HWA SCHOLARSHIP PROGRAM

Supported by Hira Foundation Trust (Regd.)

Corp. Office: #52, St. John’s Church road, opp. Coles Park, Bangalore – 560 005

Regd. Office: #57, 1st Cross, Shivaganga Layout, Outer Ring Road, Mahadevapura, Bangalore – 560 048

Email : hwafoundationblr@gmail.com
www.hwafoundation.in

APPLICATION FOR HWA SCHOLARSHIP

1. Personal Details

Applicant's Name *

Name or Parent / Guardian *

Age

Gender

Phone Number

Alternate Phone Number

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Nearby landmarks to identify the location Building / Road / Electric Post no. / etc.

Occupation of the Family Head

Annual Income of the Family

Ration Card Status

BPL
APL

Whether Differently abled

Yes
No

2. Educational Details

Year/Semester

Tick the box of Pursuing Education

PG / Above PG
Degree
PUC (+2)
9th / 10th / 12th
Below 8"
Diploma
Certificate Program
Coaching

Others ( Please Specify )

Details of Education

Course

Institution

University/ Board

Year of Passing

Marks %

Additional Qualification 1

Add Course

Course

Institution

University/ Board

Year of Passing

Marks %

Additional Qualification 2

Add Course

Course

Institution

University/ Board

Year of Passing

Marks %

Additional Qualification 3

Add Course

Course

Institution

University/ Board

Year of Passing

Marks %

Additional Qualification 4

Add Course

Course

Institution

University/ Board

Year of Passing

Marks %

Details of Family Member

Name

Age

Relationship with the head of the Family

Occupation

Details of disability or disease, if any

Add family member 1

Add Member

Name

Age

Relationship with the head of the Family

Occupation

Details of disability or disease, if any

Add family member 2

Add Member

Name

Age

Relationship with the head of the Family

Occupation

Details of disability or disease, if any

Add family member 3

Add Member

Name

Age

Relationship with the head of the Family

Occupation

Details of disability or disease, if any

Total Members of family

Bread winner of the Family

Parent Status

Widowed
Divorce
Other

Is the father supporting the family

Yes
No

Comments

Decleration of the Parent / Guardian *

I do hereby declare that the furnished details are true to the best of my knowledge and i understand that any false information revealed during verification would result in blacklisting and won't recieve any help whatsoever from the Association or its network NGOs in the Future.

Place

Date

For Verification Use only

Name of the Verification Officer

Signature

Remarks

HWA Charitable Foundation

HWA Charitable foundation is a not for profit, Section-8 Company registered under Companies act, government of India. Although, HWA was formally registered under section -8 in 2019, HWA team was formed in 2005 and has been constantly working among the poor and the underprivileged in Bangalore.

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52, St.Johns Road
Opp. Cole’s Park, Shivaji Nagar
Bangalore, Karnataka
India – 560005

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