Tuesday, 10 November 2015

RC.NO.682. PROFORMA TO BE SUBMITTED BY THE STUDENT FOR PRATIBHA AWARDS - 2015

ANNEXURE - I
PROFORMA TO BE SUBMITTED BY THE STUDENT FOR
PRATIBHA AWARDS - 2015



  1. 1  .   Name of the Student                             :


  1. 2.    Father  / Guardian Name                        :


  1. 3.   Phone number(Mobile No)                      :


  1. 4.    Name of the School / address , where     :
         student  appeared SSC examination


  1. 5.     Residential Address                                 :


  1. 6.    Name of the College / Institution             :
 where he/she is admitted for further
studies.


  1. 7.    Name of the course pursuing now           :


  1. 8.    Admission No.                                          :


  1. 9.    Adhaar Card No.                                      :


  1. 10. Name of the Bank                                   :

1                        Branch                                                    :

1             Account No.                                           :(*If bank account is not available,                  
A new bank A/c should be opened by
the student’s name only.)

1            IFSC Code                                               :

1             MICR Code                                              :       

1             The Xerox copy of the 1st page               :
          of the latest bank pass book
         should be enclosed
                                     

The above information is verified and found correct.





Signature of the student                                 Signature of the Head Master

                   with stamp




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