AIPSBCOEA,KERALA

DEPARTMENTAL SCHOLARSHIP FOR TECHNICAL / NON-TECHNICAL EDUCATION FOR CHILDREN OF EMPLOYEES OF THE DEPARTMENT OF POSTS FOR THE YEAR 2011-12.... 

Model of application form is given below

APPLICATION FOR SCHOLARSHIP FOR TECHNICAL / NON-TECHNICAL EDUCATION
                                                    FOR THE YEAR 2011-2012
A. Details of Applicant (Employee)

1. Name
2. Date of birth
3. Designation and office address with PIN code
4. House address with PIN code
5. Whether belongs to SC/ST/OBC
6. Whether belongs to Group D
7. Basic pay of the applicant as on 30.07.2011
8. Basic pay of spouse (if employed)

B. Details of student

1. Name
2. Relationship with the applicant(son/daughter)
3. Whether physically handicapped
4. Date of birth
5. Signature

C. Details of Course

1. Name of the course
2. Whether degree / diploma
3. (a)  Total duration
    (b)  State at which (year / semester) the student
          is studying
4. Name of the Institution
5. State / University by which recognized / affiliated

D. Scholarship record of the student commencing from Matriculation examination before joining the course of study undertaken by the student( should be supported by attested copies of mark sheets / certificates )

 Sl.      Name of examination        Year of passing     Maximum marks     Marks obtained     Percentage
 no.
1           Matriculation
2           Std.XII/PDC/
             Higher secondary
3           Any other examination
             passed
4
5

Note : If there is gap between passing of minimum qualifying examination and joining    the course of studies and is not covered nu the scholastic record, details of the period should be indicated.

E Details of assistance

1. Is the student receiving any
    stipend / monetary assistance
    from any other sources
2. If answer to (1) above yes, state
   (a) Amount
   (b) Source
3. If the applicant is in receipt of this
    scholarship for any other student,
    please give details

I declare that:
       1. The particulars given above are true and complete the best of mu knowledge and belief
       2. No other child of mine is already in receipt of a scholarship from the Department of Posts.
       3. The child for whom I have applied for scholarship now was not given book award for the current                 year of his / her studies ( if yes, please furnish particulars)
       4.my basic pay in the revised scale together with that of my spouse does not exceed Rs.10600/-
per month (certificate from the employer in respect of the salary of spouse is enclosed)

Station                                                                                                          Signature of applicant  
Date                                                                                                              (Govt. servant)

Certified that the entries under column 'C' and 'E' are correct

Station
Date                                                                                  Signature of the Head of  the Educational                                                                                                                        Institution and official with seal


Certified that the entries under column 'A' are correct as per office record. Certified from the employer in respect of the salary of the spouse of the official is enclosed.

Station                                                                                                   Signature of HPM/HRO/AO
Date                                         (seal)                                                               Head of the Unit

Certified that all the entries in the form have been filled in and that all relevant certificates have been
attached.

Station                                                                                                    Signature of SSPOs /SPOs/DPS/
Date                                          (seal)                                                              Competent Authority