Submit Date : 14/12/2023
Application No:
GOVERNMENT OF GUJARAT 232400000001829944
VKY-157 Food Bill Assistance in College Attached Hostels
Fresh Application
Student Personal Details
Name of Student : Bhuriya Anilbhai Parvatbhai
Name of Student (As per Aadhar) : Bhuriya Anilbhai
Mother's Name : Bhuriya Kailashben parvatbhai
Date of Birth : 07/07/2004 Gender : Male
Category : ST(7ȵkɅlISKWĤiS Religion :Hindu
Caste : Bhil [j_
Aadhaar Status Verified: Yes(14/12/2023 13:36:00)
Annual Income of Parents/Guardian/Husband (Rs): 45000 Habitation Type: Rural
Mobile Number : 8758934559 E-mail Address : anilbhaiparvatbhai@gjmail.com
Aadhar No : 90xxxxxx4391 Parent/Guardian occupation: Farm Labour(EpĂ\ȩl^
Is Orphan: NO Day Scholar / Hosteller : Hosteler
Marital Status : Unmarried Hostel Type: Private Hostel
Current Address: Permanant Address:
State Gujarat State Gujarat
District Sabarkantha District Panchmahals
Taluka Himatnagar Taluka Morwa (Hadaf)
Village Village Sagwada
PinCode PinCode 389115
Address:At : Berna Address:At : Sagwada
Student Bank Account Detail/Aadhar Bank Detail
I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 90xxxxxx4391 Bank name : -
Mandate Date : 12/14/2023 12:00:00 AM Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 46xxxxxx0156 IFSC Code : BARB0RAJAYA
Student Name(As per Bank Name): ANILBHAI PARVATBHAI BHURIYA
Name of Bank : BANK OF BARODA
Branch Name & Address : RAJAYATA
I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.
Student Academic Details
Present Course/Class/Trade Type: Information Technology
Present Course/Class/Trade Name : BCA (Bachelor Of Computer Application)
Present Course/Class/Trade Year : 3RD YEAR(5th Semester/6th Semester)
Courtesy :: National Informatics Centre, Gujarat Page 1 of 3 232400000001829944 Print Date :13/02/2024
Studying in : Gujarat Enrollment No: BCA33421008687
Present Institute District : Sabarkantha Present Institute : GROW MORE INSTI OF COMP APPLI (BCA)
Admission Type : Regular Paid Seat (Self Finance) Present Course Branch : -
Present Class Start Date : 15-Jul-2023 Present Course Completion Date : 30-Apr-2024
Hostel Detail
Is Hostel run by Department No
Is Hostel attached With College Yes
Free facilities provided by Hostel? No
Previous stream :BCA (Bachelor Of Computer Application) Previous Class/Course : 2ND YEAR(3rd Semester/4th Semester)
Previous Passing Year : 2022 Previous (%) : 50.00
Are You Employed in any Organization/Establishment with leave without pay? : No
Previous Education Detail
Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH General B5064204 2019 52.83
11th Std/12 Std 12TH Arts G589316 2021 41.28
List of documents which you have attached :
1 Caste Certificate From the Competent Authorities
2 First Page Of Bank PassBook/Cancelled Cheque
3 Fee Receipt of Current Course Year
4 Self Attested Certificate of Previous academic marksheet
5 Income Certificate From the Concerned Authorised Authority/Persons
6 Hostel Certificate(Only For Hosteller Student)
I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.
Verify Mobile Number: Yes 13/02/2024
Place : Signature of the applicant
Date : 13/02/2024
It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and all
the Documents has been checked.
It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority
Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.
Courtesy :: National Informatics Centre, Gujarat Page 2 of 3 232400000001829944 Print Date :13/02/2024
This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2023
-2024.If student will irregular, than we will immediately reported to the said authority.
The actual School/College/University year began on __________________ and will be ended on _____________________
Date : Signature Of Head Of The School/College/Institute/University With Official Seal
Place :
*Note : Stamp Signature will not be accepted
Courtesy :: National Informatics Centre, Gujarat Page 3 of 3 232400000001829944 Print Date :13/02/2024
