Cash Award Form

Date*

District Office *

Upload Photo*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed

Name Of The Examination Passed*

Year*

Name Of The Applicant Student*

Gender*

Male Female

Mobile Number*

Address*

Date of Birth Of The Student*

Name Of The Father/Mother*

Registration Number Of The Father/Mother*

Date Of Registration Of The Father/Mother*

Id Card*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed

Details Of Monthly Contribution

#	Date Of First Payment Of Contribution	Date Of Last Payment Of Contribution	Name Of The Branch Of Bank Where Remitted The Contribution
1

Caste Category *

Name of The School, Where From Passed The Exam*

Address of The School, Where From Passed The Exam*

Year Of Study*

Month And Year Of Passing Exam*

Marks Obtained In The Exam

#	Subject	Marks Obtained	Maximum Marks
1

Name Of The Bank Where Cash Amount to be Deposited*

Address Of Bank*

Account No*

IFSC Code *

Signature Of The Applicant*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed

Declaration By The Parent - the facts mentioned above are true to my knowledge and information*

Signature Of The Parent*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed

Attested Copy Of Id Card Of Father/Mother*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed

Attested Copy Of Pass Certificate From The Head Of The Institution*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed

Attested Copy Of The Marksheet Of The Exam*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed

Copy Of Payslip Of Account Paybook*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed

Caste Certificate*

Choose file

Maximum File size allowed is 1MB
Only pdf, png and jpeg images allowed