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    of 3

    GOVERNMENT OF GUJARAT Submit Date : 10/03/2023

    Application No:
    Post-Matric Scholarship for girls (Having annual family income more 222300000002460735
    than 2.50 Lac)(Freeship Card / Medical Loan Student Only)
    Fresh Application

    Student Basic Details


    Name of Student : Chaudhary Nandini Pragnesh
    Name of Student (As per Aadhar) : Chaudhary Nandini Pragnesh
    Mother's Name : Hemangini Chaudhary
    Date of Birth : 06/11/2002 Gender : Female
    Category : ST(7ȵkɅl‡ISKWĤiS  Religion :Hindu
    Caste : Choudhri (Surat and valsad districts)(ItV^Ž Ʌk^S7Wpa_dhPĥƣ_h\h5 

    Aadhaar Status Verified: Yes(02/03/2023 20:53:00)

    Annual Income of Parents/Guardian/Husband (Rs): 378999 Habitation Type: Urban


    Mobile Number : 9510940311 E-mail Address : [email protected]
    Aadhar No : 32xxxxxx3832 Parent/Guardian occupation: Business(V5Vs
    Is Orphan: NO Day Scholar / Hosteller : Hosteler
    Marital Status : Unmarried Hostel Type: Private Hostel

    Current Address: Permanant Address:


    State Gujarat State Gujarat

    District Gandhinagar District Gandhinagar

    Taluka Gandhinagar Taluka Gandhinagar

    Village Village
    PinCode 382007 PinCode 382007

    Address:DAIICT college reliance cross roads Address:DAIICT college reliance cross roads

    Student Bank Account Detail/Aadhar Bank Detail


    I voluntarily give my consent to use my Aadhaar details.
    Aadhar Number : 32xxxxxx3832 Bank name : -
    NPCI Date : - NPCI Status :
    I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
    Account No : 30xxxxxx7834 IFSC Code : BARB0MOTERA
    Student Name(As per Bank Name): Nandini Pragnesh Chaudhary

    Name of Bank : BANK OF BARODA

    Branch Name & Address : MOTERA ROAD


    I hereby accept that
    1.Details provided by me are correct to best of my knowledge
    2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
    3.Shall 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: Engineering & Technology

    Present Course/Class/Trade Name : B.Tech (Bachelor of Technology)

    Present Course/Class/Trade Year : 3RD YEAR(5th Semester/6th Semester)

    Studying in : Gujarat Enrollment No: 202001090

    Present Institute District : Gandhinagar Present Institute : Dhirubhai Ambani Institute of Information And
    Communication Technology, Gandhi Nagar

    Page 1 of 3 222300000002460735 Print Date :09/01/2024


    Admission Type : Regular Paid Seat (Self Finance) Present Branch Course : -

    Enter Your Research/Thesis Subject :


    Present Class Start Date : 10-Aug-2022 Present Course Completion Date : 11-Nov-2022

    Fees Amount
    Admission Fees (Rs) 86000
    Tution Fees (Rs) 20000
    Misc.Fee(NonRefundable Fees) 27500
    Exam Fees(Rs) 0

    Total (Rs) 133500

    Previous stream :B.Tech (Bachelor of Technology) Previous Class/Course : 2ND YEAR(3rd Semester/4th Semester)
    Previous Passing Year : 2022 Previous (%) : 52.00

    Educational Break : No No. Of. Year in Break :


    Are You Employed in any Organization/Establishment with leave without pay? : Not Applicable
    Freeship Card Detail
    Freeship Card No: 1051
    Freeship Card Issued Date: 19/12/2020
    Freeship Card Issued by District:Tapi
    Freeship Card Issued By Designation ID :
    Name of course for which Free ship card is issued : B.E. (INFORMATION AND COMMUNICATION TECH.)

    Indicate the details of Exemption Fees (Total Fees Amount Not Taken by
    Institute/college/University) :
    Admission Fee(In Rs.) : 86000

    Tution Fee(In Rs.) : 20000

    Misc.Fee(In Rs.)(Non Refundable) : 27500

    Exam Fee(In Rs.) : 0

    Previous Education Detail


    Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
    9th Std/10th Std 10TH science 1109841 2018 92

    11th Std/12 Std 12TH Science 11607787 2020 84

    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 Self Attested Certificate of Previous academic marksheet

    4 Income Certificate From the Concerned Authorised Authority/Persons

    5 Freeship Card

    Page 2 of 3 222300000002460735 Print Date :09/01/2024


    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 : 09/01/2024
    Verify Mobile Number : Yes 28/12/2023
    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. 2022
    -2023. 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 :

    Page 3 of 3 222300000002460735 Print Date :09/01/2024

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