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APPLICATION FORM (Student's Aid Fund)

This document is an application form for financial assistance under the Students' Aid Fund at Assam University for the session 2023-2024. It requires personal information, educational qualifications, family income details, and bank account information from the applicant. The form must be accompanied by an income certificate and is only available to students whose annual family income is up to Rs. 1.00 lakh.

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52 views2 pages

APPLICATION FORM (Student's Aid Fund)

This document is an application form for financial assistance under the Students' Aid Fund at Assam University for the session 2023-2024. It requires personal information, educational qualifications, family income details, and bank account information from the applicant. The form must be accompanied by an income certificate and is only available to students whose annual family income is up to Rs. 1.00 lakh.

Uploaded by

ia5718491
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ASSAM UNIVERSITY, SILCHAR

APPLICATION FORM FOR GRANT OF FINANCIAL ASSISTANCE


UNDER STUDENTS’ AID FUND
Session: 2023-2024
1. Name of the student
(Block letters)
2. Department: Semester: Roll No.:
3. Gender: Category:
4. Father’s Name:
5. Mather’s Name:
6. Spouse Name:
7. Full Permanent Address:

8. Contact No. :
9. Guardian’s Name :

10. Educational Qualification:


Examination Board/University Year of Passing Division/ % of marks
Grade
HSLC
HS
TDC
11. Whether father/mother of the applicant is in
any Govt/Non-Govt service, if so mention the
present post held, basic pay and total annual
income/salary

12. If father/mother both are not in any service the


source of income of the applicant’s family and
total income

13. Whether drawing/applied for any Scholarship/


Fellowship/ Stipend etc. from University and
any other source, if so mention the same.

Contd…..to p/2
DECLARATION FORM

The information as provided in the application for Grant of Financial Assistance under
Student’s Aid Fund are true to the best of my/guardian’s knowledge and belief. In case any of the
particulars furnished is found to be false at any subsequent stage I shall be bound to refund the
entire amount to the University and shall also be liable for other legal actions which the university
authority shall decide in course of time against me. The annual income of my family is
Rs._______________ and I have submitted Annual Family Income Certificate from appropriate
Govt. authority is in force for the purpose.

Bank Details (self) of the applicant is mandatory:


1. Name of account holder
2. Account number
3. Bank Name
4. Branch name & address
5. IFS Code
6. Mobile No.
7. E-mail id
*(Enclose photocopy of bank pass-book)

Full signature of the applicant

Full signature of the Guardian

I recommend/ do not recommend the name of the above student for Grants of Financial Assistance
under Student’s Air Fund of Assam University, Silchar.

He/She has submitted appropriate income certificate as proof of his/her annual family income.

Signature of the Head


(with seal)

Department of ____________________________

Note: The students belong to the Category whose Annual Family Income upto Rs. 1.00 lakh per
annum shall be eligible for applying the same scheme. No application shall be entertained without
proper income certificate as proof of the family income.

----

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