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Pre-Matric Scholarship 2011-12 (Fresh & Renewal) : Government of Karnataka Directorate of Minorities

The document provides information about the Pre-Matric Scholarship scheme for students belonging to minority communities in Karnataka for the 2011-2012 academic year. [1] Students from classes 1 to 10 belonging to Muslim, Christian, Sikh, or Buddhist communities can apply for the scholarship if they meet certain criteria. [2] The deadline for students to submit applications to their school heads is July 20, 2011. School heads must then submit applications to Block Education Officers by July 30, 2011. [3] The annual income of a student's parents or guardian cannot exceed Rs. 1 lakh for the student to be eligible.

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Vee Thiru
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124 views

Pre-Matric Scholarship 2011-12 (Fresh & Renewal) : Government of Karnataka Directorate of Minorities

The document provides information about the Pre-Matric Scholarship scheme for students belonging to minority communities in Karnataka for the 2011-2012 academic year. [1] Students from classes 1 to 10 belonging to Muslim, Christian, Sikh, or Buddhist communities can apply for the scholarship if they meet certain criteria. [2] The deadline for students to submit applications to their school heads is July 20, 2011. School heads must then submit applications to Block Education Officers by July 30, 2011. [3] The annual income of a student's parents or guardian cannot exceed Rs. 1 lakh for the student to be eligible.

Uploaded by

Vee Thiru
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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GOVERNMENT OF KARNATAKA DIRECTORATE OF MINORITIES

PRE-MATRIC SCHOLARSHIP 2011-12 (FRESH & RENEWAL)


(Ministry of Minority Affairs Govt. of India Scheme) For Students belonging to the Minority Communities - Muslims, Christians, Sikhs & Buddhists. st th For students of 1 to 10 Standard only. 1. The students have to submit the filled in applications only to the Head Master / Principal of their respective schools on or before 20th-JULY-2011. 2. In turn the Head Masters/Principals have to submit the applications along with the list of the candidates in the prescribed format available on the website www.gokdom.com to their respective B.E.Os on or before 30th-JULY-2011. PART - I (TO BE FILLED BY THE CANDIDATE) Full Name (in Block Letters as per school register)
Affix recent color passport size photograph (do not staple)

Details of Parents/Guardian ( in Block letters) Fathers Name Guardians Name Fathers/Guardians Occupation Annual Income of Parents/Guardian Date of Birth
(As per school records)

Gender
(Mark by Tick)

Religion

Nationality

Male ( ) School Address : (IN CAPITAL LETTERS)

Female ( )

Name and address of the school


PINCODE : Academic & Fee Details
Examination Passed during 2010-11

TALUK :

DISTRICT :

Percentage of Marks Obtained

Class Studying during 2011-12

Annual Fee for the year 2011-12 (in Rs.)

TUITION FEE (a)

ADMISSION FEE (b)

TOTAL FEE (a+b)

RENEWAL DETAILS
Did you receive the Pre-Matric Scholarship by the Directorate of Minorities during the year 2010-2011 Yes ( ) No ( )

If yes, Amount Received : __________________ Cheque No _______________ www.gokdom.com Page 1

Home Address: ( IN CAPITAL LETTERS)

PINCODE :

TALUK :

DISTRICT :

Bank Details and Account Number of the Student: (Compulsory for Renewal cases/Optional for Fresh Applicants) (i) Name of the student (as in the Bank Account) : _______________________________________________________ (ii) Saving's Account Number : __________________________________________________________________________ (iii) Bank Name : _______________________________________________________________________________________ (iv) Branch Name with Full Address : ____________________________________________________________________ ________________________________________________________________________________________________________

CONDITIONS (1) Only Students who have scored not less than 50% marks in the previous final examination may apply. (2) In case of 1st Standard students, 50% marks requirement will not apply. Only the income criteria will be applicable. (3) The annual income of the students parents / guardian from all sources should not exceed Rs.1 lakh. Documents to be enclosed (attached) with the application (i) Photo of the student must be pasted on the first page of this application. (ii) Xerox Copy of the Caste & Income Certificate issued by Tahsildar or (ii) Original Affidavit on non-judicial stamp paper of Rs.20/- as per the format given on Page 4 of this application DECLARATION (i) I hereby declare that the information given above is correct. (ii) I am not availing any other scholarship from any other source. (iii) I shall abide by the terms and conditions for sanction of the Pre-Matric Scholarship. (iv) I undertake that if, at any stage, it is found to the satisfaction of the sanctioning authority in the State Government that the information given by me is false or if I violate the terms and conditions of the scholarship, the scholarship sanctioned to me, may be cancelled and the entire amount of scholarship will be refunded by me or recovered from me, apart from such penal action as warranted by law.

Signature/Thumb impression of Parent/guardian Place Date : _________________________ : _________________________

Signature of the student

www.gokdom.com

Page 2

PART - II [ TO BE FILLED UP BY THE HEAD MASTER / PRINCIPAL OF THE SCHOOL ] Verification/information to be furnished by the Head Master / Principal of the School

(i) It is certified that the information filled in the above mentioned columns by Shri/Kumari ___________________________________________________________________________________________ son/daughter of _______________________________________________________________________________________ who is studying in _____________ standard for the academic year 2011-2012 in our school is correct.

(ii) He/She has secured ____________ percentage of marks in the previous annual examination.

I have scrutinized the documents and verified with the school records and certify that the information furnished above is correct and true to the best of my knowledge.

Date Place

: ____________________ : ____________________

Signature of the Head Master/Principal of the school With official seal having the complete address of the school

IMPORTANT NOTE:1. If you have the Caste & Income certificate issued by Tahsildar, you can attach a Xerox copy of it attested by a gazetted officer along with the application form. 2. If you do not have the Caste & Income certificate issued by Tahsildar , then type the matter given in Page No.4, on a non-judicial stamp paper of Rs.20/- and get it attested by a Public Notary and attach the original to this application. 3. DO NOT attach any Original or Xerox Copy of Marks Card or Address Proof documents with this application.

www.gokdom.com

Page 3

AFFIDAVIT FORMAT
(To be typed on a Non-Judicial Stamp Paper of Rs.20/- and notarized by Public Notary with Seal & Signature )

DECLARATION OF PARENTS'/GUARDIAN'S ANNUAL INCOME & MINORITY COMMUNITY

I ....................(Father/Mother/Guardian) Of .................................(Name of Student) who is studying in ................. Standard hereby declare that my annual income from all sources is Rs....... (in figures) Rupees....only. I declare that I belong to .............. (Muslim/Christian/ Sikh/Buddhist) community. If any stage, it is found that the information given by me is false/not true, all benefits given to the student under the scheme of Pre-Matric scholarship for students belonging to Minority Communities could be withdrawn and legal action as deemed fit, may be taken against me or my Ward.

Date : _______________ Place : _______________ Address : __________________________________________ __________________________________________ __________________________________________

Signature (Father/Mother/Guardian)

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