SCHOLARSHIP FOR HIGHER EDUCATION APPLICATION FORM

Application Status: Submitted

Advertisement No: SHE - 2014
Application Ref. #: DST/INSPIRE/02/2014/052232
IVR No: 201400085889
Personal Particulars
Salutation: Mr.
First Name: Ashok Middle Name: Last Name: Kumar
Date Of Birth: 7/1/1997 Gender: Male Aadhaar Card No: 369245850785
Father's Name/Male Guardian Name: OM PRAKASH
Mother's Name/Female Guardian Name: RAM RANI
10th Class Certificate or Marksheet as Proof of Date of Birth: Attached
Below
Place of Birth: Urban
Email Address: ashok19840@gmail.com
Social Community: OBC
Differently Abled: No Other:
Enrollment Information (B.Sc. / Integrated M.Sc. Level)
Program Enrolled: BSc Honors
Course Enrolled: Maths
Enrollment/Admission Year: 2014 Admission No: 14/027088
State (In which college is located): DELHI
University Type: University University Name: University of Delhi
University Address:North Campus,Pincode:110007
College Name: Atma Ram Sanatan Dharam College: Dhaula Kuan 110 021
District (In which college is located): New Delhi
Endorsement Certificate: Attached Below
Senior Secondary Performance Information (12th Standard)
Name of the Board: Uttar Pradesh Board of High School and Intermediate Education
Passing Year: 2014 Rank in Class 12th: Board Roll Number: 0896563
Eligibility Note: Attached Below 12th Marksheet: Attached Below
Marks Information
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Subjects Marks Obtained Maximum Marks Grade
MATHEMATICS 91 100
PHYSICS 92 100
CHEMISTRY 87 100
ENGLISH 96 100
GENERAL HINDI 88 100
Other Subjects
Subjects Marks Obtained Maximum Marks Grade
SPORTS&PHY EDU 81 100
Total Marks Obtained: 454 Maximum Marks: 500 Overall Percentage(%): 90.8
School Name: PT D D U S V M I C LAKHIMPUR KHERI
School Address: VILL&POST-UDAYPUR ,GOLA ROAD, DISTT- LAKHIMPUR KHERI
State (In which school is located): UTTAR PRADESH
District (In which school is located): Lakhimpur Kheri
PinCode: 262701
National Level Competitive Examinations
Examination Year Rank
Rank
Certificate/Certificate
Other Details
Year of Passing Class X:2012 Parents Annual Income: 36000
Have you attended INSPIRE
Science Camps:No
If Yes, please provide details. N/A
Contact Information
Permanent Address
Address: VILL-KEDARIPUR, POST- BIRAMPUR, DISTT-LAKHIMPUR -KHERI
Town/City: Lakhimpur Kheri State: UTTAR PRADESH Pincode: 262727
Telephone Number (with STD
code): N/A
Mobile Number: 9648877817
Communication Address
Address: VILL-KEDARIPUR, POST- BIRAMPUR, DISTT-LAKHIMPUR -KHERI
Town/City: Lakhimpur Kheri State: UTTAR PRADESH Pincode: 262727
Telephone Number (with STD
code): N/A
Mobile Number: 9648877817
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Are you availing any other scholarships: N/A
Declaration: It is certified that all particulars given by me in columns above are true to the best of my
knowledge. If any particulars are found false, I am aware that my application for scholarship are liable for
cancellation.
Place: New Delhi Submitted Date: 10/29/2014 State: DELHI
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