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 ofknowledge and belief. Neither I am in receipt of any scholarship from any other source nor am I workinganywhere. I understand that in the event of particulars /information given herein being found false orincorrect my claim for award of scholarship is liable to be rejected or cancelled and in the event ofdiscrepancy being detected after the award of scholarship, I shall be liable to refund the entire amount ofscholarship/fee with interest @ 18% and the department will be free to initiate legal action against me.Signature of Parents/GuardianSignature of the studentSignature of wardenSignature of Principal/Head of InstitutionWith sealwith seal(In case of hostler for PMSS/IRDP)………………………………………………………………………………......………………………………List of mandatory enclosures:-* Attach Caste certificate, in original duly signed by the competent authority for Post MatricScholarship Scheme (SC/ST/OBC)/Attach Caste certificate & Bonafide Certificate for allScholarship Schemes.** Attested copy of certificate, diploma, degree etc. in respect of all/previous examination passed.*** Bank Statement must be attached for verification of student A/C No. & Branch name.**** IFSC code is must for online payment of scholarship amount in the student's A/C.***** Hostel verification must be verified by the Hostel Warden in the prescribed forms.****** Copy of Fees Structure and affiliation of Institution in case of Post Matric SC/ST/OBCscholarship must be attached......................................ReceiptReceived a sum of Rs.........................(Rupees.................................) on account of Scholarshipamount through Cheque/RTGS/NEFT. No............................Dt..............................for the class in whichStudent studying..................................and session............................. from the Directorate of HigherEducation, H.P. Shimla-1.Counter Signature of Principal/Head of Institutionwith sealSignature of 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 of a particular scheme.APPLICATION FORM FOR PROTSAHAN CHHATRAVRITI YOJANAName of the Scheme Protsahan Chhatravriti Yojana...............................Year............................................1. Name of the student (in capital letters)...................................................................................................2. Date of Birth..........................................................................................................................................3. Sex (Male/Female)...............................................................................................................................4. Father's Name (Sh.)........................................Mother's Name (Smt.)...................................................
5. Permanent Home Address.......................................................................................................................................................................................................................................................................................Telephone/Mobile No............................................................................................................................6. Class in which admitted..........................................Date of Admission..................................................7. Name of the Institution in which admitted..............................................................................................8. Anticipated percentage of month wise attendance till the end of session (month wise 80% and aboveattendance is compulsory for this Scheme & attendance to the duly verified by the classteacher)....................................................................................................................................................................................................................................................................................................................9. Actual distance from Permanent Home...................................................................................................10. Admissible Amount month wise.............................................................................................................11. Total Refundable amount (i.e. Claim)....................................................................................................Declaration :I hereby declare that the information furnished above is true and correct to the best of myknowledge. If any information about the distance is found incorrect at any stage, I shall be liable torefund the entire amount of Protsahan Chhatravriti with interest @ 18% and the department willbe free to initiate legal action against me.Signature of Parents/GuardianSignature of studentDate :Verified by the class Teacher (with Name)At the time of paymentApproved.Principal/Headmaster(With seal)Proforma-I(To be submitted category wise)Estimated budget demand of (Gen./SC/ST)................................students under "ProtsahanChhatravriti Yojana" for the year 2011-12 in r/o GSSS/HS............................Distt..........................H.P.DDO Code................................................Try. Code..........................................Sl.No.Name of thestudentFather's Name Class Boys Girls Distancein Km.RateNo. ofMonthTotalAmount
Page 1 and 2: CHAPTER -5Scholarship5.1 Scholarshi
Page 3 and 4: “I hereby certify that the schola
Page 5 and 6: must be quoted in High School Merit
Page 7 and 8: Class Boys Girls9 th and 10 th 300/
Page 9 and 10: GroupIIGroupIIIGroupIVBusiness Admi
Page 11 and 12: Group I(i) Degree and P.G Level Cou
Page 13: Department of School Education and
Page 17: Proforma-II(To be submitted categor

Scholarship - Department of Higher Education

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