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One of the Most Pleasant Parts of Writing a Report Is the Opportunity to Thank Those Who Have Contributed to It. This Project Report Is a Synergistic Product of Many Minds. We Are Grateful to Indian Institute of

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MINORITY WELFARE - MERIT CUM MEANS SCHOLARSHIP SYSTEM

STUDENT APPLICATION

Fresh

For official use only
Sl No of application Year Course Whether approved

Student ID:

T2013FkaM09448

Affix a self attested passport size photograph

1.Full name(in block letters)
2.Father's name/Husband's name 3.Mother's name 4. Domicile State/UT (State/UT which the student belongs to) 5. Address for correspondence: House No. & Street Detail City/Town/ Village & P.O. District State Pincode

: SHAIK FAIZAL
: shaik nawaz : najmunisa : Karnataka

c/o S.A basheer manzil, no.105, kaveri road, r.s palya, bangalore-560033 BANGALORE URBAN Karnataka 560033

6. Permanent address(please enclose residential certificate from concerned state government authority): House No. & Street Detail c/o S.A basheer manzil, no.105, kaveri road, City/Town/ Village & P.O. r.s palya, bangalore-560033 District State Pincode BANGALORE URBAN Karnataka 560033 22-Jul-1995 Male Muslim Indian

7. Date of birth (Please enclose certificate) : 8. Whether male or female 9. Religion 10. Nationality 11. Aadhaar Number : : : :

Printed Date: 10-Sep-13

Page 1 of 8

12. Details of educational qualifications from matriculation/SSLC/SSC onwards (Please enclose certificates attested by a gazetted officer): Last Qualifying Exam HSC University/Board/Institution/Council of Examination Main Subjects Year of Passing 2013 Division Percenta /Class/ ge marks Grade 83.6666

13. Details of course for which scholarship is being sought: Name of the technical/professional course: UG( Planning ) Duration of course Academic year 4 2013-2014

14. Basis of admission in professional/technical course (whether on the basis of qualifying competitive examination or on other grounds. Please give details):

15. Details of college/institution: (i) Name of the college/institution where admitted: (ii) Address of

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