REGISTRATION DETAILS APPLICATION ID MN201920008753043 REGISTRATION DATE 25/11/2019 APPLIED FOR SCHEME POST MATRIC SCHOLARSHIP FOR ST STUDENTS-MANIPUR STATE OF DOMICILE MANIPUR SCHOLARSHIP CATEGORY POST MATRIC/TOP CLASS/MCM LAMNEILHING DATE OF BIRTH NAME OF STUDENT 15/05/2002 KIPGEN (DD/MM/YYYY) GENDER FEMALE RELIGION CHRISTIAN COMMUNITY/CATEGORY ST FATHERS NAME PAOBOI KIPGEN MOTHERS NAME HEVEI KIPGEN ANNUAL FAMILY INCOME 80000 AADHAR NUMBER XXXXXXXX7393 MOBILE NUMBER 9366313414 EMAIL ID DAY SCHOLAR/HOSTELER HOSTELER ACADEMIC DETAILS RAYBURN HIGH SCHOOL (14030109910) NEW LAMKA(H) CHURACHANDPUR PRESENT INSTITUTE MANIPURCHURACHANDPUR, MANIPUR PRESENT CLASS/COURSE XII-SCIENCE CLASS START DATE 05/04/2019 PRESENT YEAR 1 MODE OF STUDY REGULAR/FULL TIME PREVIOUS BOARD/UNIVERSITY NAME BOARD OF SECONDARY EDUCATION MANIPUR PREVIOUS CLASS/COURSE 10TH PREVIOUS PASSING YEAR 2018 NAME PREVIOUS CLASS(%) 66 10TH CLASS ROLL NO. 22989 BOARD OF SECONDARY EDUCATION 10TH CLASS PASSING YEAR 2018 10TH CLASS BOARD NAME MANIPUR 12TH CLASS ROLL NO. 12TH CLASS PASSING YEAR 0 12TH CLASS BOARD NAME COMPETITIVE EXAM EXAM CONDUCTED BY QUALIFIED COMPETITIVE EXAM ROLL COMPETITIVE EXAM YEAR 0 NO ADMISSION FEE 5500 TUITION FEE 14400 MISC FEE 1000 BASIC DETAILS IS ORPHAN NO IS DISABLED NO TYPE OF DISABILITY - PERCENTAGE OF DISABILITY - MARITAL STATUS UN MARRIED PARENTS PROFESSION OTHERS IFSC CODE SBIN0006484 BANK ACCOUNT NUMBER 38422588693 CONTACT DETAILS STATE MANIPUR DISTRICT KANGPOKPI BLOCK ADDRESS 56 PIN CODE 795129
SIGNATURE OF CANDIDATE SIGNATURE OF HEAD OF SCHOOL/INSTITUTE/COLLEGE WITH STAMP
** ACCOUNT DETAILS MUST BE ENTERED CORRECT. NO MODIFICATION WILL BE ALLOWED AFTER THE FINAL SUBMISSION OF APPLICATION. *** STUDENTS ARE ADVISED TO SUBMIT ONLY ONE APPLICATION FORM. IF NSP FINDS MORE THAN ONE APPLICATION ( IN FRESH OR RENEWAL CATEGORY) OF A STUDENT, THEN ALL THE APPLICATIONS SUBMITTED BY THE STUDENT WILL BE CONSIDERED AS DUPLICATE AND WILL BE REJECTED. **** AADHAR NUMBER PROVIDED BY YOU, WILL BE AUTHENTICATED BY UIDAI AND MAY BE USED FOR PAYMENT OF SCHOLARSHIP THROUGH AADHAR PAYMENT BRIDGE(APB). ***** FOR ANY QUERY/ GRIEVANCE/ RTI, PLEASE CONTACT SCHOLARSHIP MINISTRY/DEPARTMENT/STATE.