Bhagat Phool Singh Scholarship Scheme

Bhagat Phool Singh Scholarship Scheme
Application Form

1. Student’s Name:

2. Date of Birth:

3. Are you an Indian Citizen?

4. List of Schools/Colleges Attended:

Sr. No.	School/College	Year of Passing	Percentage
1.
2.
3.
4.

5. Gender:

Male Female Other

6. Extracurricular Activities (Include sports, awards, scholarships):

7. Community Activities (Include NCC, NSS and others):

8. Course Details:

9. Family Details:

10. Please supply 3 personal adult references (other than relatives):

Name	Relationship	Home Phone	Work Phone

11. Anticipated Date of Course Completion:

12. Applicant’s Digital Signature and Contact Information:

13. Father/Mother/Guardian Details:

Father’s Name: Occupation:

Mother’s Name: Occupation:

14. One-Page Essay:

I hereby declare that all information provided is true and correct to the best of my knowledge. I understand that Abhyudaya Jan Kalyan Nyas reserves the right to verify, reject, or withdraw the scholarship at any time without assigning a reason.

Contact Info