****** Copy <strong>of</strong> Fees Structure and affiliation <strong>of</strong> Institution in case <strong>of</strong> Post Matric SC/ST/OBCscholarship must be attached......................................ReceiptReceived a sum <strong>of</strong> Rs.........................(Rupees.................................) on account <strong>of</strong> <strong>Scholarship</strong>amount through Cheque/RTGS/NEFT. No............................Dt..............................for the class in whichStudent studying..................................and session............................. from the Directorate <strong>of</strong> <strong>Higher</strong><strong>Education</strong>, H.P. Shimla-1.Counter Signature <strong>of</strong> Principal/Head <strong>of</strong> Institutionwith sealSignature <strong>of</strong> StudentNote: - One student is entitled to receive only one scholarship (which is on the higher side) in aparticular session until and unless it is otherwise mentioned in the norms <strong>of</strong> a particular scheme.APPLICATION FORM FOR PROTSAHAN CHHATRAVRITI YOJANAName <strong>of</strong> the Scheme Protsahan Chhatravriti Yojana...............................Year............................................1. Name <strong>of</strong> the student (in capital letters)...................................................................................................2. Date <strong>of</strong> Birth..........................................................................................................................................3. Sex (Male/Female)...............................................................................................................................4. Father's Name (Sh.)........................................Mother's Name (Smt.)...................................................
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