West Bengal Chief Minister Relief Fund Scholarship PDF
West Bengal Chief Minister Relief Fund Scholarship PDF
Application Form
To,
The Honourable
Chief Ministers
Govt. Of West Bengal
'Nabanna'
325, Sarat Chatterjee Road
Howrah - 711 102
CAST-
Female
Gender- Male
Permanent Address-
GEN
SC
ST
OBC
Religion-
P.O
P.S
DIST/ CITY
PIN
Board/University
Passing Year
Marks Obtained
Class/Div/Grade
% of Marks
Bank Information:
Account Holder Name
Bank Name
Branch Name
IFSC Code
Account Number
I do hereby certify that the above particulars are correct and true to the best of my knowledge and belief.
Date:
Place:
___________________________________
Signature of the applicant
Date:
_________________________________
Signature of the Student
SELF DECLARATION
I am ............................................................................................, Son. / Daut. of ..................
............................................................, Vill ...........................................................................,
Post ........................................................, P.S ........................................................................,
Dist. .............................................................., Pin ........................................................., do
here by decleared that I have been reading in Class ........................................ and My
Current academic seasion is 2016-2017 at .............................................................................
................................................................................................................................................
................................................................................................................................ (School /
College / University Name & Address). I have not received any kind of scholarship of
financial assistance for my education from any Govt. Department or any private agencies
during this year.
Date:
_________________________________
Signature of the Student
.........................................................................
Counter singed bt Head of Institution with Seal
How to Apply