ENGINEERS OF CHARITY (EOC)

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APPLICATION FORM

 NAME:                                                                 REG NO:

ADDRESS:

PHONE:

COURSE:                                                                                                 DURATION:

INSTITUTION

NAME AND ADDRESS:

PHONE:

GUARDIANS NAME:

FAMILY DETAILS

NAME

RELATION

JOB

INCOME(ANNUAL)

OTHER INCOME:

EDUCATIONAL QUALIFICATIONS

COURSE

INSTITUTION

YEAR OF PASSING

PERCENTAGE

EXPENDITURE DETAILS

PROJECTED

SUBSIDISED

RECOMMENDED

TUITION FEE

EXAM FEE

BOOK AND STATIONARY

TOTAL

RECOMMENDED BY

CLASS TEACHER:                                                                            SIGNATURE:

HEADMASTER:                                                                                SIGNATURE:

SCHOLARSHIP AMOUNT EXPECTED:

ARE YOU WILLING TO PAY BACK THE AMOUNT AFTER COMPLETION OF COURSE?

YES / NO

 DECLARATION

I……………………………………………. HEREBY PROMISE  THAT  THE FACTS MENTIONED ABOVE AND

 ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF.  I AGREE THAT ANY MIS APPROPRIATION

OF THE FACTS WILL LEAD TO THE CANCELLATION OF THE SCHOLARSHIP.

SIGNATURE:

PLACE:                                                                  

 DATE:    

   

FOR OFFICE USE ONLY

INITIATED BY (WITH CLASS AND PHONE)

1.

2.

VERIFIED BY: (WITH CLASS AND PHONE)

1.

2.

RECOMMENDED AMOUNT:

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SEND THE FILLED UP APPLICATION FORM TO:     majorrajeshr@yahoo.com