Application for Financial Assistance
Name of the student *
Gender *
Roll No., Class, Branch *
Date of Birth & Age *
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DD
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Age *
permanent Address *
present Address *
Category of Admission *
EAMCET Rank *
ACADEMIC PERFORMANCE &Percentage of Marks secured in SSC *
ACADEMIC PERFORMANCE &Percentage of Marks secured in Inter *
ACADEMIC PERFORMANCE &Percentage of Marks secured in Degree *
ACADEMIC PERFORMANCE &Percentage of Marks secured in B.Tech I -I Sem *
ACADEMIC PERFORMANCE &Percentage of Marks secured in B.Tech I -II Sem *
ACADEMIC PERFORMANCE &Percentage of Marks secured in B.Tech II -I Sem *
ACADEMIC PERFORMANCE &Percentage of Marks secured in B.Tech II -II Sem *
ACADEMIC PERFORMANCE &Percentage of Marks secured in B.Tech III -I Sem *
ACADEMIC PERFORMANCE &Percentage of Marks secured in B.Tech III -II Sem *
ACADEMIC PERFORMANCE &Percentage of Marks secured in B.Tech IV -I Sem *
ACADEMIC PERFORMANCE &Percentage of Marks secured in B.Tech IV -II Sem *
Attendance Percentage in B.Tech I Year *
Attendance Percentage in B.Tech II Year *
Attendance Percentage in B.Tech III Year *
Attendance Percentage in B.Tech IV Year *
student details:Name of the Institution & Medium of Instruction in SSC *
student details:Name of the Institution & Medium of Instruction in Inter *
Mother Tongue *
Scholarship / Financial Assistance received during School days *
Scholarship / Financial Assistance received during College days
Any extraordinary achievement Curricular/ Co curricular/ Extra Curricular *
Do you engage private tuitions if yes, Details of classes you handle & the number of students you coach & income you get *
Do you undertake any part time job if yes, Details & income *
Any difficulties you are facing in pursuing your studies (elaborate - if needed attach a separate sheet) *
From any source If receiving mention the amount & Agency which sanctioned the amount *
Annual Income (proof to be enclosed, if available) *
Father's Name, Occupation & Address Employee/Businessman/Farmer/Professional/any other (indicate) *
Mother Name, Occupation & Address Employee/House wife/ Businessman/Farmer/Professional/any other (indicate) *
Assets Owned by the Family Land owned by Father (Specify complete details) *
Assets Owned by the Family Land owned by Mother (Specify complete details) *
Type of House owned by the Parents: Address *
Type of House owned by the Parents *
Living in Rented/Own House *
Address & location of the house *
If rented monthly rent paying *
Fathers Annual Income *
Landline / Cell Phone Number *
Family Educational Background:Parents Educational Background S.S.C / Inter/Degree / Post Graduate *
Family Educational Background:Brothers & Sisters Educational Background S.S.C / Inter/Degree / Post Graduate *
Family Ration Card Details (White/ Pink) Specify Number *
Number of members included in ration card *
Belong to City / Rural Background *
a) Presently staying with Parents/ Hostel/ Self cooking/Mess ( Given details *
a) Presently staying with Parents/ Hostel/ Self cooking/Mess ( Given details If staying in the Hostel, how much amount you are paying to the hostel per month) *
Presently staying with Parents/ Hostel/ Self cooking/Mess ( Given details If self cooking (individual / combined cooking and the expenditure incurred (your share) *
Presently staying with Parents/ Hostel/ Self cooking/Mess ( Given details)Do you cook once or twice a day (Morning/ Night) *
The mode of Transport to the College General Bus Pass/ Exclusive Bus Pass/ Shared Auto/ Two Wheeler/Bicycle/ On Foot *
Write a brief note on why you requires Financial assistance *
LIST OF ENCLOUSERS 1)Ration Card 2) Adhar card 3) Education Details 4)Income Certificate 5) Attendance Details (File Size should less than 2MB) *
Required
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