www.scholarships.net.in

Organisation : Shishu Sarothi
Scholarship Name : Bharti Infratel Scholarship Program 2017-18

Website : http://shishusarothi.org/
Application Form : https://www.scholarships.net.in/uploads/13281-Form.pdf

Scholarship:

Bharti Infratel Scholarship Program 2017-18 Application Form

Related / Similar Scholarship : Bharti Infratel Scholarship Program 2020

To be filled in English by the candidate in Block Letters. Put a tick mark in box where applicable.

List of Required Documents / Testimonials To Be Submitted Along With Application:
** Self attested Photocopy of proof of date of birth
** Self attested Photocopy of mark sheet of the HSLC examination
** Self attested Photocopy of certificate HSLC examination
** Self attested Photocopy of mark sheet of the 10+2 examination
** Self attested Photocopy of certificate of the 10+2 examination
** Self attested Photocopy of mark sheet of Graduate examination, if any
** Self attested Photocopy of certificate of Graduate examination, of any
** Self attested Photocopy of mark sheet of Post- Graduate examination, if any
** Self attested Photocopy of certificate of Post-Graduate examination, if any
** Recent Admission receipt ( current semester /year )
** Any other certificate relevant to educational qualification, if any
** Self attested Photocopy of a Photo Identity Card ( Voter ID /Passport / Driving License / Adhar Card)
** Self attested Photocopy of Disability Certificate
** Self attested Photocopy of BPL Card, if any
** Self attested photocopies Income Certificate (s) of parents
** 4 Coloured Passport Size Photograph of the candidate

Application with all testimonials / documents is to be submitted / sent to:
To,
The Executive Director
Shishu Sarothi Centre for Rehabilitation & Training for Multiple Disability Off
Ramkrishna Mission Road, Birubari
Guwahati – 7810 16, Assam

Tel: 0361 2470990 / 2478912 / 9207049810

Application Format :
1. Name of the candidate (as mentioned in the certificate)
2. Father’s Name
3. Mother’s Name
4. Address for Communication
5. Permanent Home Address
6. Date of Birth as per Birth Certificate/School Leaving Certificate
7. Sex : Male/ Female
8. Nationality
8. Details of Disability
9. Educational Qualifications

10. Previous financial support received, if any

If YES, provide the following:
** Source
** Course
** Duration
** Amount

11. Previous skill training course, if any

If YES, provide the following:
** Skill Training Course Name
** Institute
** Duration
** Year of Admission
** Year of Completion
** Course fee, if any

12. Family & Income:
** Father’s Name
** Contact No.
** Occupation / Source of Income
** Annual Income
** Mother’s Name
** Contact No.
** Occupation / Source of Income
** Annual Income
** Any other Source of Income of the Household
** Total Annual Household Income
** No. of Siblings ( Brother/Sister ) , if any

If in your family there are persons with disability other than you, give the following
** Name of the Person
** Relationship
** Age
** Type of Disability

Does your family possess a BPL (Below Poverty Line) Card?
If YES, provide BPL Card No.

Are you employed or earning some income?
If YES, provide the following
** Source of Income
** Amount earned annually

13. Details of course of study for which Bharti Infratel Scholarship is applied
** Name of the Course
** Name of the Institution
** Address of the Institution
** Duration of the Course
** Course fee per month/semester/year
** Pursuing* / Yet to apply / Applied for admission / Drop out
** If pursuing which year / semester
** If drop out, reason for drop out

*If pursuing/ already in college , Part II of this application has to be filled up and submitted.

Declaration:
We hereby declare that the information furnished above is correct and true to the best of our knowledge and based on records. We possess all supporting documents and evidence for the input. We also agree to abide by the Rules & Regulations and Terms & Conditions of Bharti Infratel Scholarships Scheme, if awarded to the applicant.

Place:
Date:

In case of orthopedically challenged / any applicant who is unable to sign by himself / herself, application may be submitted only with Parents / Guardian’s signature.