Scholarship Application Form Students will require following information while submitting their application for scholarships. Please collect all information, documents and then register and submit the application carefully. Once application is submitted, you will not be able to chance the details. In case of any incorrect, details, and absence of the scanned copy of the board mark sheet and caste certificate, the application will be rejected. 1 2 Identification Details: Samagra ID - 9 Digit Aadhaar No (Compulsory for Hoshangabad, Bhopal, Harda, Burhanpur, Jabalpur & Khandwa Districts ) 10th Board marksheet Details: 3 4 5 Secondary Board Name Year of 10 examination Board Enrollment No. as printed on board mark sheet 6 Scanned copy of the board mark sheet in JPG format (less than of 100 Kb size) Caste Certificate Details : Certificate No Certificate Issued By Caste Certificate Date Scanned copy of the Caste Certificate in JPG format (less than of 100 Kb size) 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 (mandatory) (mandatory) Income Details: (mandatory) Annual Family Income Income Certificate No Income certificate Issued by Date of Issue Personal Details: (mandatory) Name (as printed in 10th board mark sheet) FatherвЂ™s First Name (as printed in 10th boardmark sheet) Mother First name (as printed in 10th board mark sheet) Date of Birth (as printed in 10th board mark sheet) Category Religion (mandatory) Mobile Number (mandatory) Email Address (Optional) Last Year Exam Exam Name, Institute and Result Current Year Institute (mandatory) Institute Name Course Course year Admission Date Enrollment Number Hostel Status Whether Stay in Government Hostel Date of Admission in Government Hostel Bank Account Details: (mandatory) Bank Account No. IFSC code of the Branch Branch Name DD/MM/YYYY (SC/ST/OBC) Y/N DD/MM/YYYY (mandatory)