Ȫ \]ȪȪ_ èȡ¡ȰȪ]\ȯǔȯȯȡȡ[ȯÈǔȡBHOPAL ȯ ͪ°ȡ[ãȡ Ʌ Ȳ[ ȯ¡Ȱ)
Fresh Application Backward Classes & Minorities Welfare Dept.
Madhya Pradesh Scholarship Portal 2.0
Integrated Scholarship Application form- Post Matric Scholarships for year 2020-21
Applicant Unique ID: 3940088 Scheme : Post Metric Scholarship for OBC
Application ID: 5537138 First Time Lock Date: 26/12/2020
Version No: 1 Verification Code: 3403 Lock Date: 26/12/2020 IPAddress : 122.168.47.225
Instructions for colleges & offices: Please check all information in each section and place a tick mark in on the box. Institute
will use the first Box with I sign and Sanctioning Office will use second box with O sign in it.
Institute : [16452],Jawaharlal Nehru College District: BHOPAL Course : B. B. A./BBA/1st Year [1029]
Old Scholarship Details(Before 2014-15 No Post Metric Scholarship was sanctioned Last Year.
Details Application Form 10th Board Data Samagra Data Counselling Data
Name MOHAMMAD AHTESHAM MOHAMMAD
AHTESHAM
Father/ Husband Name MOHAMMAD IMRAN Mohammad Imran
DOB 27/10/2001 27/10/2001
Gender Male #Ǖǽ%
Category OBC #\ͪ% OBC #\ͪ%
Religion : Muslim Special Category : No Voter ID : -- I O
Aadhar No. : XXXXXXXX8336
2. Details As Per DigitalCaste Certificate : Reg No: RS/444/0106/17404/2016, Name : MOHAMMAD AHTESHAM I O
IMRAN, Father Name : MOHAMMAD IMRAN, Mother Name : FARHAT JAHAN, Category : OBC, Caste : Dhobi
3.Academic Details As Repoted by Student : Enrollment No. : 2197 Admission Date :07/10/2020 I O
Details As Repoted by Student Counselling Details
Admission Mode Direct Admission
Institute [16452],Jawaharlal Nehru College District: BHOPAL
Course B. B. A./BBA/1st Year [1029]
Academic Year 2020-21
Hostel Admission Non-Hosteler(Day-Scholar) --
Last Year Exam Details : Exam Name: COMMERCE, Exam Date : 01/03/2020
I O
School./Institute :MAULANA AZAD HIGHER SECONDARY SCHOOL Result : PASS
School Scholarship Details Generated From Samagra Portal
Name : MOHAMMAD AHTESHAM Category : OBC DOB : XXXXXX2001 Gender : Male
Father Name : MOHAMMAD IMRAN BPL : ¡ȣȲ CWSN : No
Sno Academic Year School Current Class
1 2017-18 ALL SAINTS SCHOOL 11 th
4. 10th Board Details 10th Board Name: C.B.S.E. Board, Year: 2016-2017, Roll No.: 1206527 I O
5. Total Annual Family Income : Rs.40000/- Income Certificate : issued by-JASINTA EKKA ON : 11/08/2018
Father/ Husband Occupation : Own Business/Shop, Income: 40000/-
Mother Occupation : House Wife ,Income: 0/- I O
Other Income : Rs.0/-
6. Contact Details Mobile No : 9179741919 ahtesham135786[AT]gmail[DOT]com I O
4 rani kamlapati ghat civil line near comunity hall dandi park Huzur, District :- BHOPAL
Generated by Scholarship Portal as on 26/12/2020
Ȫ \]ȪȪ_ èȡ¡ȰȪ]\ȯǔȯȯȡȡ[ȯÈǔȡBHOPAL ȯ ͪ°ȡ[ãȡ Ʌ Ȳ[ ȯ¡Ȱ)
Fresh Application Backward Classes & Minorities Welfare Dept.
Madhya Pradesh Scholarship Portal 2.0
Integrated Scholarship Application form- Post Matric Scholarships for year 2020-21
Applicant Unique ID: 3940088 Scheme : Post Metric Scholarship for OBC
Application ID: 5537138 First Time Lock Date: 26/12/2020
Version No: 1 Verification Code: 3403 Lock Date: 26/12/2020 IPAddress : 122.168.47.225
Correspondance Address :
Permanent Address : 4 rani kamlapati ghat, civil line near comunity hall dandi park Huzur, District :- BHOPAL
7. Bank Account No: 498702010079528, IFS Code: UBIN0549878, UNION BANK OF INDIA, SHASTRI NAGAR – I O
BHOPAL, BHOPAL
8. Change History NIL I O
ALERT: Details of Applications already registered by using same Samagra ID :
Nil
ALERT: Details of Applications already registered by using same 10th Board Roll No :
Nil
]ȯfȲ\ͧȡȡȧȪȡDeclaration from Student and Parent/ Guardian
1. We, MOHAMMAD AHTESHAM S/D/W/o MOHAMMAD IMRAN and MOHAMMAD IMRAN hereby declare that Board Roll No, Samagra ID, caste
certificate and income certificate, bank account details and all other information given in the application form is complete and correct. We have not
submitted any other application for scholarship for current academic year in any other institution in India. We also undertake that, if any information
given above is found to be false at any stage, entire amount of scholarship will be recovered and competent authority will be free to initiate legal penal
action against us.
¡MOHAMMAD AHTESHAM S/D/W/o MOHAMMAD IMRAN kMOHAMMAD IMRAN Ȫȡȯ¡ɇ
ͩ`ȪƠȡȡȣ ¡ȣ¡ȰfȲ Ē]_Ȣ¢ȡCBȪ[ȣ¢ȡȧȡ[ȢȡǓȡ]Ĥȡğɇ\ȡ`Ȳȡ\Û
ͪǗ[fȲ ¡ȣ¡Ȱ@]ȯȯȪ[^ ğȯèȪͧȯͧfȯf¡ȣ]ȯͩȡ¡Ȱ@\`ȪƠȡȡȣȡ_
ȡȢ¡ȰȪ¡]ȯǓè¡ȪȡȯȡfȲȡͧȡͪ ȣȡȯȢfȲ¡ȡȯͨȡȡǗȢȡ[ȡ¡ȣȧȡȯȢ@
Ǒ]Øɉȯ]ȡȡğǙǓȯȯ¡Ǖ]ȡfȯȪ¡ȡȣȡğǙͪƣǓèȣȡȯȢȡȡğǙͪƣȧǔȢȣ_
¡Ȱ` ȯȡ ȯȣȡȯȢ)^ ¡ȯͩĐȡȡ ȯ ǔÛͪȡȸȪ¡ȯȡȯͧfͩ ȢȢȪȡȯ\Û[ͩ ȢȢȡğǙͪƣ
ȯͪǔ[ Ȣȡ ǑȡȡȯȡȡͪȡȸȪȡȣ Ǘ Ȣ ÞȰͧè ɅȡǑȡȡȯȡȡȡğǙͪƣèȢǙȡ[\ͬȡȣ\ȡ
\Û ¢\ͬȡȣ]æ ȯɅȪ` ȯͪǽÚȡȢÖ ȲǑ¡ȡȧȡȡjȲfȲȯ¡
f]_][ȡ_ȡ Éȡ[ȡ¡ȣȧȡȯȢ)
ɇȪ [Ǘ[¡Ȫȯȯ¡ȯȪ [ ȲèȡȪ°ȯȡȯȢ¡ǗȱȪ¡ȯȣǗ[ǔàȯȡȣ¡ȪȢȧȯȯƮȡȡǗ[Ʌ ȲȲͬȪ [ȯͧȯĤȡƯ
ȡğǙͪƣȡ Ȫ ȲȲͬǔȡȡȡ[ȯȡÚ ȯ ȡȡ ȯȡ ǗȱȡǗȲȢ)ȡğǙͪƣȡ ȯȧǔèǓɅȡ ȯȯ
ͪǽƨȪ_Ȣȡ[ȡ¡ȣȯȯͧȯèȲğ¡ȯȡ)
\ͧȡȡͪȡȯ¡èȡ¢ Date ( ]ȯȯ¡èȡ¢
Declaration from Institute Head & Institute Scholarship Nodal Officer
We, hereby, certify that the student is enrolled in the approved course of Govt MP. All the details filled by the student in the above application
form have been verified with the original documents and have been found to be correct and authentic. He/ She has passed last exam and is eligible
for sanction of scholarship. College has ORIGINAL COPY of his School Leaving Certificate. His / Her attendance is regular, as per the instructions of
Government
We have verified all details as per te scheme guidlelines & instructions and recommend him/ her for sanction of scholarship as per the rules. We
also undertake that, if the above student does not attend the classes regularly or discontinues the course, We will immediately report the matter
to the concerned district office so that his scholarship can be put on hold. In case any information of found to be incorrect, Government will be
free to initiate action against the institute.
The institute is accredited by the Government and permission is given to conduct related course.
(Signature ) (Signature ) Date (Signature )
Scholarship Nodal Officer HOD Director/Prinicpal
Generated by Scholarship Portal as on 26/12/2020
Ȫ \]ȪȪ_ èȡ¡ȰȪ]\ȯǔȯȯȡȡ[ȯÈǔȡBHOPAL ȯ ͪ°ȡ[ãȡ Ʌ Ȳ[ ȯ¡Ȱ)
Fresh Application Backward Classes & Minorities Welfare Dept.
Madhya Pradesh Scholarship Portal 2.0
Integrated Scholarship Application form- Post Matric Scholarships for year 2020-21
Applicant Unique ID: 3940088 Scheme : Post Metric Scholarship for OBC
Application ID: 5537138 First Time Lock Date: 26/12/2020
Version No: 1 Verification Code: 3403 Lock Date: 26/12/2020 IPAddress : 122.168.47.225
Your 10th Board Details 10th
Board Name: C.B.S.E. Board,
Year: 2016-2017, Roll No.: 1206527
(Signature of Parent / ȡͪȡȯ¡èȡ¢ Date (Signature of Student / ]ȯȯ¡èȡ¢
Ȫ ȡğȡğȡȯ]ȯȨ[Ǒ¢ȡȢȡͪ`Þ¡ȣȲ¡Ȫȯ ȲèȡĤǕȡğȡğȡȯȢȧǗĤǓ ȡ[Ȣ ȯ
ȡȡȣ ×ȡͪȯ)
Generated by Scholarship Portal as on 26/12/2020
