WEST BENGAL CHIEF MINISTER RELIEF FUND

(Nabanna) SCHOLARSHIP
Application Form – 2018
To,
The Honourable
Chief Minister’s
Govt. Of West Bengal
'Nabanna'
325, Sarat Chatterjee Road
Howrah - 711 102

Name-

Father`S Name-

Date of Birth- CAST-

GEN SC ST OBC

Gender- Male Female Religion-

Permanent Address-

P.O
P.S
DIST/ CITY PIN
Details of Education Qualification:
Name of Examination Board/University Passing Year Marks Obtained Class/Div/Grade % of Marks

Present Course Details:

Course Name
Duration
Session
Name of Institute
Institute Address
Bank Information:
Account Holder Name
Bank Name
Branch Name
IFSC Code
Account Number

I do hereby certify that the above particulars are correct and true to the best of my knowledge and belief.

Date: ___________________________________
Place: Signature of the applicant

Application Download from– www.davidcafe.in

 Recommendation from MLA
Monthly family income of the student

This is to certify that entire family income of Shri / Smt............................................................

....................................................(Parent's Name) Father/ Mother of Mr./Ms..........................

......................................................... (Student Name) Resident of ..........................................

................................................................................................................................................

.............................................................................................................................................is

Rs................................ (Rupees..........................................................................) per annum.

His/her Business occupation is ..............................................(mention the post)(Pvt./Govt.) /

Business / Farming / Labour etc. He/ She has no other occupation and income and there is
no other earning member in his / her family.

_________________________________
Date: Signature of the Student

---------------------------------------------------------------
Competent issuing authority Signature with Seal

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 SELF DECLARATION

I am ............................................................................................, Son. / Daut. of ..................

............................................................, Vill ...........................................................................,

Post ........................................................, P.S ........................................................................,

Dist. .............................................................., Pin ........................................................., do

here by decleared that I have been reading in Class ........................................ and My

Current academic seasion is 2018-19 at .............................................................................

................................................................................................................................................

................................................................................................................................ (School /

College / University Name & Address). I have not received any kind of scholarship of
financial assistance for my education from any Govt. Department or any private agencies
during this year.

_________________________________
Date: Signature of the Student

.........................................................................

Counter singed bt Head of Institution with Seal

Application Download from– www.davidcafe.in

 Eligibility & Others Details
Eligibility:

Assistance from Chief Minister’s Relief Fund and Chief Minister’s Discretionary Fund is given to the student

 Who is a permanent resident of the State of West Bengal.

 Who is studying in any institutions of the State after passing out the State Board /Council of Secondary
Education or a State aided University in West Bengal.
 Who has got 65% marks in aggregate in Madhyamik Examination [for H.S. level] or 60% in aggregate in H.S.
Examination [ for U.G. level] or 55% Marks in the Honours Subject [for P.G. level]
 Who do not enjoy any other governmental(central/state) scholarship or stipend for the same course or stage
of study.
 Whose annual family income does not exceed Rs. 60000/-.

Impotent Information & Document :

 Copies of Mark Sheets of all previous examinations passed.

 Copies of Rank Card & Allotment letter of Selection Committee (only for JEE or Equivalent Examination)
 Copy of Monthly Family Income Certificate from any one mentioned within the bracket – (DM/ SDO/BDO /
Group-A Govt. Officer not below the rank of Joint B.D.O./ Executive Officer in case of Municipality/ Deputy
Commissioner of Corporation).
 Copy of Recommendation from MP/MLA stating monthly family income of the student.
 Self declaration of the student under his/her signature regarding present course of study mentioning
year/semester and receipt of any scholarship / aid/assistance, duly countersigned by the head of the Present
institution with seal .Photo copies of all the documents are required to be attested by Group-A Govt.Officer.
 Self Bank Account Details (IFSC Code, Branch Code, Branch Name, Account Number, Bank Name) with Photo
copy of Bank Pass Book.

How to Apply

 Visit Unofficial website- www.davidcafe.in

 Click to Scholarship Tab.
 Download Application Form.
 Print out Application from.
 The Application from is correctly & completely filled up.
 Attach with Application from all relevant Document.
 Send Application from with Document through Ordinary Post / Dropbox to the Address of -
Nabanna, 14th Floor,325 Sarat Chatterjee Road, Shibpur, Howrah- 711 102.
 Incomplete application will be canceled.

Any Others Information Visit Official Website – www.wbcmo.gov.in

Application Download from– www.davidcafe.in