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    Annexure II Revised (1)

    Uploaded by

    Priyajyoti Das

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Annexure II Revised (1)

    Uploaded by

    Priyajyoti Das
    6 views1 page

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    Copyright:

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    6 views1 page

    Annexure II Revised (1)

    Uploaded by

    Priyajyoti Das

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Annexure

    (Application Format for Verification of Scholarship Application)

    To
    The Principal
    IMPS College of Engineering and Technology
    Nityanandapur, Malda-732103

    Sub: Application for verification and approval of (Title of the Scholarship)


    Scholarship Form – reg. Please tick the appropriate (Fresh/Renewal) Application
    Sir,
    I would like to apply for (Title of the Scholarship) Scholarship.
    I have filled in the details in the Scholarship Form, which are true and correct to the best of my knowledge. In the
    Academic Session 20.. -20.. , I have not received any other Scholarship till date. I do hereby declare that I will not
    apply for multiple scholarships for same academic session. I will be liable to return the amount of any one
    scholarship, if it will be proved that I have received two different scholarships for the same academic year. Kindly
    verify and approve the form (as mentioned below in the Appeal Box) so that it can be processed further.

    Yours faithfully,

    Name of Student: Signature:


    Stream: Semester: Year:
    Registration No. : Roll No. :

    Active Mobile Number: Guardian’s Signature:

    ** Attachments: Copy of Online Application Form, Domicile Certificate/Address Proof, Income Certificate from
    competent authority, Cast Certificate (if any), Aadhar Card, Copy of Bank Pass Book Front Page, Physical
    Disability (PH) certificate (if any), Copy of the receipt of latest Fee Submission, Admit card and result of
    Secondary/Madhyamik, Result of Higher Secondary, Result of last Examination passed (if any), Copy of the
    documents related to the previous Scholarship received (if any) and Other documents relevant to theScholarship
    Scheme (if any).

    Appeal Box
    Your Appeal Detail (reason for which required) Tick in the appropriate
    option
    Issuance of Bonafide Certificate

    Issuance of Certificate of the Institute


    as given in the Form
    Photo Attestation

    Online Verification

    Any Other (Give detail)

    (For Office Use only)


    Verified By
    Verifying Authority Verified/Rejected Remarks (if rejected)
    (Signature with Date)
    HOD of (CE/EE/CSE/ECE)

    Dr. Sudipta Das, Principal

    Mr. Ashoke Kumar Chakraborty,AO

    Mr.Satyabrata Pradhan, Academic Cell

    Submitted Please.

    Principal, IMPSCET

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