APPLICATION FOR HWA SCHOLARSHIP
Application Number: {field_id=”127″}
Previous App Number:
1. Personal Details
Applicant’s Name: {field_id=”1″}
Photo
Name or Parent / Guardian: {field_id=”67″}
Age: {field_id=”68″}
Gender: {field_id=”14″}
Ph: {field_id=”70″}
Alternative Ph: {field_id=”71″}
Address: {field_id=”2″}
Nearby landmarks to identify the location Building / Road / Electric Post no. / etc: {field_id=”72″}
Occupation of the Family Head: {field_id=”73″}
Annual Income of the family: {field_id=”74″}
Ration Card Status: {field_id=”167″}
Whether Differently abled: {field_id=”96″}
2. Educational Details Details
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Others (Please Specify): {field_id=”85″}
Course
Institution
University/ Board
Year of Passing
Marks %
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Details of Family Member
Name
Age
Relationship with the head of the Family
Occupation
Details of disability or disease, if any
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{field_id=”143″}
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{field_id=”166″}
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Total Members of family: {field_id=”141″}
Bread winner of the Family: {field_id=”97″}
Parent Status: {field_id=”98″}
Is the father supporting the family:{field_id=”100″}
Comments: {field_id=”139″}
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 receive any help whatsoever from Association or its network NGOs in the Future.
Place: {field_id=”128″}
Date: {field_id=”129″}
Signature:
For Verification Use only
Name of the Verification Officer:
Signature:
Remarks:
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