Saloni Shiksha Protsahan Nidhi

Name of Student

Date of birth

Father’s /Mother’s/Gradian Name (Please mention if student have Single Parent)

Residential Address

PIN Code

Mobile No.

Email address

Income-tax PAN

Aadhar No

Annual Income of Family

Name and Occupation of members

Do you / Parents have Owned House

Yes

(If Yes Total Area in sq feets Urban /Rural)

Do you/Parents have Owned any Land:

Yes

(If Yes Total Area in sq feets Urban /Rural)

Do you / Parents have Owned Four-Wheeler

Yes

Do you / Parents have Owned Two-wheeler

Yes

Educational Background

Current School

Current Class

Previous Academic Record

Desired Course / Stream

Reason for Requesting Free Education (Please provide a brief explanation

Declaration

I hereby declare that the information provided is true and accurate. I understand that providing false information may lead to rejection of my application

Signature

Name

Supporting Documents (Please attach the following documents)

Income certificate/Proof