MAULANA AZAD EDUCATION FOUNDATION
(MINISTRY OF MINORITY AFFAIRS ,GOVT. OF INDIA)
MAULANA AZAD CAMPUS,CHELMSFORD ROAD, NEW DELHI – 110 055
PRINT
Applicant Details
Registration No:
Applicant's Name
Date of Birth(DD/MM/YYYY)
Religion
Nationality
Adhar No.
Email Id
Contact No.
Family Details
Father/Guardian's Name
Total Annual Income Rs.
Present Address Details
Address
District
State
Pin Code
Permanent Address Details
Address
District
State
Pin Code
Present Institution Details
Class
Admission Year
Institute Name
Institute Address Service Required
District Service Required
State Service Required
Pin Code
Contact No. -
Matriculation Details
Year of Passing
University/Board
Roll NO (Board)
Obtained Marks
Maximum Marks
Percentage
District
State
Pin Code
 
List of documents to be attached compulsorily in Hindi/English version
(•)  Photo must be attested by the principal of Present School/College.
(•)  Verification form should be attested by the Principal of Present School/College.
(•)  Mark sheet should be attested by Principal of present School/College.
(•)  Annual income of the parents must be less than 100000 (one lack).
(•)  Income certificate should produced in Hindi/English language only.
(•)  Income certificate should be issued by Tahsildar, Block officer or Notary Public of the concerned area/Block/Distt.
(•)  Proof of Religion certificate attested by the Principal of present School/College.
(•)  Verified copy of Pass Book/Cancelled Cheque of the Bank Account of Students.
Self Decleration
I hereby declare that the statements made by me in this application form are true and correct to the best of my knowledge & belief. I am aware that if there are false statements in the foregoing application, I am liable to be prosecuted under the Indian Panel Code for forgery as well as any other panel consequences. I further agree to abide by the terms and conditions of the scholarship if selected for the Maulana Azad National Scholarship. The entire amount of Scholarship can be recovered in lump sum from me in case the above information is found fully or partially incorrect.
 
Place :__________________
Date :____/____/______ Signature of applicant
 
Verification Form By Principal of School/College

(i) Certified that Miss       daughter/ward of        

has been admitted in the School/College against**......................................................................................

as a regular and full time student in Class/course ............................................ on.................................................and is at present studying in class/

Year  ........................................... in the academic session.....................................

(ii)  is/is not in receipt of Scholarship/educational Loan aid from………………………………. @ Rs…………….. (Rupees……………………………………

………….only)    per month/per annum from Central/State Govt. University or from any other Institution/Agency/Person.


(iii) It is further certified that the name, address & occupation of the Father/Guardian mentioned in the admission ..................................................................

(iv) She belongs to:      community (i.e. Muslim/Christian/Sikh/Jain/Buddhist/Parsi)



  (Signature and Full Name with Seal of Principal of the School/College)



Place:________________

Date :____/____/______

Principal's Name: 

School/College:   

Full Address:   

Distt:   

State:   

Ph./Mobile No.***(Compulsory)   




PRINT