Scholarship Form 2017-18

JAMIAT ULAMA-I-HIND
1-Bahadur Shah Zafar Marg, New Delhi-110002

To be read carefully before applying for
scholarship
1. A limited number of scholarships are available only for well-merited students of lower
income group, who cannot continue their education without such financial support.
Therefore, the student must attach the photocopy of admission receipt with the
application.
2. Scholarship is offered to students pursuing technical/professional Degree courses like B.E,
B.TECH, C.A., MCA, MBBS, BDS, BAMS, BUMS, B.PHARMA and B.ED. The
students in the final year of their courses are not eligible for the scholarship. Apart from
the income criterion, the student must have secured at least 60% aggregate marks in
the previous examination.
3. Income of the parent/guardian is one of the basic criteria for the award of scholarship.
Therefore:
i. In class of salaried class, the student must have indicated the designation, pay
scale, basic pay, and other allowances along with total emoluments of the
parent/guardian. A mere statement saying, "Service" will not be acceptable. The
student must attach a Salary Certificate or Pension Certificate (in case of retired
person) of his/her parent/guardian along with the applicant.
ii. In case of agriculture/horticulture etc, the student has to indicate the total land
holding with details of irrigated and non-irrigated land and other landed property
owned by his/her family along with the total income of the family. These details
must be stated in the affidavit from his/her parent/guardian. Incase of certificate
from Revenue authority, these details must be indicated in the certificate.
iii. In case of business class, the students must categorically state the name of the
business/type of the business along with the total turn over and the total income of the
family. The same details must be stated in the affidavit from his/her parent/guardian.
iv. Income for all other sources must also be mentioned specially, if mother is also
employed/business.
4. It must be noted that all income certificate and statements made by the student in the
application is subject to further verification by the Jamiat Ulama-i- Hind. In case of any
deliberate discrepancy/concealment of facts, the Jamiat Ulama-i-Hind may initiate
necessary action as per law.
5. The income certificate /affidavit must be from the parent's/guardian's side and should have
been issued from the respective home station. The income certificate issued or affidavit
made from the place where the student is studying, as against the home station, will NOT
be acceptable (in case of photo copy, it should be attested)
6. The form should be complete in all respects. All appendices enclosed with the application
form should be filled in and forwarded along with the application itself. Incomplete
application will be rejected and no correspondence will be entertained.
7. The last date of receipt of the application form with all necessary documents in the
office of Jamiat Ulama-i- Hind, 1-Bahadur Shah Zafar Marg, New Delhi-110 002 by
31st January 2018, which must be adhered to.
8. Form must be recommended by the President/Secretary of Jamiat Ulama City/District/ State
units of applicant’s area.
Note: - Only application to be submitted. Please detach this page from application.
JAMIAT ULAMA-I-HIND
1, Bahadur Shah Zafar Marg
New Delhi-110 002
Ph.: 23311455, 23317729
Educational Scholarship Application Form 2017-18
1. NAME:
(In Capital Letters)
2. a. DATE of Birth: b. Place of Birth:
3. Full Address:
a. Present: b. Permanent:
c. Phone Number (if any):

4. a. Father's full name with contact no. : _______________________________
b. Guardian's name with contact no. : ________________________________
c. Reason for Father not being a guardian:

5. Occupation of Father/Guardian:
Incase of Service Incase of Agriculture
a. Designation: a. Total Land Holding:
b. Office Address: b. Located at (address): _
c. Pay Scale/Grade: c. Other Landed Property:

d. Basic: d. Total Income (Annual):
e. Allowance:
f. Total emolument (monthly):
g. Mother's Income (if any):
Incase of business Incase of any other
a. Type: _________________________ a. Type: ____________________
b. Ownership/ Partnership___________ b. Total income (monthly) _____
c. Address:_______________________ c. Family income
______________________________ from all sources:___________
d. Total income: ___________________
e. Family income
from all sources: ________________
7. Particulars of all examination passed commencing with the Matriculation or
equivalent
Name of Board/University Year % of Marks or Subject taken
Examination Rank if any
8. (a) Name and full address

of the institute where the
student is studying : __________________________________________
(b) Name of the University
With which the institution
is affiliated:_________________________________________________
9. Date of admission:______________________________________________
10. Class/year in which the applicant is studying:_________________________
11. Course & Subject taken:_________________________________________
12. Number of years required for its completion:_________________________
13. Admission got through payment of
Donation / or through open competition:____________________________
14. Terms Fees:___________________________________________________
15. I hereby declare that the statements made above by me in this application form
are true to be best of my knowledge and belief.
Place: _______________
Date: __________________
Signature
(To be filled and signed by the Head of the Institution)
Certified that Mr. /Miss ____________________________________________

son/daughter/of ___________________________________was admitted in this
institution on payment of Rs. _______________________________for the year as
a regular and full time student in class/ year _____________on ____________and
is at present studying in class/ year ___________ in the academic session of
20___- 20___.
He /She is in receipt of scholarship /Financial Assistance from ______________

______________________ Rs. _____________ per month/per annum. He/she is
not in receipt of any other scholarship or financial assistant from a state govt/
university or any other institution or person. It's further that the occupation and
income of the father /Guardian mentioned in the admission record of the student in
this institution is ________________________________________________.
Place:_______________
Date:_______________
Signature of the
Head of the Institution
With seal
……………………………………………………………………………………
IMPORTANT
Verified by the President/General Secretary of the State / District / City

Jamiat Ulama unit with seal.
__________________________________________________________________
__________________________________________________________________
Name of the signing authority: …………………………………………………….
Designation: …………………………………… Contact No.: ……………………
Signature: ………………………... Office Seal:

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JAMIAT ULAMA-I-HIND

1-Bahadur Shah Zafar Marg, New Delhi-110002

Educational Scholarship Application Form 2017-18

c. Phone Number (if any):

b. Guardian's name with contact no. : ________________________________

c. Reason for Father not being a guardian:

c. Pay Scale/Grade: c. Other Landed Property:

8. (a) Name and full address

Certified that Mr. /Miss ____________________________________________

He /She is in receipt of scholarship /Financial Assistance from ______________

Verified by the President/General Secretary of the State / District / City

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