126 Miles Stones, Delhi-Jaipur NH-8, Behror, Rajasthan-301 020

Tel : 01494-299930, 299931, 299932, 299933, 299934

Mob: 09310968576, 09309082044, 09001161546, 09001022055, 09636694142
CHANGING HEARTS AND MINDSETS e-mail: rinchen.dolma@raifoundation.org; behror@raifoundation.org
Web : www.raifoundation.org

NOMINATION FORM FOR

GIFTED/GENIUS GIRL SCHOLARSHIP
(To be filled in by the student only)

1. Name of the Applicant :

2. Date of Birth :

3. Name of the Father/Guardian :

4. Occupation and Monthly Income :

5. Name of the Mother :

6. Occupation and Monthly Income :

7. Present Address :

City & Country :

(Ph) Landline: Mobile:

Email (if any) :

8. Education Qualification of the applicant (Class Xth onwards)

Certificate / Degree Year of Passing University / Board % of Marks

9. Write about your extracurricular activities and accomplishments:

10. Give us some glimpse of some situations pertaining to your High School, Family or Community that will give us
a better understanding about you and your aspirations.

11. How was your education? What was missing and what was your learning output?

12. How have your brothers/sisters and parents impacted your thoughts? Give us some details about them.

13. What community work and social contribution have you made during your school / college holidays?

14. Have you had access to computer and internet? If yes, what have you learned?

15. Give examples where you have demonstrated qualities of leadership, enthusiasm, innovation and
determination.

Please write on a separate sheet of paper an essay (400 words). It can be in your native language:
16. What do you aspire to be and how this scholarship will help you realize your dreams and achieve you goals.
17. Please provide a separate recommendation from Principal / Head of the Institute / NGO / Orphanage who
should provide reason, why the applicant should be awarded Girl Genius, Gifted Girl Scholarship.
18. Courses offered (Please Tick ( ) your preferred option):

qBachelors in Business Management- BBA (50 Seats) Duration - 3 Years

qBSc Graphics and Multimedia (50 Seats) Duration - 3 Years

qBSc Media & Communication (50 Seats) Duration - 3 Years

qBA Airhostess & Customer services (50 Seat) Duration - 3 Years

qBSc. Hospitality Management (50 Seats) Duration - 3 Years

qBTech Biotechnology (25 Seats) Duration - 4 Years

qBA Fashion Technology (50 Seats) Duration - 3 Years.

qBTech Electronic & Communication (25 Seats) Duration - 4 Years

qMasters in Business Management -MBA (50 Seats) Duration - 2 Years

19. Give reasons for choosing the course you have chosen. How will you use this knowledge to serve society?

ENTRY & ELIGIBILITY CRITERIA:

• For Under Graduate degree programs 12th pass (Fully Cleared).
• For Post Graduate degree program, Graduation must (fully cleared).
• Basic English writing and speaking skills.
• The combined income of both parents should be below Rs. 8,000/- per month for 100% scholarship on the total
cost of Rs. 2.0 Lacs per annum for the course including boarding and lodging.

PLEASE NOTE:
• All admissions are at Behror Campus (on main Delhi-Jaipur highway about 120 km from Delhi) except the 50
engineering seats which are at EIILM University, Sikkim for B Tech degrees.
• All applicants will be selected by a selection committee of the foundation and their decision will be final.
Interview may be requested if required at Behror Campus before final selection.
• All Students will be directly enrolled with Rai Community College registered with Indira Gandhi National Open
University Delhi and with EIILM University Sikkim (Eastern Institute For Integrated Learning in Management
University) through us under their Distance Learning Degree Program.
• Transport to and from the campus during admissions and vacations will be the responsibility of the
parents/students. Students are allowed to stay during Summer/Winter holidays at campus.
• Passport/Visa processing fees, visa extension fees, minor medical expenses which is not covered under the
cashless medical facility, out of pocket expenses for basic personal requirement is to be borne by the
student/parents themselves.
• Academic session for 2010 batch (All Graduation programs) will commence from 1st July, 2010 and Post
Graduation program will commence from 1st August, 2010. New joiners will undergo an orientation program
for one week. Fully filled up form duly complete in all respect should reach us by 15th April, 2010. All the
information is mandatory. Half filled nomination forms will not be accepted.
• New students admitted to the UG/PG degree courses have to submit the following documents:-
1. Income Certificate of Parents (original).
2. Character certificate from the Principal of the school/college last attended.
3. Evidence of the date of Birth.
4. Attested copy of the statement of marks and pass certificates (10th, 12th, Graduation) of the qualifying
examinations.
5. Attested copy of the Graduation Degree or Provisional Certificate.
6. Transfer certificate.
7. Migration certificate.
8. Ten (10) number of colored passport size photographs.
9. Residential Proof.
10. Medical certificate

We hereby declare that all the information provided by us is true and correct to the best of our knowledge.

Signature of the Applicant Signature of the Applicant /

Head of the Institute / NGO / Orphanage

Signature of Parent Seal of the School / College / NGO/ Orphanage

Enclosures:
• Attested photocopies of Marks Sheet (Class Xth onwards).
• Legal proof of Income of Parents (attested photocopy)
• Case History duly signed by the Head / Trustee of the NGO / Orphanage
Rules and Regulations (For Students under GGGS Scheme)
1. Students should maintain 75% attendance in classes.
2. Change of course will be entertained within the first one month of joining and not later.
3. It is mandatory for all students to maintain minimum 55% in academics.
4. Students failing in exams will have to repeat that paper at their own cost as required by university.
5. If any student drops the course after commencement of the academic session, fees of that particular semester and
premiums of medical insurance shall be charged.
6. All Campus rules and regulation as mentioned in student handbook are to be followed strictly.
7. Any students found violating the campus and hostel rules will be asked to discontinue.
NOTE: In case it is found at any stage that any incorrect information has been given or some material facts have been
concealed, the student is liable to eviction from the college besides such other action, which the university may deem
fit may be initiated against her and Rai Foundation will not be responsible for student’s loss of months/years.
• The college may change the Knowledge hub anytime if it deems proper without assigning any reasons.
Fully filled in nomination forms duly complete in all respect should reach to the following address by 15th April, 2010

Rinchen Dolma
Program Head, GGGS
Rai Foundation ,Behror Campus, 126 milestones , Dehli-Jaipur N.H-8, Rajasthan 301020
Email: rinchen.dolma@raifoundation.org, babita.bhan@raifoundation.org behror@raifoundation.org
Web: www.ccrf.in
Tel: - 01494 -299930, 31,32,33,34
Mobile: -09310968576, 09311488020, 09309082044, 09001161537