12/13/25, 9:45 AM STSC92512138867578
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Scholarship Application Form
ST&SC and MBC Welfare Department
Academic Year 2025-26 STSC92512138867578
Government of Odisha
Basic Information
Department Scheme Academic Year Application Type
ST&SC and MBC Welfare Post Matric Scholarship 2025-26 New
Department
Applicant Details
Applicant Name Category Applicant Gender
SUBHADRA DAS EBC Female
Religion Date of Birth OTR No.
Hindu 05 Aug 2006 (19 Year) 25010109944157
Aadhaar No.
XXXXXXXX1761
Bank account is seeded with Aadhaar when applied by student.
Bank Name : ODISHA GRAMEEN BANK | Sync Date : 15 Nov 2025
Mobile No. Alternative Mobile No. e-Mail Id
7749930577 7853038116 subhadradas531@[Link]
Father's Name Father Educational Status Father Occupational Status
BASANTA DAS Not literate Daily Wage Earner
Mother's Name Mother Educational Status Mother Occupational Status
PRABATI DAS Not literate House Wife
Guardian Name Individual/ Family Information
VIEW
-- Beneficiary of NFSA
Address Information
District Block/ULB GP/Ward
Angul Talcher Mpl Talcher (M) - Ward No.19
Pin Code Address
759100 po-handidua,dist-angul,state-odisha
Educational Qualification Details
For : Matric-Annual
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Passing Total Secured Percentage Marksheet/
Course Board Roll No. Year Mark/CGPA Marks/CGPA (%) Certificate
X BSE, Odisha 071AE0162 2023 600 300 50.00 Uploaded
Plus 2 CHSE, 223CA017 2025 600 353 58.83 Uploaded
Odisha
Institute / Course Information (Current Education Information)
Institute Type
Pvt. Unaided
Institute District Block/ULB
Narayani Institute of Management & Computer Angul Banarpal
Education
Nature of Course Course Branch/Stream/Trade
Self Financing Social Works BSW (Bachelor of Social Work)
Course Year (Current Year of Study) Admission/Registration No. Admission/Readmission Date
1st Year NRMGT250024 01 Sep 2025
Enrollment No. Enrollment Date
NRMGT250024 01 Sep 2025
Any Exam Conducted during current academic year? : No
Residential Status
Whether
Day Scholar
APAAR ID (Automated Permanent Academic Account Registry ID) Information
Do you have APAAR ID ? Reason
No Not Yet Registered for APAAR ID
Eligibility Information
Issuing Year Income Certificate No. Token No
2025-26 E-INC/2025/1157472 864BCD45
Family Income (in Rs.) To Whom the Certificate Issued Issuing Authority
60000.00 BASANT KUMAR DAS Revenue Officers not below the rank of
Tahasildar / Additional Tahasildar
Issue Date Applicant Father Applicant Mother
05 Jul 2025 GOURA DAS MARICHA DAS
Issuing District Income Certificate
ANUGUL NA
Matriculation Certificate No. Issuing Authority Matriculation Certificate
2330487148 BSE, Odisha (Annual) Uploaded
Self Declaration Certificate
Uploaded
Institute Declaration Certificate
NA
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Bank Information
Account Holder Name IFSC Code Account No.
SUBHADRA DAS IOBA0ROGB01 055334002001566
Whether account number tagged /seeded with
the Aadhaar number?
Yes
Bank Name Branch Name
Odisha Grameen Bank LANGIJODA
Passbook front page
Uploaded
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Student Declaration
1. I have read and understood the conditions of award of Scholarship.
2. I am aware that my application is liable to be rejected, if it is found at any stage, that Aadhaar number provided by me is wrong or Aadhaar number is
of someone’s else.
3. I am aware that if more than one application is found, all my applications are liable to be rejected.
4. I am aware that for any wrong entry or mis-match of the Bank-account details, the State Government will not be responsible for mis-credit and I will
be held responsible for diversion of public money on this ground.
Date ........................
Place ........................
Full Signature of Applicant
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