GOVERNMENT OF GUJARAT Submit Date : 27/11/2024
Application No:
(BCk-6.1) Post Matric Scholarship for SC students (Government of 242500000000797825
India Scheme)(Freeship Card Student Only)
Fresh Application
Student Basic Details
Name of Student : Rohit Hetalben Balvantbhai
Name of Student (As per Aadhar) : Rohit Hetalben
Mother's Name : NAYANABEN
Date of Birth : 19/10/2003 Gender : Female
Category : SC(7ȵkɅlISĤiS Religion :Hindu
Caste : Hindu Chamar eƛȳkI\h^
Aadhaar Status Verified: Yes(16/11/2024 10:11:40)
Ration Card No. : 119011000684827 Ration Card Member No. : 119011000684827003
Name As Per Ration Card: (Rohit Hetalben / ^seSe°S_ZpW
EKYC Status As Per Ration Card: Yes EKYC Date: 23-09-2024
Aadhar Number Matched With Ration Card: Yes
Consent Status: I hereby give my consent to use my personal data available with food and civil supply department. I hereby give my consent to
government of Gujarat for fetching my identity for the purpose of post matric scholarship.
Annual Income of Parents/Guardian/Husband (Rs): 85000 Habitation Type: Urban
Mobile Number : 8200403574 E-mail Address : hetalrohit34@[Link]
Aadhar No : 52xxxxxx1561 Parent/Guardian occupation: Agriculture(EpSj
Is Orphan: NO Day Scholar / Hosteller : Day Scholar
Marital Status : Unmarried Hostel Type:
Current Address: Permanant Address:
State Gujarat State Gujarat
District Vadodara District Vadodara
Taluka Karjan Taluka Karjan
Village Sayar Village Sayar
PinCode 393105 PinCode 393105
Address:Ramdev Faliyu Navi Sayar Ta karjan dist Vadodara Address:Ramdev Faliyu Navi Sayar Ta karjan dist Vadodara
Student Bank Account Detail/Aadhar Bank Detail
I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 52xxxxxx1561 Bank name : -
NPCI Date : 11/24/2024 12:00:00 AM NPCI Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 39xxxxxx0893 IFSC Code : SBIN0015814
Student Name(As per Bank Name): Hetalben Balvantbhai Rohit
Name of Bank : STATE BANK OF INDIA
Branch Name & Address : MOTI KORAL
I hereby accept that
[Link] provided by me are correct to best of my knowledge
[Link] not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
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[Link] refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.
Student Academic Details
Present Course/Class/Trade Type: Management
Present Course/Class/Trade Name : MBA (Master of Business Administration)
Present Course/Class/Trade Year : 1ST YEAR(1st Semester/2nd Semester)
Studying in : Gujarat Enrollment No:
Present Institute District : Vadodara Present Institute : Dr. J.K. Patel Institute of Management(SFI) Vadodara
711
Admission Type : Management Quota Present Branch Course : Financial Management
Enter Your Research/Thesis Subject :
Present Class Start Date : 05-Sep-2024 Present Course Completion Date : 31-May-2025
Fees Amount
Admission Fees (Rs) 0
Tution Fees (Rs) 71650
[Link](NonRefundable Fees) 0
Exam Fees(Rs) 0
Total (Rs) 71650
Educational Break : No No. Of. Year in Break :
Freeship Card Detail
Freeship Card No: 969
Freeship Card Issued Date: 22/07/2024
Freeship Card Issued by District:Vadodara
Previous Education Detail
Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH General B5167376 2019 63.33
11th Std/12 Std 12TH Commerce G448688 2021 71.6
Commerce [Link] Bachelor Of Commerce Commerce 610704 2024 62.7
Disablity Detail
Is Disability : No Type of Disability : -
Percentage of disability : - Required Guide/Coaching Guide: No
Guide Name: -
Guide Address: -
List of documents which you have attached :
1 Caste Certificate From the Competent Authorities
2 First Page Of Bank PassBook/Cancelled Cheque
3 Income Certificate (Competent Authority)(Form no.16 required For Govt. Employee)
4 Std:10 Marksheet
5 School Leaving Certificate (If Any)
6 Death Certificate of Father (If Father not Alive)
7 Std:12 Marksheet(If Any)
8 Graduate Marksheet(If Any)
9 Freeship Card
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I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.
Date : 27/11/2024
Verify Mobile Number : Yes 27/11/2024
Place : Signature of the applicant
It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
all the Documents has been checked.
It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority
Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.
This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2024
-2025. If student will irregular, than we will immediately reported to the said authority.
The actual School/College/University year began on __________________ and will be ended on _____________________
Signature Of Head Of The School/College/Institute/University With Official Seal
Place :
*Note : Stamp Signature will not be accepted
Date :
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