GOVERNMENT OF GUJARAT Submit Date : 13/12/2023
Application No:
Umbrella Scheme for Education of ST Students Post-Matric 232400000001804764
Scholarship
Fresh Application
Student Basic Details
Name of Student : Gadsa Kiran kumar Javanbhai
Name of Student (As per Aadhar) : Gadsa Kirankumar Javanbhai
Mother's Name : Gadsa Nandaben
Date of Birth : 16/10/2001 Gender : Male
Category : ST(7ȵkɅlISKWĤiS Religion :Hindu
Caste : Dungri Garasia Ȯk5F^F^hdj]h
Aadhaar Status Verified: Yes(13/12/2023 16:48:00)
Annual Income of Parents/Guardian/Husband (Rs): 65000 Habitation Type: Rural
Mobile Number : 8140635618 E-mail Address :
[email protected] Aadhar No : 50xxxxxx2194 Parent/Guardian occupation: Farm Labour(EpĂ\ȩl^
Is Orphan: NO Day Scholar / Hosteller : Hosteler
Marital Status : Unmarried Hostel Type: Private Hostel
Current Address: Permanant Address:
State Gujarat State Gujarat
District Sabarkantha District Arvalli
Taluka Himatnagar Taluka Modasa
Village Village Modarsumba
PinCode 383001 PinCode 383315
Address:At Berana Address:At Modarsumba
Student Bank Account Detail/Aadhar Bank Detail
I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 50xxxxxx2194 Bank name : -
NPCI Date : 12/13/2023 12:00:00 AM NPCI Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 75xxxxxx4763 IFSC Code : BARB0BGGBXX
Student Name(As per Bank Name): KIRANKUMAR JAVANBHAI
GADASA
Name of Bank : BARODA GUJARAT GRAMIN BANK
Branch Name & Address : BARODA GUJARAT GRAMION BANK
I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.
Student Academic Details
Present Course/Class/Trade Type: Information Technology
Present Course/Class/Trade Name : BCA (Bachelor Of Computer Application)
Present Course/Class/Trade Year : 3RD YEAR(5th Semester/6th Semester)
Studying in : Gujarat Enrollment No: BCA33421008709
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Present Institute District : Sabarkantha Present Institute : GROW MORE INSTI OF COMP APPLI (BCA)
Admission Type : Regular Paid Seat (Self Finance) Present Branch Course : -
Present Class Start Date : 15-Jun-2023 Present Course Completion Date : 30-Apr-2024
Fees Amount
Admission Fees (Rs) 100
Tution Fees (Rs) 18000
Misc.Fee(NonRefundable Fees) 0
Exam Fees(Rs) 3120
Total (Rs) 21220
Previous stream :BCA (Bachelor Of Computer Application) Previous Class/Course : 2ND YEAR(3rd Semester/4th Semester)
Previous Passing Year : 2023 Previous (%) : 50.00
Educational Break : No No. Of. Year in Break :
Are You Employed in any Organization/Establishment with leave without pay? : No
Previous Education Detail
Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH Genera A4293895 2019 55.66
11th Std/12 Std 12TH Arts G848280 2021 48.43
Disablity Detail
Is Disability : No Type of Disability : -
Percentage of disability : - Required Guide/Coaching Guide: No
Guide Name: -
Guide Address: -
List of documents which you have attached :
1 Caste Certificate From the Competent Authorities
2 First Page Of Bank PassBook/Cancelled Cheque
3 Fee Receipt of Current Course Year
4 Self Attested Certificate of Previous academic marksheet
5 Income Certificate From the Concerned Authorised Authority/Persons
I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.
Date : 13/12/2023
Verify Mobile Number : Yes 13/12/2023
Place : Signature of the applicant
It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
all the Documents has been checked.
It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority
Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.
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This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2023
-2024. If student will irregular, than we will immediately reported to the said authority.
The actual School/College/University year began on __________________ and will be ended on _____________________
Signature Of Head Of The School/College/Institute/University With Official Seal
Place :
*Note : Stamp Signature will not be accepted
Date :
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