R.C.No:682 PROFORMA TO BE SUBMITTED BY THE STUDENT FOR PRATIBHA AWARDS - 2015

ANNEXURE - I

PROFORMA TO BE SUBMITTED BY THE STUDENT FOR

PRATIBHA AWARDS - 2015

1.   Name of the Student                             :

2.    Father  / Guardian Name                       :

3.   Phone number(Mobile No)                     :

4.    Name of the School / address , where    :

student  appeared SSC examination

5.     Residential Address                                       :

6.    Name of the College / Institution           :

 where he/she is admitted for further

studies.

7.    Name of the course pursuing now           :

8.    Admission No.                                     :

9.    Adhaar Card No.                                  :

10. Name of the Bank                                :

11. Branch                                                :

12.  Account No.                                       :

(*If bank account is not available,                  

A new bank A/c should be opened by

the student’s name only.)

13. IFSC Code                                           :

14. MICR Code                                          :       

15. The Xerox copy of the 1^st page              :

of the latest bank pass book

should be enclosed

                                     

The above information is verified and found correct.

Signature of the student                                 Signature of the Head Master

                   with stamp

Download Here--> R.C.No:682 PROFORMA TO BE SUBMITTED BY THE STUDENT FOR  PRATIBHA AWARDS - 2015