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Madhya Pradesh Scholarship Renewal Form

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0% found this document useful (0 votes)
24 views3 pages

Madhya Pradesh Scholarship Renewal Form

Bcom notes
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Ȫ\]ȪȪ_èȡ¡ȰȪ]ǓȡȧèȡȢȨȣȯǔÈ¡ȡƭȡɅȲ[ȯ¡Ȱ)

Department of Technical Education , Skill Development and Employment


Madhya Pradesh Scholarship Portal 2.0
Renewal Application Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year 2023-24

Applicant Unique ID: 4508814 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna


Application ID: 10564507
First Time Lock Date: 14/03/2024
Version No: 1 Veri!cation Code: 8321 Lock Date: 14/03/2024 IPAddress : [Link]
o!ces:: Please check all information in each section and place a tick mark in on the box. Institute
Instructions for colleges & o!ces
will use the !rst Box with I sign and Sanctioning O"ce will use second box with O sign in it.
Institute : Institute for Excellence in Higher Educaiton, Bhopal Course : [Link]. (Honours) /Accounts/2nd Year [1248]
District: BHOPAL
Ȫ\]ȪȪ_èȡ¡ȰȪ]ǓȡȧèȡȢȨȣȯǔÈ¡ȡƭȡɅȲ[ȯ¡Ȱ)
Details Application Form Name of Entrance Examination : --
Name SOUMIL PANJWANI Roll No of Entrance Examination :
Renewal
Father Application
Name SANJAYPANJWANI Common Rank in(JEE main/NEET/CLAT) :
Madhya Pradesh Scholarship Portal 2.0
DOB 04/02/2004Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year
Gender Department
Male पुरुष
[[पु ष]] of Technical Education , Skill Development and Employment
Category GENE
GENERRAL [सामान्य
सामान्य]]
Applicant Unique ID: 4508814 2023-24
Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna
Application
Religion : ID: 10564507 Special Category : No
Hindu I O
First Time Lock Date: 14/03/2024
Please check all information in each section and place a tick mark in on the box. Institute
Version Institute
No:
will use the 1 Boxfor
!rst Excellence
with in Sanctioning
HigherCode:
Veri!cation
I sign and 8321
Educaiton,
O"ce Bhopal Lock box
will use second Date: O Course
with 14/03/2024: [Link].
sign in it. (Honours): /Accounts/2nd
IPAddress [Link] Year [1248]
[Link]:
Domicile of M.P. BHOPAL
: Yes,Student is Domicile of Madhya Pradesh I O
for colleges & o!ces:
[Link] Details As Reported by Student : Enrollment No. : R235960280292 Admission Date ::01/08/2022
01/08/2022 I O
Institute : SOUMIL PANJWANI
Previous Year Percentage : 73.00
Details Application Form Name of Entrance Examination : --
Details As Reported by Student
Name SANJAYPANJWANI Roll No of Entrance Examination :
Admission Mode College Level Counselling
Father Name 04/02/2004 Common Rank in(JEE main/NEET/CLAT) :
Institute Male [पु रुष]
[17181],Institute for Excellence in Higher Educaiton, Bhopal District: BHOPAL
DOB
Course [Link]. (Honours) /Accounts/2nd Year [1248]
Gender GENERAL [सामान्य]
Academic
Religion : Year
Hindu
2023-24
Special Category : No I O
Category
Hostel Admission Non-Hosteler(Day-Scholar)
I O
4. Total Annual Family Income : Rs.55000/-
2. Domicile of M.P. : Yes,Student is Domicile ofEnrollment
Madhya Pradesh
No. : R235960280292 Admission Date :01/08/2022
Father/ Husband Occupation : Own Business/Shop, Income: 55000/-
[Link] Details: As Reported by Student : I O
Mother Occupation House Wife ,Income: 0/- I O
Other Income : Rs.0/- I O

Previous Year Percentage


College : 73.00
Level Counselling
5. Contact Details Mobile No : 9770600170 PANJ
PANJWWANISOUMIL007[AT]GMAIL[DOT]COM I O
Correspondence [17181],Institute
Address for Excellence in Higher Educaiton, Bhopal District: BHOPAL
As :Reported by Student
I 47 VARDH
ARDHMMAN GREEN PARK ASHOKA GARDEN BHO
HOPPAL, District :- BHO
I 47 VARDHMAN GREEN PARK ASHOKA GARDEN BHOPAL, District :- BHOPAL HOPPAL
Details
[Link]. (Honours) /Accounts/2nd Year [1248]
Admission
Permanent Mode:
Address I 47 VARDH
ARDHMMAN GREEN PARK ASHOKA GARDEN BHO
HOPPAL, District :- BHO
HOPPAL

2023-24
Institute
6. Total Annual Fees Claimed(Rs.) 17932/-
Non-Hosteler(Day-Scholar) I O
Course
Academic Year I O
[Link] Admission
Total Annual Family Income : Rs.
I 47 VARDH 55000
MAN GREEN /- ASHOKA GARDEN BHOPAL, District :- BHOPAL
PARK

Father/ Husband Occupation : Own Business/Shop, Income: 55000/-


I 47 VARDHMAN GREEN PARK ASHOKA GARDEN BHOPAL, District :- BHOPAL

Mother Occupation : House Wife ,Income: 0/-


Other Income : Rs.0/-
I O
5. Contact Details Mobile No : 9770600170 PANJWANISOUMIL007[AT]GMAIL[DOT]COM
Correspondence Address :
I O
Permanent Address :
17932/-

6. Total Annual Fees Claimed(Rs.)

I O
:
Generated by MP Medha
Medhavvi Portal as on 14/0
14/033/2024

Ȫ\]ȪȪ_èȡ¡ȰȪ]ǓȡȧèȡȢȨȣȯǔÈ¡ȡƭȡɅȲ[ȯ¡Ȱ)

Department of Technical Education , Skill Development and Employment


Madhya Pradesh Scholarship Portal 2.0
Renewal Application Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year 2023-24

Applicant Unique ID: 4508814 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna


Application ID: 10564507
First Time Lock Date: 14/03/2024
Version No: 1 Veri!cation Code: 8321 Lock Date: 14/03/2024 IPAddress : [Link]
]ȯfȲȡȧȪȡ Declaration From Student and his Parent
ȡȧȪȡDeclaration
We, SOUMIL PANJPANJW WANI S/o SANJAYPANJ
SANJAYPANJW WANI and SANJAYPANJ
SANJAYPANJW WANI hereby declare that 12th Board Roll No, Board Name, Board Year, Aadhaar No, SAMAGR
ID, Entrance Exam Roll No, Rank, Marks, Domicile, Annual Income and occupation details of father and Mother, Amount Claimed, Hostel
Generated
Status, College detils, Course Details, Category and all other information given in the application byisMP
form Medha
complete vi Portal
and [Link]
We onhave
14/0not
3/2024
submitted any otherȪ\]ȪȪ_èȡ¡Ȱ Ȫ]ǓȡȧèȡȢȨȣȯ
application for Mukhyamantri Medhavi ǔÈ¡ȡƭȡɅ
Vidharthi Yojna or any other scheme Ȳ[ȯ
that o"er the reimbursement ¡Ȱfor
of fee ) current
academic year in any other institution. We also undertake that, if any information given above is found to be false at any stage, entire amount of
scholarship will be recovered and Director, Technical Education , Government of Madhya Pradesh will be free to register FIR and initiate legal penal
action and against us.
Renewal Application
¡SOUMIL PANJ
PANJW WANI S/o SANJAYPANJ
SANJAYPANJW Madhya
WANI k Pradesh Scholarship
SANJAYPANJ
SANJAYPANJW WANIPortal 2.0 ¡ɇ`ȪƠȡȡȣ¡ȣ¡ȰfȲ¢ȡCDȪ[ȣ¢ȡȡ\
Ȫȡȯ
Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year
]ȡȲĤǓȪȢȣ¢ȡ\ǕĐȡȲɅ\ȲǗǓȡȢȡ[]ɇ\ȡ`Ȳȡ\ÛǗ[fȲ¡ȣ¡Ȱ@]ȯȯȪ[
^ğȯǕÉDepartment of TechnicalEducation
ȲğȢȯȡȢÚȡȸȪȡfȲ , Skill Development
\ÛȢ\ÛȪȡȯ and Employment
\Ȳ[Ȣ\ÛȲ èȡɅ]ȯĤèǕ¡ȣȲȡ
¡Ȱ@\`ȪƠȡȡȣȢȢèȡ_ȡȢ¡ȰȪȲǗ[ȡȡȣȡȯȢfȲ¡ȡȯȡȡǗȢȡ[ȡ¡ȣȯf
Applicant Unique ID: 4508814 2023-24
Ȳ ȡȢȧ¢ȡèȲğ¡ɉȯ@
 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna
Application ID: 10564507
First Time Lock Date: 14/03/2024
We, SOUMIL PANJWANI S/o SANJAYPANJWANI and SANJAYPANJWANI hereby declare that 12th Board Roll No, Board Name, Board Year, Aadhaar No, SAMAGR
ID, Entrance
Version Exam
No: 1 Roll No, Rank, Marks, Domicile,
Veri!cation Code: Annual
8321 Income and occupation
Lock Date: details of father and
14/03/2024 Mother, Amount
IPAddress Claimed, Hostel
: [Link]
Ǒ¡Øɉȡȡȣȯ
Status, College detils, Course ]ȡȡğǙ
Details, Category Ǔȯȯ¡Ǖȯȡfȯ Ȫ¡ȡȣȡğǙ ƣǓèȣȡȯ ȢȡȡğǙ ƣȧǔȢ
]ȯ fȲ and all other information given in the application form is complete and correct. We have not
ȡȧȪȡ
submitted any other
ȣ_¡Ȱ `ȯapplication for Mukhyamantri
ȡȯȣȡȯ Medhavi
Ȣ)^¡ȯ VidharthiDeclaration
Đȡȡȯ Yojna From
or any other
ǔÛȡȸȪ¡ȯStudent
scheme that and
o"er
ȡȯ thehis Parent of fee for
reimbursement
fȢȢȪȡȯ current
\Û[ Ȣ
academic year in any other institution. We also undertake that, if any information given above is found to be false at any stage, entire amount of
ȢȡğǙ ƣȯ
scholarship willbe
ǔ[ ȢȡǑȡȡȯ
recovered ȡȡȡȸȪȡȣǗ
and Director, Technical Education , Governmentof ȢÞȰ èɅ
Madhya PradeshȡǑȡȡȯ ȡȡȡğǙ
will be free to register FIR andƣèȢǙ ȡ[penal
initiate legal 
action and against us.
\ȡȣ\ȡ\Û¢\ȡȣ]æȯ ɅȪ`ȯǽÚȡȢÖȲǑ¡ȡȧȡȡjȲfȲ
ȯ¡f]_][ȡ_ȡÉȡ[ȡ¡ȣȧȡȯȢ)

¡SOUMIL PANJWANI S/o SANJAYPANJWANI kSANJAYPANJWANI Ȫȡȯ¡ɇ`ȪƠȡȡȣ¡ȣ¡ȰfȲ¢ȡCDȪ[ȣ¢ȡȡ\


]ȡȲĤǓȪȢȣ¢ȡ\ǕĐȡȲɅ\ȲǗǓȡȢȡ[]ɇ\ȡ`Ȳȡ\ÛǗ[fȲ¡ȣ¡Ȱ@]ȯȯȪ[
Date (Signature of Parent / Father/ ȡȡȯ¡èȡ¢(Signature of Student / ]ȯȯ¡èȡ¢
^ğȯǕÉȲğȢȯȡȢÚȡȸȪȡfȲ\ÛȢ\ÛȪȡȯ\Ȳ[Ȣ\ÛȲèȡɅ]ȯĤèǕ¡ȣȲȡ
¡ȰDeclaration from Institute Head & Institute Scholarship
@\`ȪƠȡȡȣȢȢèȡ_ȡȢ¡Ȱ ȪȲNodal O!cer
Ǘ[ȡȡȣȡȯ ȢfȲ¡ȡȯȡȡǗȢȡ[ȡ¡ȣȯf
We, hereby, cer!fy that the student is enrolled in the approved course of Govt MP. All the details "lled by the student in the above applica!on
ȲȡȢȧ¢ȡèȲğ¡ɉȯ@
form have been veri"ed with the original documents and have been found to be correct and authen!c. He/She is eligible for sanc!on of
scholarship. College has ORIGINAL COPY of his School Leaving Cer!"cate. He is a#ending regular Classes, as per the instruc!ons of Government
We have veri"ed all details as per the
Ǒ¡Øɉȡȡȣȯ scheme guidelines
]ȡȡğǙ Ǔȯ&ȯinstruc!ons
¡Ǖȯȡfȯand recommend him
Ȫ¡ȡȣȡğǙ for sanc!on of scholarship
ƣǓèȣȡȯ as per the
ȢȡȡğǙ rules. We also
ƣȧǔȢ
undertake that, if the above student does not a#end the classes regularly or discon!nues the course, We will immediately report the ma#er to the
ȣ_¡Ȱ `ȯEduca!on
Director, Technical ȡȯȣȡȯ Ȣ)^¡ȯ
so that his Đȡȡȯ
scholarship can ǔÛȡȸȪ¡ȯ
be put on hold. In case any informa!onfound
ȡȯfȢȢȪȡȯ \Û[
to be incorrect, Government willbe
Ȣ
free to
ȢȡğǙ ƣȯagainst
ini!ate ac!on ǔ[the
ȢȡǑȡȡȯ
ins!tute. ȡȡȡȸȪȡȣǗȢÞȰèɅȡǑȡȡȯȡȡȡğǙƣèȢǙȡ[
The ins!tute is accredited by the Government and permission
\ȡȣ\ȡ\Û¢\ȡȣ]æȯ is given
ɅȪ`ȯ to conduct related course.
ǽÚȡȢÖȲ Ǒ¡ȡȧȡȡjȲfȲ
ȯ¡f]_][ȡ_ȡÉȡ[ȡ¡ȣȧȡȯȢ)
Date (Signature ) (Signature ) (Signature )
MMVY Scheme Incharge HOD Director/Principal
We, hereby, cer!fy that the student is enrolled in the approved course of Govt MP. All the details "lled by the student in the above applica!on
Date 
form have been veri"ed with the original documents and have been found to be correct and authen!c. He/She is eligible for sanc!on of
ȡȡȯ
scholarship. College has ORIGINAL COPY of his School Leaving Cer!"cate. He¡èȡ¢ ]ȯȯ
is a#ending regular Classes, as per the instruc!ons ¡èȡ¢
of Government
(Signature
We have veri"ed all ofthe
details as per Parent / Father/
scheme guidelines & instruc!ons and recommend him (Signature
for sanc!onof Student /as per the rules. We also
of scholarship
undertake that, if the above student does not a#end the classes regularly or discon!nues the course, We will immediately report the ma#er to the
Declaration from Institute Head & Institute Scholarship Nodal O!cer
Director, Technical Educa!on so that his scholarship can be put on hold. In case any informa!on found to be incorrect, Government will be free to
ini!ate ac!on against the ins!tute.
The ins!tute is accredited by the Government and permission is given to conduct related course.

Date (Signature ) (Signature ) (Signature )


MMVY Scheme Incharge HOD Director/Principal
:
Generated by MP Medha
Medhavvi Portal as on 14/0
14/033/2024

Generated by MP Medhavi Portal as on 14/03/2024


:

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