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Pmss Renewal Form

The document is an application form for the Mahendra Institute of Technology's Post-Matric/Free-Education Scholarship Scheme for the academic year 2024-2025. It requires personal details such as the applicant's name, date of birth, and family information, along with academic records and financial information. The form also includes sections for contact details, bank information, and accommodation status.

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anusanu162
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85 views7 pages

Pmss Renewal Form

The document is an application form for the Mahendra Institute of Technology's Post-Matric/Free-Education Scholarship Scheme for the academic year 2024-2025. It requires personal details such as the applicant's name, date of birth, and family information, along with academic records and financial information. The form also includes sections for contact details, bank information, and accommodation status.

Uploaded by

anusanu162
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
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MAHENDRA INSTITUTE OF TECHNOLOGY

(AUTONOMOUS)
APPLICATION FORM FOR SCHOLARSHIP SCHEME
POST-MATRIC / FREE-EDUCATION SCHOLARSHIP SCHEME
(WRITECAPITALLETTERSONLY)

PHOTO
SCHOLARSHIP ID NO* …………………………….………….………..

ACADEMIC YEAR*2024-2025

Studying Year/Dept/* …………………..……………..

Students Roll. No.*..................................Reg No*…………………….…..…

NAME OF THE APPLICANT*…………………………………………………….....

NAME AS PER AADHAR*……………………………………………………………

DATE OF BIRTH……………….………... GENDER*M/ F

FATHER NAME* ……………………………. MOTHER Name*………………………………………………

RELIGION* / COMMUNITY*/ CASTE*………………/……..…………./………….…………..……...

ANNUAL INCOME / *……………………………Occupation*…………….....................MQ/GQ*………

10 th Reg no*…………….…………………. 12 th Reg no*..………..………………………………

MOBILE NO*…………………………………..…. EMAIL…………………………..……………..…

AADHAR NO*……………………………..……

ADDRESS FOR CORRESPONDENCE* PERMANENT ADDRESS*

……………………………………… …………………………………….
……………………………………… ……………………………………
DISTRICT……………………… DISTRICT………………………..
TALUK…………………………... TALUK…………………………..
PINCODE………………………… PINCODE………………………..

BANK A/C NO: …………………….………. …….


Bank Brach name*………….………..…..…………
Bank IFSC Code*……………......… …………

HOSTELLER * YES / NO
DATE OF JOINING……………………… DATE OF LEAVING 30-04-2024
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