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Department of Technical Education, Skill Development and Employment

1. The document is a scholarship renewal application form for Ronak Patidar under the Mukhyamantri Medhavi Vidhyarthi Yojna scheme in Madhya Pradesh for the 2019-20 academic year. 2. It provides details about Ronak such as his name, father's name, date of birth, gender, category, religion, Aadhar number, domicile, academic details, annual family income, contact details, fees claimed and declarations signed by Ronak and his father. 3. The form also includes declarations signed by the head of Ronak's institute and nodal officer verifying his enrollment and recommending the renewal of his scholarship.

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Ronak Patidar
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243 views4 pages

Department of Technical Education, Skill Development and Employment

1. The document is a scholarship renewal application form for Ronak Patidar under the Mukhyamantri Medhavi Vidhyarthi Yojna scheme in Madhya Pradesh for the 2019-20 academic year. 2. It provides details about Ronak such as his name, father's name, date of birth, gender, category, religion, Aadhar number, domicile, academic details, annual family income, contact details, fees claimed and declarations signed by Ronak and his father. 3. The form also includes declarations signed by the head of Ronak's institute and nodal officer verifying his enrollment and recommending the renewal of his scholarship.

Uploaded by

Ronak Patidar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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“ȪŠ\‚š]”€Ȫ€Ȫ_ ˜è™ȡ¡ȰȪ]”Ǔ“€Š˜žȡ €ȧ™蝞ȡ Ȣ”Ȩ›ȣŠȯǔȓ€˜¡ȡͪƭȡ›™˜Ʌ Ȳ”€[€š €ȯ¡Ȱ)

Department of Technical Education , Skill Development and Employment


Madhya Pradesh Scholarship Portal 2.0
Renewal Application Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year 2019-20

Applicant Unique ID: 2993318 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna


Application ID: 10230484
First Time Lock Date: 01/11/2019
Version No: 1 Verification Code: 9536 Lock Date: 01/11/2019 IPAddress : 14.139.241.50
Instructions for colleges & offices: Please check all information in each section and place a tick mark in on the box. Institute
will use the first Box with I sign and Sanctioning Office will use second box with O sign in it.
Institute : [51012],NLIU, National Law Institute University, Bhopal District: BHOPAL Course : B.A.LL.B(Hons.)(NLIU)/B.A.LL.B (Hons.)/2nd
Year [5501]

Details Application Form Name of Entrance Examination : CLAT


Name RONAK PATIDAR Roll No of Entrance Examination : 10031461
Father Name MAHESH Common Rank in(JEE main/NEET/CLAT) : 948
DOB 11/07/1999
Gender Male #”ǕǽŸ%
Category OBC #\ͪ”%

Religion : Hindu Special Category : No I O


Aadhar No. : XXXXXXXX4682

2. Domicile of M.P. : Yes,Student is Domicile of Madhya Pradesh I O

3.Academic Details As Reported by Student : Enrollment No. : 2018BALLB93 Admission Date :30/06/2018 I O

Previous Year Percentage : 63.30

Details As Reported by Student


Admission Mode Direct Admission

Institute [51012],NLIU, National Law Institute University, Bhopal District: BHOPAL

Course B.A.LL.B(Hons.)(NLIU)/B.A.LL.B (Hons.)/2nd Year [5501]

Academic Year 2019-20


I O
Hostel Admission 30/06/2018

4. Total Annual Family Income : Rs.590000/-


Father/ Husband Occupation : Own Business/Shop, Income: 375000/-
Mother Occupation : Own Business/Shop ,Income: 215000/- I O
Other Income : Rs.0/-

5. Contact Details Mobile No : 9685041800 IAMRONAKLAW[AT]GMAIL[DOT]COM I O


Correspondence Address : L 207 INDIRA NAGAR NEEMUCH, District :- NEEMUCH

Permanent Address : L 207 INDIRA NAGAR NEEMUCH, District :- NEEMUCH

6. Total Annual Fees Claimed(Rs.) 194250/- I O

Generated by MP Scholarship Portal as on 01/11/2019


“ȪŠ\‚š]”€Ȫ€Ȫ_ ˜è™ȡ¡ȰȪ]”Ǔ“€Š˜žȡ €ȧ™蝞ȡ Ȣ”Ȩ›ȣŠȯǔȓ€˜¡ȡͪƭȡ›™˜Ʌ Ȳ”€[€š €ȯ¡Ȱ)

Department of Technical Education , Skill Development and Employment


Madhya Pradesh Scholarship Portal 2.0
Renewal Application Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year 2019-20

Applicant Unique ID: 2993318 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna


Application ID: 10230484
First Time Lock Date: 01/11/2019
Version No: 1 Verification Code: 9536 Lock Date: 01/11/2019 IPAddress : 14.139.241.50
]ȯ‘€fȲ”ȡ›€€ȧƒȪŸŽȡDeclaration From Student and his Parent
We, RONAK PATIDAR S/o MAHESH and MAHESH hereby declare that 12th Board Roll No, Board Name, Board Year, Aadhaar No, SAMAGRA
ID, Entrance Exam Roll No, Rank, Marks, Domicile, Annual Income and occupation details of father and Mother, Amount Claimed, Hostel
Status, College detils, Course Details, Category and all other information given in the application form is complete and correct. We have not
submitted any other application for Mukhyamantri Medhavi Vidharthi Yojna or any other scheme that offer the reimbursement of fee for current
academic year in any other institution. We also undertake that, if any information given above is found to be false at any stage, entire amount of
scholarship will be recovered and Director, Technical Education , Government of Madhya Pradesh will be free to register FIR and initiate legal penal
action and against us.

¡˜RONAK PATIDAR S/o MAHESH kšMAHESH ƒȪŸŽȡ€šȯ¡ɇͩ€`”šȪƠ‡ȡ“€ȡšȣ ¡ȣ¡ȰfȲ€¢ȡCD–ȪŒ[”šȣ¢ȡ€ȡ\“ǕИȡȲ€


]’ȡš“Ȳ–šĤǓ™Ȫ‚Ȣ”šȣ¢ȡ\“ǕИȡȲ€šɅ€\Ȳ€˜Ǘ›Ǔ“ȡ ȢȡͪŸ[€]™–ɇ€\€ȡ`ȲŠȡ\ۙͪšŽ”ǗŽ[fȲ ¡ȣ¡Ȱ@]ȯ‘€“ȯ”ȪŠ[›
”š^  ğ˜ȯ˜Ǖə˜ȲğȢ˜ȯ’ȡȢͪÚ™ȡȸ™Ȫ‡“ȡfȲ\ۙͩ€ Ȣ\ۙ™Ȫ‡“ȡ€ȯ\Ȳ‚[ͩ€ Ȣ\ۙ Ȳèȡ“˜Ʌ]ȯ‘“ĤèǕ“¡ȣȲͩ€™ȡ
¡Ȱ@\‚š`”šȪƠ‡ȡ“€ȡšȣͩ€ Ȣ—Ȣ菚”š‚›”ȡ_‡ȡȢ¡ȰȪ Ȳ”ǗŽ[šȡͧžȡͪ” ›ȣ‡ȡȯ‚ȢfȲ¡˜ȡšȯͨ›ȡ•€ȡ“Ǘ“Ȣ€ȡ™[ȡ¡ȣ€ȯͧ›f
 Ȳ…ȡ›€€“Ȣ€ȧͧž¢ȡ蝏Ȳğ¡ɉ‚ȯ@

™Ǒ‘¡˜‚›Ø™ɉ‡ȡ“€ȡšȣ€ȯ]’ȡš”š†ȡğǙǓ›ȯȯ¡Ǖ™ȯ”ȡf‚™ȯȪ¡˜ȡšȣ†ȡğǙͪƣǓ“šè€š‘ȣ‡ȡȯ‚Ȣȡ†ȡğǙͪƣ€ȧǔ‡“Ȣ
š€˜‘ȣ‚_¡Ȱ` ȯȡ” ›ȯ›ȣ‡ȡȯ‚Ȣ)^ š¡€ȯͩЙȡ€›ȡ” ȯ ˜ǔےͪ’ȡȸ€Ȫ¡˜ȯžȡ€ȯͧ›fͩ€ Ȣ—Ȣ™Ȫ‡“ȡ€ȯ\ۏ‚[ͩ€ Ȣ
—Ȣ†ȡğǙͪƣ ȯͪǔ‡[
ŒȢȡš €šǑ‘™ȡ‡ȡ™ȯ‚ȡȡͪ’ȡȸ€Ȫ€ȡ›ȣ Ǘ…Ȣ
ޛȰ€ͧ›èŠ ˜ɅŒȡ›Ǒ‘™ȡ‡ȡ™ȯ‚ȡȡ†ȡğǙͪƣèȢ€Ǚ€ȡ[
\ͬ’€ȡšȣ\ȡ\ۙ ¢˜\ͬ’€ȡšȣ]æ™€ ˜ˆȯ‚ɅȪ` €ȯͪǽڑ—ȡšȢ™‘ÖŒ ȲǑ¡ȡ€ȧ’ȡšȡjȲfȲ
€ȯ¡f•]_]š‘‡[€šȡ_‡ȡ€š É€ȡ™[ȡ¡ȣ€ȧ‡ȡȯ‚Ȣ)

Date (Signature of Parent / Father/ ”ȡ›€ͪ”ȡ€ȯ¡èȡ¢š (Signature of Student / ]ȯ‘€€ȯ¡èȡ¢š

Declaration from Institute Head & Institute Scholarship Nodal Officer


We, hereby, certify that the student is enrolled in the approved course of Govt MP. All the details filled by the student in the above application
form have been verified with the original documents and have been found to be correct and authentic. He/She is eligible for sanction of
scholarship. College has ORIGINAL COPY of his School Leaving Certificate. He is attending regular Classes, as per the instructions of Government
We have verified all details as per the scheme guidelines & instructions and recommend him for sanction of scholarship as per the rules. We also
undertake that, if the above student does not attend the classes regularly or discontinues the course, We will immediately report the matter to the
Director, Technical Education so that his scholarship can be put on hold. In case any information found to be incorrect, Government will be free to
initiate action against the institute.
The institute is accredited by the Government and permission is given to conduct related course.

Date (Signature ) (Signature ) (Signature )


MMVY Scheme Incharge HOD Director/Principal

Generated by MP Scholarship Portal as on 01/11/2019


“ȪŠ\‚š]”€Ȫ€Ȫ_ ˜è™ȡ¡ȰȪ]”Ǔ“€Š˜žȡ €ȧ™蝞ȡ Ȣ”Ȩ›ȣŠȯǔȓ€˜¡ȡͪƭȡ›™˜Ʌ Ȳ”€[€š €ȯ¡Ȱ)

Department of Technical Education , Skill Development and Employment


Madhya Pradesh Scholarship Portal 2.0
Renewal Application Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year 2019-20

Applicant Unique ID: 2993318 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna


Application ID: 10230484
First Time Lock Date: 01/11/2019
Version No: 1 Verification Code: 9536 Lock Date: 01/11/2019 IPAddress : 14.139.241.50

Last Exam Marksheet

Fees Receipt

Generated by MP Scholarship Portal as on 01/11/2019


“ȪŠ\‚š]”€Ȫ€Ȫ_ ˜è™ȡ¡ȰȪ]”Ǔ“€Š˜žȡ €ȧ™蝞ȡ Ȣ”Ȩ›ȣŠȯǔȓ€˜¡ȡͪƭȡ›™˜Ʌ Ȳ”€[€š €ȯ¡Ȱ)

Department of Technical Education , Skill Development and Employment


Madhya Pradesh Scholarship Portal 2.0
Renewal Application Mukhyamantri Medhavi Vidhyarthi Yojna Application form for year 2019-20

Applicant Unique ID: 2993318 Scheme : Mukhyamantri Medhavi Vidhyarthi Yojna


Application ID: 10230484
First Time Lock Date: 01/11/2019
Version No: 1 Verification Code: 9536 Lock Date: 01/11/2019 IPAddress : 14.139.241.50

Admission Slip

Generated by MP Scholarship Portal as on 01/11/2019

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