Bank of Baroda
HEAD OFFICE: MANDVI, BARODA
APPLICATION FORM FOR
Please paste
a recent
Photograph of
Student
EDUCATIONAL LOAN
EDUCATIONAL LOAN APPLICATION FORM
The Branch Manager,
Bank of Baroda,
______________ Branch,
____________________.
Dear Sir,
I/ my ward have / has secured admission to ________________ course conducted by
_________________School/ University / College/ Institute located at ______________.
For my / his / her education we request you to provide us financial assistance of
Rs_____________(Rs. _________________________________________________)
the details of which are as given in this request application.
We undertake to repay the loan in ____________monthly installments beginning
____________months starting
s after –1- year after the course period or –6- months after
the borrower (student) getting the job.
Please complete all sections in BLOCK LETTERS and tick √ boxes wherever
applicable
(A) PARTICULARS OF THE STUDENT:
Name:_________________________________________________________________
________________________________________________________________
Date of Birth:_________(DD) _______(MM)__________ (YYYY) Age:
Address:_______________________________________________________________
(Overseas address if student going for overseas studies)_________________________
PIN : _______________________
Telephone:____________ Fax:____________________ Mobile No. _______________
Nationality: ___________ Marital Status:_____________ Caste/Religion_____________
Life Insurance Policy details (if any):____________________________
EDUCATIONAL DETAILS : Please enclose mark lists of the examination passed
Examination Institution/University Year Number of Percentage Class Specialisation
from which passed Passing Attempts of marks Obtained if any
SSC
HSC
Degree
Post
Graduate*
Any Other *
• To be specified in the column "Specialisation"
PARTICULARS OF SCHOLARSHIPS / PRIZES WON FOR ACADEMIC DISTINCTION:
Examination Specify the academic distinction Name of the Amount of Duration of
for which the scholarship prize Scholarship Scholarship Scholarship
was awarded Prize Rs.
From To
Any other information (Extra curricular activities and distinction awards received
if any):___________________________________________________________
PARTICULARS OF THE COURSE FOR WHICH THE LOAN IS REQUIRED
Name of the course:___________________________________________________________
University Institution:__________________________________________________________
Course/Institution is affiliated
To/recognized by
Duration of the course:________________________________________________________
Part time / Full time :__________________________________________________________
Correspondence / Distance Education
Expected per month income after completion of the course Rs:_________________________
In case of studies abroad state the details of R.B.I. approval (if necessary). Details of
Foreign Exchange required, Copies of Passport, Visa and other details to be submitted.
PURPOSE OF THE LOAN: (Rs. in '000)
Require Fee Payable Examination Cost of Books/ Caution Other Edu. Lodging Travel Total
ment for to College/ /Library/ Equipments/ deposits/ Exp. /Boarding Exp/ Expen
School/ Laboratory/ instruments building (e.g. Study passage ses
Institution fees /Uniforms fund/ tours, money
refundable projects,
deposit thesis etc.)
st
1 Year
nd
2 Year
rd
3 Year
th
4 Year
th
5 Year
Source of finance : Details of Scholarship / Loans / Own Funds
Loan amount Own Sources Scholarship Total
1 st
2nd
3rd
4th
5th
(a) GUARDIAN'S / PARENT'S/GUARANTOR'S PARTICULARS: (If guardian & guarantor are
different separte sheet showing these particulars for each to be obtained)
Name :________________________________________________________________
Relationship with Student:_________________________________________________
Date of Birth:_____________ (DD)_______(MM)_______(YYYY) Age :
PAN/GIR No.:_______________. Driving License No:_______________
Passport No(If any) _________________________________
Residential Address (For Correspondence - with proof of residence)
______________________________________________PIN_____________________
Telephone : _______________ Fax:________________ Mobile No. _______________
Permanent Address:_____________________________________________________
______________________________________________PIN:____________________
Telephone : _______________ Fax:________________E-Mail. __________________
Whether residing in Own/Rented Accommodation: Since When residing :
Interest during study period will be serviced - Yes / No
Sex: Male Education : SSC Any Other Information
Female Under Graduate
Marital Status Graduate
Single Post-Graduate
Married Doctorate
Divorced If Professional : Doctor
Widowed Architect
No. of Dependents CA
(Excluding Spouse)
No. of Children MBA
Engineer
Lawyer
Others
If Salaried : If Self Employed / Professional / Business
Name of the Organisation_____________________ Name of the Company________________
Designation Executive Managerial Clerk Office Address______________________
_________________________________
Department PIN_______________________________
Office Address:___________________________ Tel: ____________ Fax:______________
___________________PIN__________________ E-mail:____________________________
Tel: ___________Extn No.______ Fax:________ Business Pvt. Ltd Parnership
Details
E-mail:_________________________________ Proprietorship Others Established
Working with Govt./Public Public Ltd since:_____________________ Designation
Sector
Pvt. Ltd Partnership MNC Executive Managerial Gross Monthly
Proprietorship Income:__________________
Working Since:_____Retirement Age:________ Year in Current Business:
>5 3-5 1-3 <1
(Greater) (Less)
Income Details of Parent / Guardian : Any other earning
member in the family
1. Gross Monthly Income Rs
(Proof to be submitted)
2. Net Monthly Income
3. Appr. Monthly house hold expenses
4. Monthly repayment of other loan
amount
5. Net Surplus available
6. Net Income of other family
member/s (Relation with the
(Excluding Co-applicant & student________)
Guarantor)
About Bank Account (including credit facilities if any)
Deposits
Name of the Bank, Type of A/c No. of years Balance Remarks
Branch, Address & & A/c No. account held Outstanding
Telephone No
Loans
Name of the Bank Type of Security When sanctioned Balance Overdues
Branch & Loan & & Repayment Outstanding if any
Telephone No Limit Schedule-Amount
of Installment
Credit Card Details ________________________________
Credit Cards Owned:__________ Card Issuer___________ Other Assets ColourTv
Card No.______________________________ Refrigerator
Bank of Baroda Account No. _______________ CA/SB Two Wheeler
Since (in Years):__________________________ Cellular Phone
Branch Name:________________________ Computer
Washing Machine
Car
Landed Property
(Details to be submitted)
DECLARATION BY THE APPLICANTS:
1. The particulars furnished above are to the best of my/our Knowledge
true and correct.
2. The advance, if granted, will be utilized for the purpose for which it is granted.
3. I/We hereby authorize the bank to pay the fee and other amounts as
may be payable directly to the institution concerned.
4. I/We undertake to submit the receipt for all the disbursements made
from the loan account.
5. I/We undertake to inform the progress of studies of the student in
respect of education for which loan is applied.
6. I/We shall-keep the bank informed of my activities/Income/Scholarship
etc. during the tenure of the loan.
7. Immediately on securing job by the student, I/We undertake to inform
the employment details.
8. I/We undertake to maintain a Saving Bank Account and /or Deposit
Account with your Bank exclusively.
9. I/We will not / have not borrow/ed from any other Bank or any other
source during the currency of the advance without you prior consent in
writing.
10. I/We undertake to meet any contingent expenses to continue the
course of study.
Date: ___________________ yours faithfully,
Place: ___________________
STUDENT PARENT/GUARDIAN
I am willing to stand as guarantor.
Place : _______________________
Date : _______________________
Signature of the Guarantor/s
