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SCHOLARSHIP FOR HIGHER EDUCATION APPLICATION FORM

Application Status: Submitted

Advertisement No: SHE - 2014

Application Ref. #: DST/INSPIRE/02/2014/052232

IVR No: 201400085889

Personal Particulars

Salutation: Mr.

First Name: Ashok Middle Name: Last Name: Kumar

Date Of Birth: 7/1/1997 Gender: Male Aadhaar Card No: 369245850785

Father's Name/Male Guardian Name: OM PRAKASH

Mother's Name/Female Guardian Name: RAM RANI

10th Class Certificate or Marksheet as Proof of Date of Birth: AttachedBelow

Place of Birth: Urban

Email Address: [email protected]

Social Community: OBC

Differently Abled: No Other:

Enrollment Information (B.Sc. / Integrated M.Sc. Level)

Program Enrolled: BSc Honors

Course Enrolled: Maths

Enrollment/Admission Year: 2014 Admission No: 14/027088

State (In which college is located): DELHI

University Type: University University Name: University of Delhi

University Address:North Campus,Pincode:110007

College Name: Atma Ram Sanatan Dharam College : Dhaula Kuan 110 021

District (In which college is located): New Delhi

Endorsement Certificate: Attached Below

Senior Secondary Performance Information (12th Standard)

Name of the Board: Uttar Pradesh Board of High School and Intermediate Education

Passing Year: 2014 Rank in Class 12th: Board Roll Number: 0896563

Eligibility Note: Attached Below 12th Marksheet: Attached Below

Marks Information



Subjects Marks Obtained Maximum Marks Grade

MATHEMATICS 91 100

PHYSICS 92 100

CHEMISTRY 87 100

ENGLISH 96 100

GENERAL HINDI 88 100

Other Subjects

Subjects Marks Obtained Maximum Marks Grade

SPORTS&PHY EDU 81 100

Total Marks Obtained: 454 Maximum Marks: 500 Overall Percentage(%): 90.8

School Name: PT D D U S V M I C LAKHIMPUR KHERI

School Address: VILL&POST-UDAYPUR ,GOLA ROAD, DISTT- LAKHIMPUR KHERI

State (In which school is located): UTTAR PRADESH

District (In which school is located): Lakhimpur Kheri

PinCode: 262701

National Level Competitive Examinations

Examination Year RankRank

Certificate/Certificate

Other Details

Year of Passing Class X:2012 Parents Annual Income: 36000

Have you attended INSPIRE

Science Camps:No

If Yes, please provide details. N/A

Contact Information

Permanent AddressAddress: VILL-KEDARIPUR, POST- BIRAMPUR, DISTT-LAKHIMPUR -KHERI

Town/City: Lakhimpur Kheri State: UTTAR PRADESH Pincode: 262727

Telephone Number (with STD

code): N/A

Mobile Number: 9648877817

Communication Address

Address: VILL-KEDARIPUR, POST- BIRAMPUR, DISTT-LAKHIMPUR -KHERI

Town/City: Lakhimpur Kheri State: UTTAR PRADESH Pincode: 262727

Telephone Number (with STD

code): N/A

Mobile Number: 9648877817



Are you availing any other scholarships: N/A

Declaration: It is certified that all particulars given by me in columns above are true to the best of my

knowledge. If any particulars are found false, I am aware that my application for scholarship are liable for

cancellation.

Place: New Delhi Submitted Date: 10/29/2014 State: DELHI

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