Bonafide Student Certificate

(To be issued only by Principal/Head of Institute)

UP Science Talent Search Examination 2016-2017
Document Verification for Scholarship disbursement 2017-18

This is to certify that Mr/Ms……………………………………………………son/daughter of

Affix recent
Mr/Mrs…………………………………is a Bonafide student of following school/college
passport
/university
size(45mmX30mm)
1. Name of Institute…..……………………………………………………………………………… photo graph duly
attested by the
2. Address of Institute ………………………………………………………………………………… Principal/Head of
…………………………………………………………………………………………………………………. Institute

…………………………………………………………………………Pincode……………………………

The above Institute is in the state of Uttar Pradesh ( ) or other state ( )

If other state Please mention …………………………………………

At present, he/she is a regular student of class (√) the correct one.

(a) CLASS –X [ ]
(b) CLASS-XI (Science Stream) [ ]
(c) CLASS-XII (Science Stream) [ ]
(d) B.Sc (1st Year) [ ]
(e) B.Sc (2nd Year) [ ]
(f) B.Sc (3rd Year) [ ]
(g) M.Sc (1st Year) [ ]
Date -------------------- -----------------------------------
Name and Signature student

The certificate is issued to certify that the student is studying in our Institute. I/we certify
that above information are true to the best of my/our knowledge.

……….…………………………………………………………

Signature of the Principle/Head of the Institute

(With stamp/seal)

Tel/Mobile No. of Principal ......................................

Email ID of Principal : ..........................................

Note: It is mandatory to carry the original Bonafide Student Certificate at the

time of Document verification.