No.

Web Reg. ID No.

RAJASTHAN YOUTH ASSOCIATION BOOK - BANK PROJECT

4, Jothi Venkatachalam Salai, (Atkinson Road) Atkinson Palace,
Ground Floor, J-Block, Vepery, Chennai - 600 007.
Phone : 2561 0369 / 2561 0978 www. ryabookbank.com

APPLICATION FORM
FOR OFFICE USE ONLY
To, PERMANENT NO.
The Chairman,
RYA Book - Bank Project
Vepery, Chennai - 600 007.

Sir,
I hereby apply for loan of set of text-books as detailed overleaf, AFFIX PASSPORT

Principal / Head of Dept.

SIZE PHOTOGRAPH
I give herewith the following particulars

To be Attested by
(ATTESTED)

1. Name : . ......................................................................................................
APPLICATION FORM
2. Age : Years 3. Sex M F GIVEN FREE
OF COST

4. Address :-
a.Correspondence :.................................................................... ..........................................................

.................................................................................................................................

Phone : ...............................Mobile : ............................... E-mail : ......................................

a. Permanent : .................................................................... ...........................................................

.................................................................................................................................

Phone : ...............................Mobile : ............................... E-mail : ......................................

5. College : ...................................................................DAY / EVE AUTONOMUS : YES / NO

6. Course : ........................................................................... Year : I / II / III / IV

7. Major : .................................................... ANCILLARIES : ..................................................

8. Name of the Father / Guardian : ................................................................................................................

a. Occupation : ........................................................... b. Annual Income : .....................................

c. Office Address : .................................................................................................................................

...........................................................................Phone : .......................................

9. NO. OF EARNING MEMBERS IN THE FAMILY :....................................... DEPENDENTS ........................

I have carefully read the rules and the instructions governing the project and here by promise to abide by
them. I am willing to excute the necessary bond before availing the loan of books.

Place :.................................
....................................................................
Date :.................................. Signature of Applicant
The information furnished herein above is true and correct to the best of my knowledge.

....................................................................
Signature of Parent / Guardian

Mr / Miss.....................................................................................................the applicant is a bonafide student

of

.......................................................................................................College and he / She is recommended for

the award of books.
....................................................................
COLLEGE SEAL Signature of Principal / Head of Dept.
 LIST OF BOOKS REQUIRED
(Language books are not loaned)
Please write the required Text Books for both the Semester

S.No. NAME OF BOOK AUTHOR ALTERNATIVE AUTHOR

 RECOMMENDATION LETTER

From Date :

Name of Recommending Person :

Address Office : ...................................................................................

....................................................................................

.................................................................................... Phone :

Res : ...................................................................................

.................................................................................... Mobile :

.................................................................................... Phone :

To

The Chairman,
Rajasthan Youth Association Book - Bank Project
4, Jothi Venkatachalam Salai (Atkinson Road) Atkinson Palace
Ground Floor, J Block, Vepery, Chennai - 600 007.

Dear Sir,

Mr. / Miss................................................................................................S / D of..................................................

residing at............................................................................................................................................................

studying at............................................................................................................................................................

has applied for loan of books from your project. I known him / her very well and I recommend him / her for
award of books. I also assure that he / she will return the books after completion of his / her studies.

Your's faithfully

.............................................................................
Signature of Recommending Person

.............................................................................
Designation with Office Seal

RULES AND INSTR UCTIONS GO

INSTRUCTIONS VERNING THE PR
GOVERNING OJECT
PROJECT

1. Please Register at www.ryabookbank.com and fill the Web Reg ID No. in the Application Form

2. The application form should be complete in all respects, otherwise it is liable to be rejected.

3. The recommendation letter should be obtained from person other than the Principal, Professors and
Head of the Departments of the College where the applicant undergoes the course.

4. The application should be accompained with Attest Photocopies of marksheets of plus two and last
examination passed.

5. Issue of books is subject to availability. We reserve rights to give books of alternate author.

6. Rajasthan Youth Association Educational Trust reserves the right to select or reject any application without giving any
reason whatsoever. The decisions of the Chairman of the Trust shall be final in all matters.

7. All Applicant who are from professional courses will have to remit special caution deposit as decided by the trust.

8. Students (if selected) will be issued text-books in the Last Week of July

9. In case if the text - book are lost / not returned you have to pay the cost of the book.

10. The last date for receiving the application is :.............................................................................

 R AJASTHAN YOUTH A SSOCIATION B OOK - B ANK P ROJECT
4, Jothi Venkatachalam Salai, (Atkinson Road) Atkinson Palace,
Ground Floor, J-Block, Vepery, Chennai - 600 007.
Under the Management of the
RAJASTHAN YOUTH ASSOCIATION EDUCATIONAL TRUST
CHENNAI - 600 007 .

SURETY BOND

I...................................................................... S/D of..................................................................

residing at....................................................................................................................................

and studying in ........................................ at................................................................................

......................................................................................do hereby undertake and assure that,

if selected as a beneficiary under the Book-Bank Project of Rajasthan Youth Association Educa-
tional Trust, Chennai. I shall take good and proper care of the books loaned to me and shall return
them on completion of my course or cessation of my studies, whichever is earlier. I further assure
that I shall not dispose of the books or damage them in any manner whatsoever.

......................................................
Date : Signature of student

I..........................................................................................................................father / guardian

of.................................................................................................................................................

residing at ..................................................................................................................................

do hereby undertake and assure that in event of the failure on part of my son / daughter / ward to
return the books. loaned out to him / her, I shall reimburse the cost of books to the above trust.
I assure you that my son / daughter / ward has not taken the books of the subjects applied from
any other Association / Trust.

......................................................
Date : Signature of Parent / Guardian

FOR OFFICE USE ONLY

MEMBER'S GUARANTEE :
Date of Receipt
Name of the Member :
of Application :........................................................
...............................................................................

Received by :.......................................................... Signature :............................................................

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