GOVERNMENT OF ODISHA

DEPARTMENT OF HIGHER EDUCATION

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FORM FOR RENEWAL OF SCHOLARSHIP
(To be submitted by the student to the College Authority)
(As directed vide Office Order No. 1237 / HE. Dt. 01.05.2013)
Registration No.
12R00000063
PART - I ( Scholarship and Institution Details )
(YEAR MEANS ACADEMIC SESSION)
Name of the scholarship ENGINEERING (BPUT-OJEE)
Name of course B.TECH(ENGINEERING)
Current year / semester of study 3 YEAR
Duration of course (In Year) 4
Wheather the student is pursuing B.Tech. course
ON REGULAR BASIS
Name and postal address of the educational Institution
SILICON INSTITUTE OF TECHNOLOGY,
BHUBANESWAR
SILICON HILLS, PATIA, BHUBANESWAR,
ORISSA, INDIA 751024
E-mail address of the Institution info@silicon.ac.in
PART - II ( Information of Scholarship Holder )
Name of the Student ABHISHEK AICH
Mobile phone number 8763727057
Name of Father / Mother/ Guardian
MADAN MOHAN AICH
Year of admission 2011
Year in which application for award of scholarship was
submitted
2013
Year for which scholarship has been disbursed in the
past
2013-14
Class to which the student is promoted 4TH YEAR
Renewal of scholarship recommended for the year/s 2013-14, 2014-15, 2015-16
PART - III ( Bank Information of Scholarship Holder )
Name of the Account holder ABHISHEK AICH
Saving Bank A/c. of student
31809326649
IFSC number of the Bank SBIN0010133
Address of the Bank
STATE BANK OF INDIA
IDCO BUILDING, INFOCITY
CAMPUS ,CHANDAKA INDUSTRIAL ESTATE,
BHUBANESWAR-751024
I have not availed any other scholarship except Medhabruti awarded by the Higher
Education Department, Govt. of Odisha.
Signature of the student
PART - IV ( Recommendation of the College Authority )
Certified that the aforesaid information furnished by the student is correct and
he / she is promoted to the next higher class.............................. It is therefore recommended that
as the academic performance and conduct of the student is satisfactory, renewal scholarship for
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Signature & Seal of
Head of the Institution /
Authorized Officer
the year....................... may be granted in his / her favour in time. The concerned student is not
availed any other scholarship awarded by the State / Central Government simultaneously during
his period of study.
Place
Date
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