INTERNATIONAL ALUMNI ASSOCIATION

OF SHRI MAHAVIR VIDYALAYA TRUST
Sursangam, 14/10 Virvijay Society, Nr. Sanghvi High School, Naranpura, Ahmedabad - 380013
For any query contact Rashmi Shah : 9824268716

LOAN SCHOLARSHIP APPLICATION FORM

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Personal Information
Passport size photograph :
Upload MarkSheet 1 :  
Upload MarkSheet 2 :  
Upload Yearly tuition fee receipt :  
Upload Parent's yearly income certificates :  
Upload Certificate/proof for Jain :  
Upload Cancel Check scan copy :  
First Name * :
Surname * :
Father's Name * :
Address Line 1 * :
Address Line 2 :  
Address Line 3 :  
Pincode * :
Country * :
State * :
City * :
Contact (Off./Resi.) * :
Contact Mobile * :
Date Of Birth * :
Email-ID * :

Educational Information
S.S.C   Marks(%) :     Class/Rank :  
11th Class   Marks(%) :     Class/Rank :  
12th Class   Marks(%) :     Class/Rank :  
1st Year   Marks(%) :     Class/Rank :  
2nd Year   Marks(%) :     Class/Rank :  
3rd Year   Marks(%) :     Class/Rank :  
4th Year   Marks(%) :     Class/Rank :  

Please give details of loan taken fom this trust - year wise (Must)

Note : Please submit the detailed mark-sheet for each of the last two examinaions.

Course Details * :
Previously Applied : Yes     No  
College Name :  
College Address :  
University Name :  
No. of years of Course :  

Finacial Information
Annual Income * :
List of Living family Members :
Father :
Mother :
No of Brothers :
No of Sisters :
Other :
Total Fees * :
Books Expence :
Lodging & Boarding Expence :
Amount received from other source :
Expected Amount * :
Objectives & Goals :

Reference Information

Pleace provide reference of the people who know you well

Reference Name * :
Reference Address * :
Contact 1 * :
Contact 2 :  
Email ID * :

Bank Details

Pleace provide your bank details for the ECS of the loan amount if approved.

Bank Name :
Branch :
Account No. :
IFSC Code :
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