JAI HO

(SCHOLARSHIP APPLICATION FORM)

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Please complete all the Sections in this form in BOLD LETTERS only

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SECTION A: PERSONAL DETAILS

NAME (AS IN YOUR CERTIFICATES) FATHER / GUARDIAN NAME GENDER DATE OF BIRTH NATIONALITY COMMUNITY MARITAL STATUS ADDRESS

: : : : : : : : .. ...

DISTRICT TELEPHONE NO EMAIL ID

: : :

STATE MOBILE NO

: :

SECTION B: ACADEMIC DETAILS NAME OF THE SCHOOL SCHOOL ADDRESS : :

DISTRICT TELEPHONE NO MARKS OBTAINED STANDARD YEAR & MONTH OF PASSING SUBJECTS

: :

STATE :

10TH STANDARD

12TH STANDARD

MAXIMUM MARKS

MARKS OBTAINED

PERCENTAGE %

OVERALL PERCENTAGE

TOTAL

SECTION C: FAMILY DETAILS Fathers Name / Gaurdians Name Mothers Name No. of SIBLINGS :

: :

EARNING MEMBERS OF THE FAMILY: (Attach pay slip for all the earning members in the family, if applicable) Type of Employment (Govt/Private/Self) Company Name & Address Income per Annum(Rs)

Name

Relationship

Designation

TOTAL SECTION D : SCHOLARSHIP DETAILS SCHOLARSHIP/SPONSORSHIP APPLIED FOR HIGHER SECONDARY EDUCATION
( 11 & 12 STANDARD EDUCATION)
th th

: Yes/No : Yes/No : Yes/No

DIPLOMA EDUCATION BACHELORS DEGREE MEDICAL : Yes/No LAW: Yes/No

ENGINEERING : Yes/No

ARTS & SCIENCE : Yes/No

PREFERRED LOCATION FOR HIGHER STUDIES : SCHOLARSHIP CATEGORY APPLIED FOR (pls tick the appropriate box) MERIT SCHOLARSHIP MERIT CUM MEANS SCHOLARSHIPS SPORTS /EXTRA CURRICULAR ACTIVTIES SCHOLARSHIP

FIRST GRADUATE IN THE FAMILY Pls specify (maximum 500 words): I need scholarships because .

(Signature of the applicant)

SECTION E: DETAILS OF DOCUMENTS TO BE SUBMITTED Student should submit the photo copies of following proofs: 1. Documents declaring income of the family 2. Mark Sheets 3. Sports Certificates 4. other credentials etc..

The copies of the mark sheet should be attested by concerned Head of the School with the School seal and other documents shall be attested from the Gazetted officer / Notary Public.

SECTION F: DECLARATION I hereby certify that the particulars mentioned above are true to the best of my knowledge and ability. I understand that any falsehood or misrepresentation of facts on my part will result in immediate disqualication/suspension of the scholarship Scheme.

I am aware that this Scholarship Scheme is being organized by M/s. Zee Entertainment Enterprises Limited and Rotary International 3230 (both ZEEL and Rotary herein referred to as the Organizers).

I agree for the below terms and conditions

Terms and Conditions 1. Only students from Tamil Nadu State Board Schools who have appeared for the examination in the year March April 2013 are eligible to apply / participate in this Scholarship Scheme. 2. The students who have registered their examination numbers by sending SMS to 57575 are only eligible to participate. 3. There shall be no entry fee for participation and Issuing of this preliminary application form does NOT guarantee the award of a Scholarship/Sponsorship. 4. Students who are participating should follow all directions/rules and regulations framed or announced by the organizers. 5. The selection for Scholarship/Sponsorship shall be done by Jai Ho Scholarship Selection Committee and their decision stands final and no representation/recommendations from the external parties will be considered. 6. The students shortlisted for the scholarship will be informed by letter/email by the Scholarship Selection Committee. The student shall acknowledge receipt of selection and communicate acceptance of scholarship within 2 days of receipt of letter/email. Non-receipt of acceptance shall be considered as decline of scholarship.

7.

All documents received from the students are required to be attested. Selection will be subject to the verification of original documents. The documents shall be verified for authenticity, if any discrepancies are found during the verification process the application for scholarship will be rejected.

8.

The form should be complete in all respects. Incomplete application will be rejected and no correspondence will be entertained.

9.

The Scholarship / sponsorship for selected students shall not be transferable to other person or location or degree and no request shall be entertained by the organizers for such transfer.
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10. The selected 10

Standard students shall be provided Scholarship/Sponsorship for their XI & XII

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Standards and the selected 12 Standard shall be given either Scholarship or Sponsorship for their Bachelors degree only. 11. Employees/members of organizers and its affiliates/subsidiaries, associated agencies, participating operators and their immediate family members and relatives are not eligible to participate in this Programme. 12. The Programme may be discontinued or terminated by Organizers at any point of time without assigning any reason thereof. 13. Organizers shall not entertain middlemen/brokers for selection of students and organizers are not liable for the students who are influenced by unknown third party. 14. Failure by organizers to enforce any of these terms in any instance(s) shall not give rise to any claim by any person. 15. Organizers in its absolute discretion reserves the right at any time, without giving any previous notice to the participants, to add, alter, modify, change or vary all or any of these terms & conditions, wholly or in part, or to withdraw the Programme and the same may be posted on the web site. 16. All disputes shall be subject to exclusive jurisdiction of the city civil courts at Chennai. 17. The duly filled application form shall reach the following address on or before June 15, 2013. M/s. Zee Entertainment Enterprises Limited , nd No.150 & 151, 2 Floor, North Usman Road, T. Nagar, Chennai 600 017. I have made this declaration at my free will and consent and without any coercion whatsoever.

Signature: Parent (Father or Mother) / Guardian____________________________

Signature: Applicant PLACE: DATE: Signature

____________________________

(Signature of the applicant)