form for -pms scholarship
DESCRIPTION
Form for -PMs ScholarshipTRANSCRIPT
PRIME MINISTER’S SCHOLARSHIP SCHEME
ACKNOWLEDGEMENT SLIP
OFFICE COPY
Your Application Form dated_________ has been received on__________. The
application will be examined for eligibility. The dak receipt number ____________ is to be
mentioned for further correspondence with this office.
Office Seal: (Signature of RSB)
Tear off Tear off
ACKNOWLEDGEMENT SLIP
STUDENT COPY
Your Application Form dated_________ has been received on__________. The
application will be examined for eligibility. The dak receipt number ____________ is to be
mentioned for further correspondence with this office.
Office Seal: (Signature of RSB)
Note: This copy duly stamped and signed by RSB given to the student by hand or by post. (Envelope enclosed along with the application may be used.)
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MINISTRY OF DEFENCE Department of Ex-Servicemen Welfare
PM’S SCHOLARSHIP SCHEME
FOR
DEPENDENT WARDS OF EX-SERVICEMEN / WIDOWS
Brochure-Cum-Application Form
For Academic Year 2009-10
Application Form consists of Col No 1 to 20, Renewal Form and list of RSB at state and UT level. (Brochure-Cum-Application consists of 31 pages)
KENDRIYA SAINIK BOARD West Block-IV, Wing-VII, 2nd Floor
R K Puram, New Delhi-110066 Website: www.mod.nic.in
Tele : 011- 26715250E-Mail : [email protected]
Note: This application form (page number 13 to 22 alongwith required documents only) is to be deposited by individual to RSB. Applications duly recommended by
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RSB’s shall only be considered by KSB. Therefore, candidates are advised not to forward applications direct to KSB as the same shall not be considered.
PRIME MINISTER’S SCHOLARSHIP SCHEME
1. Introduction.
To encourage higher technical and professional education for the dependent wards of ESM and their widows (below officer rank only) and dependent wards / widows of ex-servicemen who died in harness due to causes attributed to military service, irrespective of the rank, Prime Minister’s Scholarship Scheme has been introduced from the Academic year 2006-07.
2. Scholarships Available.
A total number of 4000 scholarships will be allotted.
3. Students eligible for the scholarship.
(a) Dependent wards of ex-servicemen and their widows (below officer rank only)
(b) Dependent Wards/widows of ex-servicemen who died in harness due to causes attributed to military service, irrespective of the rank.
(c) The scheme is open only for widows and wards of ESM.
Note: (i) The candidate irrespective of his marital status is eligible for PMSS. However, an earning / serving candidate is not eligible.
(ii) For dependent wards of widows and widows of personnel died in harness due to causes attributable as at (b), there will be no rank restriction.
4. How to Apply For Scholarship.
One candidate to submit only one application form for one course, if any candidate submit two application for more than one course, both the applications will be rejected. Forms are to be downloaded from the website www.mod.nic.in. Application forwarded on any other format will not be considered.
Application to be forwarded on plain A4 size paper (typed or handwritten) in the prescribed format duly completed in all respects with superscription on the envelope “Prime Minister’s Scholarship Scheme.”
Documents to be attached alongwith PMSS application form are as follows:-
(a) Photocopy of ESM valid I card duly certified by RSB / ZSB.
(b) Extract of ESM discharge book as per specimen. (Refer page number 22)
(c) Matriculation certificate duly attested.
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(d) Minimum Entry Qualification certificate duly attested. (10+2 Marksheet or full
Graduation Marksheet which ever is applicable)
(e) Bonafide studentship certificate from Collage in original as per specimen. (Refer
page number 21)
(f) Demand Draft of Rs. 30/- not made before 20th December 2009.
Note: Failure to attach any above mentioned documents / certificate will lead to rejection.
5. Selection Procedure.
Applications will be short listed based on Ex-servicemen category (as given in para 6) and percentage of marks obtained in minimum entry qualification (MEQ).
6. PRIORITY for Grant of Scholarship.
Order of preference for allotment of scholarships will be as under:-
Category 1 Wards/ widows of defence personnel killed in action.
Category 2 Wards of ex-servicemen disabled in action and boarded out of service with disability attributable to military service.
Category 3 Wards/widows of defence personnel who died while in service for causes attributable to military service.
Category 4 Wards/widows of Defence personnel disabled in service with disability attributable to military service.
Category 5 Wards of ex-servicemen in receipt of gallantry awards.
Category 6 Wards of ex-servicemen (PBOR).
7. Eligible Courses.
First year professional degree programme in BE, B Tech, BDS, MBBS, B Ed, BBA, BCA, B Pharma, etc. duly recognized by the respective government regulatory bodies, such as All India Council for Technical Education, Medical Council of India, UGC etc. The scheme is open for courses mentioned above in recognized institutions (in India only). Students studying abroad are not eligible for this scheme. Students getting stipend for the professional degree course are also not entitled. The candidates may avail only one time facility for first degree course (Professional) i.e. graduate level only under PMSS.
8. Scholarship for Integrated Courses.
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The facility under PMSS is restricted for professional courses only duly recognized by the respective Government regulatory bodies such as All India Council for Technical Education, Medical Council of India etc.
9. Minimum Eligible Marks in 10+2 or Graduation.(Minimum Educational Qualification for Entry) should be 60%.
Minimum educational qualification (MEQ) for entry to different professional course is different e.g. for MBBS and B E it is 10+2 where as it is graduation for B Ed and MBA. A candidate must have minimum 60% marks in MEQ to be considered for scholarship.
10. Duration of Scholarship.
Two to five years as approved by the concerned regulatory body (Except one year for B Ed and five and half years for MBBS).
11. Amount of Scholarship.
a) The amount of scholarship would be as follows:
(i) Rs. 1250/- per month for boys Paid after successful completion of each academic year.
(ii) Rs. 1500/- per month for girls
12. Renewal of Scholarship.
Candidate shall submit new Renewal Form along with two acknowledgement slip and Bonafide Certificate duly signed by the Principal / Dean / Registrar of the institution / college to the respective RSBs either in person or by post for renewal of scholarship for the subsequent academic year. RSBs will scrutinize and check the application forms and forward the same complete in all aspects to KSB immediately. RSBs will issue acknowledgement slip to the candidates at the time of submission of the application in person otherwise dispatch by post to them. Candidate to attach a self addressed envelope, duly stamped to receive the acknowledgement of renewal form by post. For easy comprehension an illustration has been given below:-
Student admitted in B Tech. September 2008
Marks in 10+2. 61%
Applied for PMSS. Before 31 December 2009
Finds his name in the list of 4000 successful candidates selected for grant of PMSS.
June 2009
Applied for first renewal of Scholarship by submitting first year / first two semester result.
October 2009
Granted first installment. December 2009Applied for second renewal of Scholarship by submitting second year / second two semester result.
October 2010
Granted second installment. December 2010Applied for third renewal of Scholarship by submitting third year / third two semester result.
October 2011
Granted third installment. December 2011Applied for fourth renewal of Scholarship by submitting fourth year / fourth two semester result.
October 2012
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Incomplete form / pages / column / documents will lead to rejection or returned to RSB unactioned.
Granted fourth installment. December 2012
* Dates given above are to illustrate an example for easy comprehension and the same may not be quoted as authority.
IMPORTANT INSTRUCTIONS FOR PM’S SCHOLARSHIP SCHEME
(a) “PM SCHOLARSHIP SCHEME” is to be written in superscript on top of the Envelope for any correspondence with KSB & RSB.
(b) Checklist duly signed by student & parent is to be attached on the top of the application form.
(c) Applications alongwith relevant documents & certificates are to be deposited to respective Rajya Sainik Board, “latest by 15th Feb 2010. Incomplete application form and non submission of required document is liable to be rejected and will be returned unactioned. The application will be received by the RSBs and will be acknowledged with a seal and date of receipt.
(d) The concerned RSBs may scrutinise / check the application forms with regard to their eligibility criteria from all aspects prior to forward the same to KSB.
(e) Candidates and RSB’s to note that all applications received after the due date will not be considered and returned unactioned.
(f) List of selected candidates will be forwarded to RSBs after the merit list is finalized by the BOO at KSB.
(g) Three stamped (Rs. 5 each) blank envelopes of 27x12 cms and one stamped (Rs. 35) blank envelope of 35x25 cms are to be attached with each application so as to facilitate correspondence with the candidate by KSB/RSB.
(h) The scholarship is admissible for only two children of ESM. Particulars of all children should be indicated in column 17 of application form. This should be in uniformity with the discharge book / certificate of the ESM.
(i) The amount of scholarship, including any other scholarship or financial assistance from any other source will not exceed the total grant of assistance available under this scheme.
(j) The payment of scholarship will be granted after the successful completion of each academic year and on the submission of the renewal form (in original), as per the percentages mentioned in ‘Criteria for eligibility’. In case, KSB ask a student to submit the mark sheet for the full year, a student is liable to produce the same, failing which the scholarship will be held up.
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(k) Candidature of a student shall stand automatically rejected if, at any stage, it is discovered that he / she has secured scholarship fraudulently by making false statement or misrepresentation of facts. Candidate shall have to refund the amount already given, if any.
(l) The attached photocopies of the supporting documents should be duly attested by gazetted officer (unattested documents will not be considered). In case of legally adopted son/daughter or child born after retirement, the certificates are to be attached with the application form duly attested by Secretary, RSB / ZSB.
(m) If the marks in the qualifying examination are expressed in grades only, then equivalent percentage (100 point scale) duly certified by the concerned college / Board must be furnished (RSB & KSB will not be calculating the percentage of marks).
(n) All candidates to open individual bank accounts in the nearest State Bank of India branch or Punjab National Bank which has “electronic clearance system” / Core Banking, to facilitate transfer of the scholarship amount. Account number of the sister concern bank will not be accepted. i.e State Bank of Travancore, State Bank of Bikaner & Jaipur, etc. Candidate to attach a attested photocopy of passbook, showing name and account number of the individual. A cancelled leaflet of a blank crossed cheque will duly authenticate the account number. A joint account with parent will also fulfill the requirement.
(o) The candidates should have secured a minimum of 60% marks at 10+2 / MEQ level or equivalent and have to secure minimum of 50% marks, uninterrupted for continuation of scholarship in every year for the duration of course up to a maximum period of 5 years as prescribed for that programme of study. A person granted scholarship for one programme would not be entitled for scholarship for another programme.
(p) In case of change of any address, course, college, it is to be intimated immediately to Kendriya Sainik Board & Rajya Sainik Board in writing. Always mention selection serial number, name of applicant and ESM particular for any correspondence with KSB & RSB after getting selected for the scholarship.
(q) The Ministry of Defence, Government of India can suitably modify these instructions to remove anomalies, if any, for successful implementation of the scheme, as may be necessary from time to time and will be applicable to all students under the scheme.
(r) Ex-servicemen entitlement will be governed as per the existing definition of ex-servicemen, as amended from time to time. The definition is available in the guide book available with the RSB/ZSB.
(s) The application form should be downloaded from the official website of MOD, i.e. www.mod.nic.in. The application form should be submitted to the respective Rajya Sainik Board, (List of RSBs is attached along with the brochure) duly completed, along with a Demand Draft (Repeat) Demand Draft only for Rs.30/- in favour of Secretary, Kendriya Sainik Board, payable at New Delhi. In case of any difficulty in obtaining the form, the same can be obtained from the Secretary / Director Rajya Sainik Board. The Demand Draft should not be issued before 20th December 2009 (the Demand Draft is not refundable in any case).
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(t) While filling the application form, leave 1 (one) box blank between 2 (Two) words. Column wise guidelines are explained further for filling up the application form.
COLUMN WISE GUIDE LINES FOR FILLING UP OF APPLICATION FORM
(i) Column -1. Fill your name as in matriculation certificate only:-
(Not to be filled in any other format.)
1st Name A J A YMiddle Name S I N G HSurname R A N A
(ii) Column -2. Put a tick (√) mark as shown.
Male √ Female
(iii) Column – 3. Date of Birth as shown in matriculation certificate only.
For Example:- (10 June 1982)
D D M M Y Y Y Y1 0 0 6 1 9 8 2
(iv) Column – 4. Mention your Rajya Sainik Board and Zila Sainik Board name,
from where your father / mother have registered and have obtained ex-servicemen /
widow identity card.
(v) Column – 5. Write your permanent address and correspondence address in
block letters.
(vi) Column – 6. Write phone number along with STD code and email ID for any
query (email ID is must).
(vii) Column – 7. Category as per para 6 to be written (attach the required
document, if any). Category 1 (One).
Category - 1 O N E
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(viii) Column – 8. Full Particulars of Father/ Ex-Serviceman is to be mentioned
as per the discharge book. A blank space to be provided between names.
(Example: - KAMLESH CHANDRA CHOUDHURY)
K A M L E S H C H A N D R A C H O U D H U R Y
1 4 5 2 3 6 K
S E R G E A N T
A I R F O R C E
(ix) Column – 9. Details of 10+2 or MEQ. Leave blank space between words.
Marks to be shown in words and figures.
a. Total Marks O N E T H O U S A N D (in words) T W O H U N D R E D (in figure) 1 2 0 0
b. Marks obtained N I N E H U N D R E D
(in words) F O R T Y
(in figure) 9 4 0
c. % of marks scored S E V E N T Y E I G H T (in words) P O I N T T H I R T Y
T H R E E (in figure) 7 8 . 3 3
(x) Column – 10. Tick as applicable.
Yes √ No
(xi) Column – 11. The student is to specify the course which he / she is presently
studying. (Example:- B TECH)
B T E C H
(xii) Column – 12. Duration of the course both in numbers and figures to be
mentioned. For example 5 years 6 months.
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(In figure)
Y Y M M
0 5 0 6
(In word)
F I V E Y E A R S A N D S I XM O N T H S
(xiii) Column – 13. Write date of commencement & completion of course as shown
below:
(Course Commencement / Date of Admission)
D D M M Y Y Y Y0 1 0 7 2 0 0 7
(Course completion)
D D M M Y Y Y Y3 1 1 2 2 0 1 2
(xiv) Column - 14 Write the full name and address of the college with email ID and
phone number of principal.
Name of Student A J A Y S I N G H R A N A
Roll No. 0 8 E A T I T 0 4 3
Name of College A J M E R I N S T I T U T EO F T E C H N O L O G Y
Full Address P U S H K A R B Y P A S S A of college J M E R
State R A J A S T H A N
Pin Code 3 0 5 0 0 4
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Tel No. (with STD Code) 0 1 4 5 - 2 3 0 0 6 2 8
E-Mail ID (if any) a i t _ a j m e r @ r e d i f f m a il . c o M
College Website w w w . a i t a j m e r . c o m
(xv) Column - 15 Write the regulatory body of your college.
A I C T E
(xvi) Column – 16. Furnish the particulars of your all children as per specimen
given:-
Sl. No. Name of Child Gender Date of Birth Age1 Prakash Singh Rana M 10/10/1982 27 Years2. Satish Singh Rana M 12/05/1984 25 Years3. Ajay Singh Rana M 03/07/1987 22 Years4. Komal Rana F 14/02/1989 20 Years
(xvii) Column – 17. Given details of the scholarship availed by your brother /
sister in the past, if not availed write Not Applicable.
Sl. No.
Selection Serial No.
given by KSB
Name of the brother/sister
Course of Study
Academic year in which applied
Amount received so far
1. 6359 Satish Singh Rana B Tech 2007-09 15000
(xviii) Column - 18 Please write the full details of bank account of the student and
attach the photocopy of passbook and cancelled cheque as required to verify the
correctness of the account number (individual student account is preferred. However,
a joint account with the father / mother is also accepted).
Name of account holder A J A Y S I N G H R A N A
Bank Name S T A T E B A N K O F I N DI A
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Branch Name A J M E R
Branch Address A J M E R I N S T I T U T E O F TE C H N O L O G Y
State R A J A S T H A N
Bank Tel. No. 0 1 4 5 - 2 3 0 0 6 2 2
Branch Code 0 5 1 4
MICR (9 digit) No. 5 1 8 0 0 2 0 0 7
(PLEASE ATTACH A PHOTOCOPY OF CHEQUE & PASS BOOK)
Account No. 3 0 2 0 0 1 5 2 4 6 8
REPEAT
Account No. 3 0 2 0 0 1 5 2 4 6 8
(xix) Column – 19. Fill up attached Demand Draft particulars.
Issue D D M M Y Y Y YDemand Draft No. 0 2 3 1 5 0 Date 1 4 1 2 2 0 0 9
Amount (Rs.) in figure 3 0
Amount (Rs.) in word T H I R T Y
Issuing Bank Name S T A T E B A N K O F I N D I A
Issuing Bank Branch A J M E R
Note: Application form from page number 13 to 22 along with required documents only to be forwarded.
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CHECK LIST OF DOCUMENTS TO BE ATTACHED WITH
THE APPLICATION FORM
1. Candidates / ESM are to ensure that the following documents are attached (as applicable) along with the Application Form (non submission of these certificate will lead to rejection and application will be returned unactioned).
(a) Attested copy of Ex-Serviceman/Widow I-card issued by RSB/ZSB. This is an important document to be attached.
(b) Extract of ESM discharge book as per specimen.
(c) If child born after discharge then affidavit is to be submitted by ESM, that child is dependent on him and he / she is a ward of ESM.
(d) Additional Certificates – Attested copy of following documents.
(i) Category 1: Part II Order Equivalent of other
(ii) Category 2: Part II Order services i.e. Army /
(iii) Category 3: Part II Order Navy / Air Force
(iv) Category 4: Part II Order
(v) Category 5: Award Certificate
(e) Attested photocopy of matriculation or equivalent examination certificate for verification of date of birth.
(f) Attested photocopy of mark sheet of MEQ as applicable (e.g. 10 plus 2, graduation / diploma etc). In case the MEQ is graduation / diploma, then complete mark sheet is required to be submitted.
(g) In case of MBA/MCA applicants, attested copy of minimum entry qualification certificate. i.e Graduation
(h) Bonafide studentship certificate to be issued by Registrar/Dean/Principal of College/Institution pertaining to course for which scholarship is claimed (As per specimen attach).
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(i) Demand Draft of Rs. 30/- (Rupees Thirty only) attached. (Application form without Demand Draft will not be processed and Demand Draft should not be made before 20th December 2009.)
(j) Photocopy of passbook showing name, account number with photograph of individual and cancelled leaflet cheque. (Scholarship will not be sent in absence of photocopy of passbook)
Date: _____________________
_______________________________Place: ____________________ Full Name & Signature of Candidate
_______________________________________Checked / counter singed by ESM / Widow
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RecentPhotographOf Student
(Write your name & ESM/widow particular on
reverse)
Selection Serial Number(To be allotted by KSB) ......................
APPLICATION FOR PRIME MINISTER’S SCHOLARSHIP FOR THE YEAR 200_ - ___.
Note: 1.) Please read column wise guide lines carefully before filing the application 2.) Application Form to be filled in Capital letters except email ID. 3.) Checklist must be attached on the top of application duly tick marked.4.) One candidate to submit only one application form for one course.
1. NAME:- First Name
Middle Name
Surname
2. Put a tick mark (√)
3. Date of Birth (please attach proof of age) (i.e : Matriculation certificate) DD MM Y Y Y Y
4. Your Rajya Sainik Board or Zila Sainik Board (Where ESM is registered and obtained Ex-servicemen Identity card)
RSB
ZSB
5. Full Address: a) Present Correspondence Address: - (Where you want your letter to be sent in case of selection / rejection)
Male Female
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LEAVE BLANK SPACE BETWEEN WORDS
b)
Permanent Address :-
6. Telephone Number. STD Code
Land Line No.
Mobile No.
E-Mail (mandatory)
7.
Ex-servicemen Category - (Mention category as per Para 6 of the brochure and attach supporting documents duly attested).
LEAVE BLANK SPACE BETWEEN WORDS
8. Ex-serviceman’s Particulars:-
a) Name of ex-serviceman
House No.
Street No. & Name
Tehsil
District
State
Pin Code
House No.
Street No. & Name
Tehsil
District
State
Pin Code
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b) Service No.
c) Rank
d) Type of Service (Tick one) Army Air Force Navy
9. Details of MEQ / course for qualifying examination for scholarship (10+2/equivalent or minimum entry qualification)
a. Name of Course/MEQ
b. Year in which exam passed
c. Total Marks (in words)
(in figure)
d. Marks obtained (in words)
(in figure)
e. % of marks scored (in words)
(in figure) 10. Whether the applicant is in receipt of any other financial assistance/scholarship/ fellowship from any govt. / Private source for the course to which the scholarship applied for. If yes, then state the amount and source
Yes No
Amount
Source
11. Name of the Course (as per specimen)
LEAVE BLANK SPACE BETWEEN WORDS
12. Duration of Course in Years in figure and months
in words
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13. Date of Commencement and Approximate Date of Completion. D D M M Y Y Y Y a) Course commenced on
D D M M Y Y Y Y b) Course completion date approximately
14. Details of College / Institute.
Name of Student
Roll No.
Name of College
Full Address of college
State
Pin Code
Tel No. (with STD Code)
E-Mail ID (if any)
College Website
15. Regulatory bodies/ Council. (For example all engineering degrees and management degree courses are recognized by AICTE & UGC and all medical degree are recognized by Medical Council of India or Dental Council of India, specify as per case).
16. Furnish particulars of all children in order of age, as reflected in the discharge certificate or attached by the RSB/ZSB/Record Office.
LEAVE BLANK SPACE BETWEEN WORDS
Sl. No. Name of Child Gender Date of Birth
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17. Details of brother/sister availing the PM’s Scholarship, if any. (Including yourself if granted earlier)
Sl. No.
Selection Serial No.
given by KSB
Name of the brother/sister
Course of Study
Academic year in which applied
Amount received so far
18. Details of Student’s Bank account for payment of Scholarship through Electronic Clearing Service.
Name of account holder
Bank Name
Branch Name
Branch Address
State
Bank Tel. No.
Branch Code
MICR (9 digit) No.
(PLEASE ATTACH A PHOTOCOPY OF CHEQUE & PASS BOOK)
Account No.
REPEAT
Account No.
LEAVE BLANK SPACE BETWEEN WORDS
19. Details of Demand Draft. Issue D D M M Y Y Y Y
Demand Draft No. Date
19
Amount (Rs.) in figure
Amount (Rs.) in word
Issuing Bank Name
Issuing Bank Branch
20. Declaration: “Certified that the particulars given by me in the application are correct and any false statement made by us will disqualify me / my ward for award of PM’s Scholarship Scheme, besides recovery of scholarship already paid. I also undertake to abide by the conditions mentioned in the general instructions of the scheme.”
Place: (Signature of ward) ________________________ Date: (Full Name of Ward) _______________________
Place: (Signature of Parent) _______________________
Date: (Full Name of Parent) ______________________
CERTIFICATE FROM RSB / ZSB
“It is certified that PM Scholarship application form for academic year 20___ - ___ in
respect of Mr. / Ms. __________________________________________________________
S/o / D/o Ex -____________________________________________________ has been
checked, found correct as per check list provided by KSB and the applicant is eligible to apply
as per rules of the scheme”.
Office seal: Director, RSB / ZSB
Place : ________________
Date : ________________
SPECIMEN COPY OF BONAFIDE CERTIFICATE
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CERTIFICATE FOR PM SCHOLARSHIP
1. It is certified that Ms. / Mr ._____________________ is Bonafide
student of __________________________________ college. His / Her roll
number is __________ and he / she is studying in the I / II / III / IV / V year
or ______ semester of the One / Two / Three / Four / five years
_______________ course in ____________________ branch (if any).
He / she has joined this college in the academic year 20___ - ___ and the
course will be completed in the month of ____________ 20___ -___.
2. This is also certified that _____________ course is a professional
degree course and this college is approved by
________________________________________________.
3. This is also certified that student is getting Rs.__________________
(If not getting write N/A) stipend from this Institute / College or any other
sources. l
Office Seal: Signature of Principal / Dean / Registrar
Date:- ______________
Place:-_____________
SPECIMEN COPY OF EX-SERVICEMEN CERTIFICATE
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EX-SERVICEMEN CERTIFICATE
(In lieu of Discharge Book)
1. Type of Service (Army, Navy or Air Force) : _______________________________________
2. Service No. : _______________________________________
3. Rank : _______________________________________
4. Name & Initials : _______________________________________
5. Trade : _______________________________________
6. Date of enrolment : _______________________________________
7. Date of Discharge : _______________________________________
8. Reason for Discharge : _______________________________________
9. Duration/Length of Service : _______________________________________
10. Regular : _______________________________________Reserve
11. ESM died on (if applicable) : _______________________________________
12. Cause of death & : _______________________________________Whether Attributable
13. Particulars of dependent children:-Sl. No.
Name Gender Date of Birth
1.2.3.4.5.6.
It is certified that the above information is duly checked from the discharge book of Ex-servicemen and found to be correct.
Office Seal: Dir RSB/ZSB/OI/C Record Office
Date: ________________________
Place: ______________________
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PRIME MINISTER’S SCHOLARSHIP SCHEME
ACKNOWLEDGEMENT SLIP
OFFICE COPY
Your Renewal form dated_________ has been received on__________. The
application will be examined for eligibility. The dak receipt number ____________ is to be
mentioned for further correspondence with this office.
Office Seal: (Signature of RSB)
Tear off Tear off
ACKNOWLEDGEMENT SLIP
STUDENT COPY
Your Renewal form dated_________ has been received on__________. The
application will be examined for eligibility. The dak receipt number ____________ is to be
mentioned for further correspondence with this office.
Office Seal: (Signature of RSB)
Note: This copy duly stamped and signed by RSB given to the student by hand or by post.
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Selection Serial Number......................
PROFORMA FOR RENEWAL OF SCHOLARSHIP UNDER PRIME MINISTER’S SCHOLARSHIP SCHEME
(To be send only if selected for scholarship)1. Name of the applicant (Ward/widow):
2. Selection serial No. given by KSB:
3. Particular of ESM:
4. Present address (where you want your letter is to be sent)(To be filled up only in case of change from previous address or write N / A)
5. Details of Bank account of SBI or PNB for Electronic Clearing Services ((PLEASE ATTACH A PHOTOCOPY OF PASS BOOK, CROSSED BLANK CHEQUE SHOWING YOUR ACCOUNT NUMBER TO BE FORWARDED, EVEN IT IS SUBMITTED EARLIER).
Name of account holderand account number
Place: ________________________________
Date: Full Name & Signature of the ward / widow
It is certify that the information submitted by my child / Self is correct.
Place : _____________________________
Date : Full Name & Signature of the Parent
LEAVE BLANK SPACE BETWEEN WORDSSPECIMEN COPY OF BONAFIDE CERTIFICATE FOR RENEWAL
Name of ESM
RankService Number
House No.
Street No. & Name
Tehsil & Post
DisttRSB
Pin Code
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CERTIFICATE FOR RENEWAL OF PM SCHOLARSHIP
1. It Is certified that Ms. / Mr ._____________________ is a Bonafide
student of __________________________________ college. His / Her roll
number is __________ and he / she is studying in the I / II / III / IV / V year
or ______ semester of the two / three / four / five years _______________
course in ____________________ branch (if any). He / she had joined
this college in the academic year 20___ - ___ and the course will be
completed in the month of ____________ 20___ - ___.
2. This is also certified that Ms. / Mr. ___________________________
__________ has successfully completed his / her 1st / 2nd / 3rd / 4th / 5th year
and scored ________ % / Grade__________ (Total marks obtained were
_____________ out of ____________) and he / she is continuing the
course in 2nd / 3rd / 4th / 5th year .
Office Seal:
Signature of Principal / Dean / Registrar
Date: ________________
Place: _______________
CHECKLIST FOR RENEWAL OF SCHOLARSHIP
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DOCUMENTS TO BE ATTACHED:
(a) A Bonafide certificate from the College/Institute indicating that the candidate continues to study in the subject course and showing his / her percentage of marks for which the Prime Minister’s Scholarship has been sought (As per the specimen attach).
(b) Candidate to attach a self addressed envelope, duly stamped to receive the acknowledgement of renewal form by post.
________________________________Full Name & Signature of the Candidate
DEPTT OF SAINIK WALFARE/RAJYA SAINIK BOARDS
Sl No Address of RSB For Detail, Pl contact RSB
1ANDAMAN & NICOBARISLANDS (UT)
Col KV Cherian (Retd)SecretaryRajya Sainik BoardA & N Administration, Secretariat
Port Blair - 744 101
Port Blair-
03192-235621 (O)03192-235621(F)03192-320360 (R)09434281518 (M)
2ANDHRA PRADESH
Brig CS Vidyasagar (Retd)Director Deptt of Sainik WelfareBlock IV, II Floor, Gruhakalpa Complex, MJ Road, Nampally, Hyderabad - 500 001
Hyderabad
040-24736890 (O)040-27990144 (R)040-24747991 (F)09440401470 (M)
3ARUNACHAL PRADESH
Shri K KholieDirector Dte of Relief, Rehabilitation & Settlement, Govt of Arunachal Pradesh, New Itanagar-791110
Itanagar-
0360-2212282 (O)0360-2290778 (R)0360-2212282 (F)0360-2213615 (F)09436041927 (M)
4 ASSAM
Cmde K C Choudhury (Retd)DirectorDte of Sainik Welfare, Sainik Bhavan, Lachit NagarGuwahati - 781 007
Guwahati-
0361-2522229 (O)0361-2412196 (R)0361-2522229 (F)
[email protected] BIHAR
Shri Md. Saood, BASDirector
Patna
0612-2217301 (O)
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Sainik Kalyan NideshalayaHome Deptt, Old Secretariat Barrack No.10, Patna – 800015
0612-2217301 (F)0612-2280333 (R)
6CHANDIGARH (UT)
Lt Col Raj Kumar Singh (Retd)Zila Sainik Welfare Officer
Zila Sainik Welfare Office (UT) Opposite Aroma Hotel, Sector-21-D, Chandigarh - 160 022
Chandigarh
0172-2701947 (O)0172-2700317 (O)0172-2726325 (F)0172-2721064 (R)09888880566 (M)
7 CHHATTISGARH
Col K L Yadav (Offg) (Retd)Director Deptt of Sainik Welfare, CGNear Collectorate Parisar, Behind Home Guard OfficeRaipur - 492 001
Raipur
0771-2445165 (O)0771-2427449 (O)0771-2352529 (R)0771-2420084 (F)09893164219 (M)
8 DELHI
Gp Capt RK Sharma (Retd)Secretary Rajya Sainik BoardOpp Tis Hazari CourtNo.1, Rajpur Road, Delhi-110 054
Delhi-
011-23991876 (F)011-23969260 (O)09818953191 (M)
9 GOA
Maj Venugopal Nair (Retd)SecretaryDeptt of Sainik WelfareCollectorate BuildingPanaji - 403 001
Panaji
0832-2227138 (O)0832-2443236 (R)0832-2227138 (F)09420686834 (M)
10 GUJARAT
Lt Col Kishor Sinh Gohil (Retd)DirectorDistt Sainik Welfare office & Resettlement, Bachat Bhawan, Ground Floor, Opp - Jyoti Sangh, Relief Road, Ahmedabad-380001
Gandhinagar
079-23251295 (O)079-23251296 (O)079-23251298 (O)079-23251294 (F)079-23245346 (R)079-25508539 (O)
11 HARYANABrig KS Budhwar (Retd)Secretary
Panchkula
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Rajya Sainik BoardSainik Bhawan, Sector 12, Shaheed Capt Rohit Kaushal Marg, Panchkula - 134 109
0172-2560462 (O)0172-2562102 (R)0172-2560462 (F)0172-2560321 (O)09888527189 (M)
12HIMACHAL PRADESH
Maj Jogi Dass Mankotia (Retd)Director Deptt of Sainik WelfareGovt of Himachal PradeshHamirpur - 177 001
Hamirpur-
01972-221854 (O)01972-224659 (O)01972-225961 (R)01972-225643 (F)09418090708 (M)
13JAMMU AND KASHMIR
Brig RS Langeh, VSM (Retd)Director Deptt of Sainik WelfareAmbphalla, Jammu - 180005
Jammu
0191-2561547 (O)0191-2465141 (R)0191-2575362 (F)09419180672 (M)
14 JHARKHAND
Col AP Singh (Offg) (Retd)DirectorSainik Kalyan Nideshalaya Ranchi (Jharkhand)
Ranchi-
0651-2330178 (O)0651-2330469 (R)0651-2331434 (F)09431105964 (M)
15 KARNATAKA
Col CM Uthaiah (Retd)Director Deptt of Sainik Welfare & Resettlement,Fd Mshl KM Cariappa, Bhavan, No 58, Fd Mshl KM Cariappa Road, Bangalore - 560 025
Bangalore-
080-25589459 (O)080-28445706 (R)080-25589459 (F)09886205130 (M)
16 KERALA
Shri KK Govindan NairDirectorDeptt of Sainik WelfareVikas Bhavan, Thiruvananthapuram - 695 033
Thiruvananthapuram
0471-2304980 (O)0471-2472401 (R)0471-2304980 (F)0471-2329279 (R)
[email protected] MADHYA
PRADESHBrig Pramod Kumar (Retd)Director Deptt of Sainik WelfareSouthern Shopping Centre
Guru Teg Bahadur Complex, TT Nagar, New Market,
Bhopal-
0755-2553992 (O)0755-2666081 (R)0755-2577209 (F)09993030601 (M)
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P.B.NO 364, Bhopal - 462 [email protected]
18 MAHARASHTRA
Col Suhas S Jatkar (Retd)DirectorDeptt of Sainik WelfareMaharashtra State ‘Raigad’, Opp National War Memorial, Solapur Road, Ghorpadi, Pune-411 001
Pune-
020-26332763 (O)020-26332764 (O)020-26850613 (F)09422314276 (M)
19 MANIPUR
Lt Col H Sharat Singh (Retd)SecretaryRajya Sainik BoardSainik Rest HouseOpp. Lamphel Police Station, Imphal-795004
Imphal-
09862672547 (M)
20 MEGHALAYA
Brig WJB Sturgeon, YSM, SM (Retd)DirectorDte of Sainik WelfarePublic Service Commission Building Beyond DC BuildingShillong - 793 001
Shillong-
0364-2225613 (O)0364-2536574 (R)0364-2225613 (F)09436101551 (M)
21 MIZORAM
Col John Zama, SM (Retd)DirectorDeptt of Sainik Welfare & Res,Tuikual ‘A’, PB No. 119Aizawl - 796 001
Aizawl-
0389-2322732 (O)0389-2322732 (F)0389-2325811 (R)09436142593 (M)
22 NAGALAND
Brig Brij Pal Singh (Retd)SecretaryRajya Sainik Board, Home Deptt, Home Br, Nagaland Civil Sectt., Kohima - 797 001
Kohima-
0370-2270029 (O)0370-2270029 (F)0370-2221991 (R)09436830124 (M)
[email protected] ORISSA Col (Dr) DK Das (Retd)
Secretary Rajya Sainik Board, Nageswar Tangi, Lewis Road, Bhubaneshwar-751002
Bhubaneshwar
0674-2432268 (O)0674-2435998 (F)0674-2721156 (R)09937940807 (M)
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24PUDUCHERRY (UT)
Col Jacob Mathen Anand (Retd)Director Deptt of Sainik WelfareJawan Bhavan Complex, Lawspet Main Road, Pakkamudayanpet, Puducherry - 605 008
Puducherry
0413-2253107 (O)0413-2250575 (F)09443228260 (M)
25 PUNJAB
Brig IS Gakhal (Retd)DirectorDte of Sainik Welfare, PunjabPunjab Sainik Bhawan, Sector 21-D, Chandigarh - 160 022
Chandigarh
0172-2701845 (O)0172-2740991 (R)0172-2707345 (F)09814297113 (M)
26 RAJASTHAN
Col Phool Singh Mehla (Retd)(Offg) NideshakSainik Kalyan VibhagSecretariat Building, North Block, Jaipur - 302 005
Jaipur-
0141-2227897 (O)0141-2227650 (F)0141-2356464 (R)09314933120 (M)
27 SIKKIM
Lt Col PB Gurung (Retd)Secretary Rajya Sainik Board, Paljor Stadium Road, Gangtok-737 101
Gangtok-
03592-202534 (O)03592-221456 (O)03592-202156 (R)03592-221456 (F)09434448861 (M)
28 TAMIL NADU
Capt S M Aslam, (Retd)Joint DirectorDte of Ex-Servicemen’s Welfare22, Raja Muthiah Salai, ChoolaiChennai - 600 003
Chennai-
044-26691747 (O)044-26691342 (O)044-22331052 (R)044-26691886 (F)09444823182 (M)
29 TRIPURA
Lt Col Mohit Ghosh (Retd)SecretaryRajya Sainik Board, Nehru Office Complex, Gorkhabasti, P.O. Kunjaban, Agartala - 799 006 West Tripura
Agartala
0381-2326507 (O)0381-2323795 (F)0381-2319005 (R)09436510584 (M)
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30UTTAR PRADESH
Shri AK Chaturvedi, PCS(Additional Charge)DirectorDte of Sainik Kalyan Evam Punarvas, Kariappa Bhawan, Kaiserbagh, Lucknow - 226 001
Lucknow-
0522-2625354 (O)0522-2625354 (F)0522-2305107 (F)0522-2391701 (R)09415404142 (M)
31 UTTARAKHAND
Brig AN Bahuguna, KC, YSM, VSM (Retd)DirectorNideshalaya Sainik Kalyan Uttarakhan, Kalidas margP O- Haathi BadkalaDehradun - 248121
Dehradun-
0135-2744208 (O)0135-2743773 (F)0135-2741481 (O)0135-2670813 (R)09358254621 (M)
32 WEST BENGAL
Col PR Pal (Retd)SecretaryRajya Sainik Board, Block 'F'(First Floor), Writers’ BuildingKolkata - 700 001
Kolkata-
033-22141347 (O)033-22144643 (F)033-22143220 (O)09874535628 (M)
Note:
Dadar Nagar Haveli: ESM of these states can submit their Prime Minister application form to Gujrat RSB.
Daman & Div
Lakshadweep: ESM of this state can submit their Prime Minister application form to Kerala RSB.
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