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Suu: :z.ooo Scholar!'h ips fo r the Students with l)j;;:thilitics.

Dear

As you nrc ;Jw:w.: tllul Nul iona l llalldit.:lippcd l.'inu nce lllltl l)cvdopnrt.:lll Corporu tion (N II FDC) Is :,implementing lWO schemes or Scholarship for Ministry of Social Justict' ~\£ Elllp\)WCrmcn;, GO\l. of lndin for the

· .i ·..:swdents with disahilitic:;. Uru.k:r these schemes, 2000 11~·w ~cho!:mships nrc provitlcd cvcry ycnr for pursuing ~; ·~. · ·i~lighcr/pro fcssionnl/tcchnical courses.'. :0 ;' 00 I' ···, ~-;-- for both the Scliemes, students may apply online nt NHFDC's website (_!vww.nh({k.nic.in). The brief

v 'details nrc ns follows:­

(i) Scholarship Scheme (Trust Fuull): Un der this scilcrnc. 1500 Scholnrships nrc provided to eligible di!'!Crcntly-ablcd students f'or Degree and l'osl Graduate h:vcl prolcssionu l lu:tl tcchnicul courses from recognized institutions in lndiil. TI1e sllldcnls may npply online (www.nhfclc.nic.in) ilny time in ncntlcm ic year and submit hard copy of the nppi icnt ion duly recommended by head of the. institlltion!l.:o lkg\: ulong with nllcslcd copy of' requisi:c dm:trrnculs. The Scholurship umount ranges up lo 1.50 lacs depending upon course fcc, maintenance allownncc, books & stationary allownncc nnd aids & appliances of student.

(i i) Sd10lnrshi p SdH'IIII' (Nntiounl Fuull) : l li~<kr th is sdH:nrc, 500 Sl: hllllmd1ip~ arc provided inn ycnr to the students with disabilities for pursuing l'ost Malric professional and tcdmicol courses of more than one year duration . The students may apply online (www.nhfuc.nic.in) nnd submit hard copy of the npplication duly recommended by head of the institution/college along with llll\!stcd copy or l'l'quisilc doctrllll'lllS rrorll I<I Ju ly, 20 IJ (() J I'' /\u~llsl . 20 IJ .

The details of scheme nrc nvailablc on NHfDC's website www.nh rdc.nic.in. The copy or ndvcrtiscment ' nl Annexure-!, Scholarsh ip Scheme (Tnrst Fund) nt Anncxurc-11 antl Scholarship Scheme (Nntionnl Fund) nt -<"A1llll'XI II\'· III fnr tht: slu•kril~ wi1 l1 dis~thililics i ~ Clli: l cJ.~cd licJewith, Iii!' ICildy lcl'elcllce. ""

I would, therefore, request you to kindly issue ncccssnry instructions to the oflkcslt·ollcgcs/institutions tr givc wider publ icity to the sclivlarsh ip ~chenu.:s l'ur the benefi t ol' Sllldcnts with disubi liti·~s. You mny nlso

jConsider tO provide n link in the wcb~i lcs o(' your dcp<1 1'(11\Cil!fOrganii'.lll ion/other c.JcpartlllCiltS tO the obOVC mentioned website ofNHFDC.

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Yours sincerely,

(llur!'h Bhnl)

Shri T .R. Sa rangnl, lAS Secretary Dcpnrtmcutoi"Wdl'nrc, Govt. of Punjab, Mini Secretariat Chandigarh- 160 017

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I :~rUona ! Handicoppocl rino ncc nnd Dovcloprnon\ Corporation (N II f DC). for IHHJ or 1 IJ r.; l ~:Jl f of Mlnl:;try of Soclul Justice & Empowerment, Govt. of India, invites applications from Students with Disabilities for award of Sc~o(arship under the following two Scholarship Schemes :­

1 , Scholarship Scheme (Trust Fund):­

• Under this scheme, 1500 ?chola)shlps will be awarded to eligible students with disabilities for degree and post graduate level professional and techni·cal courses from recognized institutions In India. --- .-• 30% scholarships will be reserved for girls, which will be transferable to f!~ale students In case of non­availability of female candidates. \

• Applicants may apply at any time in academic year for scholarship under this scheme. Scholarships will be awarded quarterly ba~is for the applications received In preceding qu<1rtcr Under this schomo, an advance copy of applicatloi\ should also be submitted online ( www.nhfdc.olc.lnJ by U1e candidate.

• Reimbursement of Non-Refundable fees restricted to the limit or fee of similar courses in Government! . Government -aided institutions. Maintenance allowance will be paid to the students for 10 months @ Rs. 2500/ per month for Professional Graduate Courses and Rs.3000/· per month for Professional Post­Graduate Courses in one academic year.

• Books/Stationery allowance will be paid to students pursuing Professional Graduate Courses@ Rs.6,000/ per annum and Rs.10,000/· per annum for pursuing Professional Post-Graduate Courses . .':)

• Diffe rently-abled students in addition will be provided financial assistance for purchase of aids &appliances (only once during life time).

• Monl11ly Income or the l>onoffcklry /poront or guor<.liu n should not be more than fls .25,000/· (Rs. 3 .00 Lakh p.a.} from all sources. Family income includes income of parent/guardian .

...-1 • A Scholarship holder under this scheme will not avail any other scholarship/ stipend fo r pursuing the courso.

2. Scllolarshlp Scheme (Notlonnl Fun<.!):­

• Under this scheme, 500 Scholarships will be awarded to eligible students with disabilities for pursuing higher academic/professional or technical qualification.

Applicant has to apply online (www.nhfdc.nic.in) for scholarship from 01.07.2013 to 31.08.2013 and

scholarship shall be awarded once in a academic year under this scheme.

Scholarship of Rs.1000/-p.m. for hostellcrs and Rs.700j-p.m. for day scholars studying In profosslonn! course:> at graduation and above level, and Rs.700/-p.rn . for t1ostcllcrs and Rs.400/-p.m. for day scholars

pursuing Dlploma;ccrtifir.ale level professional courses. Course fee reimbursed upto ceiling of Rs.10,000/­per year.

• Financial assistance can be given for computer with editing sortwt:Jre for blind/dear graduutc and post graduate students pursuing professlonCll courses and for support access software for cerebral palsy students.

• Monthly income of the beneficiary/parent or guardian should not be more than Rs.15,000/ • (Rs. 1.80 Lakh p.a.} from all sources. Family income Includes income of parentjguardlan.

• Scholarship holder under this scheme will not concurrently hold t:Jny other scholt:Jrship/slipcnd

> How to apply :-The applicant has to apply online (www.nhfdc.nic.in} and printed copy the online filled application duly countersigned and recommended by the Head of the Institution, where they are studying along with requisite documents send to: National HandfcapJX!d Finance and Development Corporotlon (NHFDC), Red Cross Ohowan, Scctor-12, fo rldabCld-.121007. It 1::; to be noted lllL l without o hard copy of appl ica tion, a candidate's application in soft copy will not be entertained

> For further detalls, please visit website of NHFDC ··www.nhfdc.nlc.tn ~or contact: NHFDC at, Telephone nos. 0129 - 22269 10, 2287512, 2287513 Fax no. 0129 -2284371, E·mt:Jil· nhfdc97@gmail.~

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SCHOLARSHIP SCHEME II - FOR l.500 DIFFERENTLY AOLED STUDENTS (To bo fundod out of Trust Fund l or Empowerment of Persons with Olsllbllltlos)

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1. Oblectiye: .1'

1.1 The objective or the Scheme is to provide financial assistance to the differently-ablcd students to enable them to pursue professional or technic<ll courses hom recognlzecJ lnslltulos and get employed/self-employed. \

1.2 Dlfferently·abled students face several barriers physical, financial, psycl1ological, mental in pursuing studies an(~· living with dignity. At times such students are deprived o f harnessing.• their · latent ski lls and thereby miss the opportunity to cum U1cir livcifl1ood and find a c.Jienifiod place for themselves in the society. This scheme envisages encouraging dlflcrenlly·abied students by providing scl1olarshlps and other assistance to pursue professional or technical courses and various skill development courses ror their empowerment.

2. Number of Schotarsh!ru!:

2.1 ~o start with evert year 1500 scholarships will be. provldecJ to Ute dltreronlly-abled students throughout the country. 30% scholarships will be reserved ror girls, which will be transferable to male

students In case of non-ava ilability of female candidates. •

3.~: ·. 3.1 These scholarships will be available for studies 10 India, by all differently-abled students w.~o are covered under tho florsons with Disahilitics (Equol Opportunity, Protection or Rlehts and Full Participation) Act, 1995 and the National Trust for the Welfare or Persons with Autism, Cerebral· Patsy, Mental Retardation and Multiple Disabilities Act, 1999. Only Indian Nationals wrtl be eligible for

I,

scholarships. :· r

4. Rate of Scholarship and other benefits under the scheme:

4.1 The following benefits will be availuble under the scherne:­

(i) Non-refundable fees shill! be fully awarded In case of GovernrnenVGovernment:-aided institution. In case or private Institutes the reimbursement would be restricted to similar courses In GovernmenVGovernment-aic!ed Institutions.

(ii) Maintenance allowance will be paid to the students for a period or 10 months only in one academic year at rollowing rates.

-­

Book/SUlllonery allowance Malntenunco allowan9(>Closs[Courso (no. Por annum) (Rs. per month)

6000/·2500/ ·Professional Graduate Courses .. -··- ..-- ---··

Professional - -- l'ost-Graduatc 10000/·3000/· courses

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(iii) Diffcrc11l.!y-alllccl students, 111 a<J(J,tion will be nrovi!lcd n icl!> ancl applinnccs, 0n:y onco c1uri111.: lilc\iJIH~. n~; 1;ivc 11 l )l!low :

Visua lly Hundicappcd

·- ···· -· -·-- ···--····Appiinnca- -·-····-···- ·· . S.No:-· ·---f.~imniP.d CO!':I ·-· ··--i~cmnrkil-

(up to)

1. Fof blindBrailler I Brailler Typewriter Rs. 10,000

2. Laptop with Screen reading software Rs. 40,000 For blind

3. Lap(op with Screen Magnification Rs. 60,000 For low vision

software

-Hearing Handicapped

.. - j' ----- AppHanca ----···--- -- --­ - -·-··· i:Siimiiiccfcost (up io1S.No.

1. Binaural digital programmable hearing aid with Rs 50,000 + Rs 3600 p.a. annual provision of button cells

2. Cell phone with SMS SIM card Rs 5,000

3. Loptop with WI FI (Oiuc tootl1) fncillty 11s 70,000

OrthopedicaiiY'Handicapped

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5.1 Conditions for Scholorship:

i) FlnanciCJI assistance will be given to pursue degree andjor post graduate level technical and professional courses from a recognized institution. Maintenance, book/stationary allowance and gmnt for purchase of asslstivc devices will be credited to the student's account. Non-refundable fees shall be-reimbursed to the student on production of proof or deposit of fees or will be paid directly to the Institute under intimation to the student.

ii) Scholarship will be awarded for only one course at a lime.

fii) Students who get admission to a college to pursue tecllnicaljprofessional courses, on the basis of a competitive examination will be eligibl~ for the scholarship without any consldorolfon of pcrconlnP,o of morl<n nl hiP,hor sccondnry/P,mduotion lovol.

lv) Students who get admission in technical/professional courses without facing any competitive examination wl!l also be eligible for schoi<Jrshlp. However, such students should hnvo not Ions limn 50% marks nt hlp,llor socondory/P,rodunllon lovol. Soloctlon of these students will be done strictly on merit basis.

v) Students who pursue their education through correspondence would also be eligible for the scholarship.

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vi) Conllnuauon of the scholurship in suuscqucrtt yci.lr!> v1111 I.Jc: autorunllc !>u!Jjcc~ to successful compleuon or tha course during the preceding year However, grace period of one year shall be admissible for the entire course in spcc1f1Cd catceones.

vii) A r.ondldotc who IS ow<Jrded scholarship for one course. <:~flcr Its complcuon will be ellg1ble for another course too. However, the awardecs will not bo clletblo for a similar or equivalent course.

viii) A scholarship holder under this Scheme will not avail any other o;cholarshlp/ stlpend for pursuing the course.

r lx) The annual Income of the beneficiary/parent or guardian of beneficiary should not exceed

Rs.3.00 lakh from all sources. However, preference shall be glvon to oconomlcally weaker students. \

5.2 Other Conditions for the Scholarship:

I) The scho larshl~ Is depended on the satisfactory progress <.~nd conduct of the scholar. If ills reported by the head of the Institution at any t ime that a scholar has by reDsons or his/her own act of default fa iled to make satisfactory progress or has been guilty of misconduct such os resorllna to or purtlclpollng In strikes. lrroeulorlty In ollonuonco without tho permission of the authorities concerned etc .• the authority sanctioning tho scholarship may either cancel the scholarship or stop or withhold further payment for such period as It may think rtt.

il) .' If a student IS found to have ob:ained a scholarship by false statement, his/her scholarship will be cancelled forthwith and the amount of the scholarship paid will be recovered. The student concerned will be blacklisted and debarred for scholarship in any scheme forever.

Iii) A scholarshtp awarded may be cancelled if the scholar changes the subject of the course of study for which the scholarship was originally awarded or changes the Institution or study without prior approval of the Government. The amount already paid may also be recovered ot tho discretion or tho Govornmonl.

iv) Ascholar is liable to refund the scholarship amount at the discretion of the Government If during the course of the year, the studies for which the scholarship has been awarded, Is di~contlnued by hlrn/her.

v) Scholarship will not be paid for the period of internship/l1ousemanshlp In the M.B.B.S. course or (or a practical training in any course, lf the student Is In receipt of some remuneration during the internship period or some allowance/stl pand during the practical training In any course.

vi) The conditions can be changed at anytime at the discretion of the Government of India.

6. Publicity of tho Scheme

6.1 The Scheme will be given wide publicity over print and electronic media. Assistance of State

Governments and other agencies such as UGC, Universities and prominent colleges and lnstltuUons

will also bo sought in giving publicity lo the Scheme. ·

7. Procedure for application

7.1 Application In enclosed prescribed format shall be submitted at any limo during an academic year to the assigned agency (I.e. National Handicapped Finance and Development Corporation. Red Cross Bhawan, Sector-12, Farldabad, Haryana - 121007). An advance copy of the application should also be submitted online (NHFOC v.'ebsite - www.nhfdc.nic.in). Each applicant shall be given a registration number on receipt of the applicntion. The screening committee shall examine these applications

quarterly and the scholarship amounl will be disbursed. Conl'd.... P/4

---­

----

--- { _)I]

;Ll;

.....~.

7.2 Renewal or tho scholarshll) IS <.lutornaUc ill IICXl yc<Jr sul>JCCI lC) Juccc:.:•.lul (,l)lllpll!liOII CJ( the

course In the previous year. I lowcvcr, in case of students wath cercbml ralsy, mental rclarllalion, mental Illness, multiple disabilities and profound server hearing impairment, one yeur eracc period may be allowed.

7.3 Along with the application the followang enclosures will have to be furnished:

(1). Academic rccoru - uttcstcu copies or relcvnnt ccrllrlc<JIC!i/rnnrk sheets for the qualifying examination.

(1i). Proof of anhual income - Proof of income shall include last salary slip of poronl/p,u:-~rdlnn, nclmowlenr.ement of income ta)\/lncome certificate e from revenue ofrlclalfgazcltcd orriccrjpubllc rcproscntol/vo o.u. MP, MU\, MLC, Panchayat officials etc.; '

(Iii). Disability qertiflcate;

(lv). Course tel receipt if any, duly paid during the academic session;

(v). RecelpVInvoice of eligible asslstlve devices du ly countersigned by the authorized signatory of the institution;

(vi). In case of continuation of scholarship in a succeeding year, a copy of the mark sheet of the preceding year.

8. ProCessing of applications

(a) The procedure for processing of applications will be out sourced to a reputed agency;

(b) All the applications will be processed In a time bound manner;

(c) The applications scrutinized by the authorized agency shall be placed before a screonlne committee poriotllcnlly ror final oword of scholor!ihlp!l;

(d) Income ccrlirlcale Is to be submitted by the student only once i.e. at tho time of I.

soncllon or scholarship, "\ -­--_,::: ­*******************•••·····

--1

'~---­

Government of India Ministry of Suciai.Jnstiec & E.mpowcrrncnt

Nntionnl Scholarship fnr l'crsons "ith llisahililil'l! (211 IJ. J~ )

The students with disabilities have to upply Online (www.nhli.lc.nic.in) nnJ submit hard C<'PY of the printed npplicntiun duly recnmnu:ndcd from the head of the Institution l:ttcst hy 31'1

August, 1013 for financial assistance for pursuing higher and technical education. El igibility conditions etc. for the Scholarship as follov>s:

I. Eligibility: ­

(I) Financial assistance will be available to Indian students with at least 40% disabilities certified as1Jcr definition under Pers~ns with Disabilities Act 1995.

(2) Finnncinl ossistnnce will be given fol' pun;uing post-Mntric/Post-Secondnry technical and professional courses including Ph.D & M.Phil fwm recognized institutions. However, for students with disabilities of Cerebral Palsy, Mental Retardation, Multiply Disabi lities, and Profound or Severe Hearing lmpnircd, the minimum educational qualification will be class . VIII pass untl scholarship will be awarded to them for pursuing gcnernl, tcchnicnl, vocntionnl or professional courses.

(3) Scholarship will be awarded to one student for pursuing only one course.

(4) finnncinl assistance can be given for computer with c<.liting solhvnre for blind/ deaf grnduate nml postgraduate students pursuing professional courses and for s~pport access son wore for cerebral palsied !>tudcnts.

(5) Continuation/ renewal of the award for next year will depend on successfu lly completing the course in the preceding year with minimum 45 (forty fiOy) percent marks for professional courses and 40% for other courses.

(6) The Assistance under this Scheme is not intended for Post-Matric/Post Secondary · ' Tcchnicni/Profcssional courses hnving duration of less than one yenr.

(7) A scholarship holder under this scheme will not concurrently hold any other scholarship/stipend. If alrendy any other scholarship/stipend ownrdcd, 'he student is required to exercise his/her option for choosing the scholnrship thot he/she proposes to avail ond inform awarding authority about the same.

(8) Monthly family income of the beneficiary should not be more than Rs. 15,000/­from all sources. Family income includes income of the parcnt/guordion,

II. Awards:·

Upto five hundred awards are to be given annually through institutions in which students ore pursuing studies/comses. Scholnrship will b~.: given to different cntegorics of disabled students ns under:

Mnle Students Fcmnlc Students .. (I) Students with orthopedic disnbility 58 ~words 58 Awards (2) Students with blindness or low vision 58 Awnrtls 58 Awards (3) Students with hearing disability 58 Awards 58 Awards (4) Students with Cerebral palsy, Mental Retardation, 76 Awards 76 Awards

Multiple Disabilities, Profound or Severe Hearing Impairment

Total : 250 Awards 250 Awards

Amount of scholarshir will vary among courses and will also dercnd on avnilnbility of hostel/residential facility with the institution. The details urc given below:

(Jt~. l 'l•r IIIUIIIh)

Hntl' of S.No Cour~l·s of Sturly ~chulnrshiJI Da;•

hustcllcrs scltolars (H.s/mon th) (I W

mooth)

(I) Ph.D. I M. Phil and Post G raduatc/Grnduntc level 1000 700 courses in Engineering/Indian nnd other systems

/'of Medicine/ Agriculture/Veterinary/ IT/ Oiotcdmology, Educmion Mnnngcmcnt I /\ rcll itccturc, l'hysiolhcrapy, Music and other professional courses

(2) Diplo111n nnd ccrtilicmc level prolcssionnl cour~cs 700 400

(J) In respect of students with cerebral pal~y. mcntnl 700 1100 rctnrdntion, multiple disabilities ond profound or scv~re hearing impainnent, for pursuing gencrallprofessionall!cchnicallvocational cour.;es afier class VIII

Ill. The students will nlso be reimbursed the course fcc subject to a ceiling or Rs. l 0,000/- per year. Besides students living in the hostcl/rc~idcntinl fncility p10vidctl hy the Institutions, those students will ulso be consiclcrccl us hostcllers who live in accommodation hired at least by a group of 3 students living together with common mess arrangement. Such students will hnvo to furnish a certificate in litis regard countersigned by th e hcnd of th e Institution nnd n cer tilicnte fro111 the owner uf the house In cnllc of own nrruugclllCIII or uccO IIIIIIOdnllon tnkcn on rent.

IV. Applications for the scholarship is required to be submi tted in as per the prescribed proforma (Annexure 'A'). Applications for renewal/continuation of award arc to be submitted in the prescribed proforma as per (Annexure 'B'). No other proforma is to be adopted for making the application. The l:lst date for receipt of upplication for new cases ns well ns rencwaVcontinuntion is 31'1 August, 2013.

Y. List of enclosures (n ttcstcd copies only):

(i) J\codcmic records (nttcstcd copy ofcertificates and Mark,-;hcets- mntric & above), (ii) Family Income Certificntc/ Proof uf nnnual income, e .g. Snlury Slip, ln!!l Income tux Assc:~smcnt order, (iii) attested copy of Disnbility Certificate (iv) Course fee receipt (if nny) with break up of each item duly paid during the academic session (v) Hostel Certificate or certificate from the house owner in case ofaccommodation hired by at least by n group of 3 students living together with common mess nrrnngcmcnts.

VI. The Hard copy of the printed applications for the scholarship may be sent to the Na tiona l Handicapped Finance nnd Ocyelopment Corporntion (Ministry of Socln l Justice & Empowermen t, Govt. o f l ndiu), l~ ccl Cross Bhuwnn, Scctur- 12, FurltluiJIHI-121 007 (Haryunn). Telephone no. 2226910, 2287512, 2287513, Fn x-0 I29-22843 71, ~-JIIIlil­nhfll£27 (f!lgrnnil .com

I.--­,- ---­

-----

I\ Stmlt:nl :.:lwuld submit only o111: applkalion along with all the rd c van! dm:nnlcnts together

wi th rccommcntlations or I he Ins! iltl l t' conccrncJ.

Applit:otio11s !'or the awnrd nl' Sl'.hn l:trslrip will ht: counlc.:rslgnl'd lllld l l'l'llll ll lll'ltdl'd by l ltt' lwnd of the institution in which thc :1pplicant is cmollctl for s!llc.ly. lkta ils of the schcmcs nrc .also be nvni lnblc on the Ministry's website W\vw.socialjusti cc.nic.in or wcbsitc of NII FDC www.nh fdc.n ic.in or may be obtained from National llandicnppcu Finance and Development Corporation (Ministry of Social Justice & Empowerment, Govt. of India), Red Cross Ohawan, Scctor- 12, rnri<.lnbn<.l - 121 007 ( ll ttry:mu).

Applications received aflel""thc lnst date i.e. 30.08.2013 and incomplete applications (without requisite documents) will not be considered.

J'

\.

~

--I ) I ,

_) ~J•Iic!!J!"" .'\u.( _____.

{fur uffirlnl uu•)

(T u be fi lled u p by the t"nud lclntcl (I) Nome of the C:mdidote:

(2) Name of the State :

(3) Residcnti:!l Address :

( ol ) Institutional Address :

(5) Male/Female :

(6) l!ducntionnl QunlificntiClu:

(7) Nnmc of the 13oard/Universitf :

(8) Course applied for:

(9) Duration of Course :

(I 0) Type of Disobili ty :

(II) Percentage of Disability:

( 12) Academic records (Allnch Cor•Y of ccni ficntc f'nHc No.__

aod Marks sheets- Mntric &. :.bovc)t•

( 13) Family Income Ccrtificotc/l'roofof Annuollncomc P••gc !\o.__

e.g. snlory slip, lnst Income tnx n~~c~smcnt nrdcr

( 14) A nested copy of Disability Ccrtilicotc Page No.__

(I 5) Course fee receipt (ifany) with brc;~k up of each Page No. __

item duly paid during the oc;~demlc scssiun

( 16) Hostel Cenificate or Certificate from the house Page No.__

owner in case ofaccommodation hired by at

lclbt by II group Of 3 stuth:nts livi nK together

with common mess arrangement. (Ccrti licnte should be submitted in orisinnl)

'(Photo copies ofthe documents from S.No.l2 to 15 should be attested by the Gnz.cttcd olnccr)

(For official usc)

( I) Course applied for : Profcssion:li/Non-Proicssional

(II) Qualification required for the course

(Ill) Marlu obtained:

-------------------

Ut

ANNEXU HE-A

/'AWl' - II

Applicnlion for nwnrd nf S('hvlnl'.~ldp to frc)ih slutlcul~ with dl.~u bilitk~ (2013-14) (All inli.lnrultion should be given <.:ithcr in English or in I lindi only)

!.Name _______________________________________________

l'hologrnph (11~ In l\1nt rkulnllon l'l'l ' lilicnlcl.sdHJt~ l r·c~or ·th)

\ ' 2. Address ______ \

(Pnssport Size)

Duly nttcstcd by lhe __________Stntc - .f------l'in._________ __

Tele no.(ifany)____ ____ Institute

3. Date of Birth

4. Sex please specify {M-Malc, f -femalc):

5. (i) Type of disability (Pl ease specify)------- ---­

[(I) Orthopncdicnlly l lnndicaprcd, (2) !!caring llnmlicnppcd, (3) Bl inc..lncss or Low Vision, ( tl) Other <.lisubilitlce

e.g. ~crebrnl Palsy, Mental Retardation Multiple Disabi lities, Profound or Severe !I caring l lanc..licappcd] 1..

(ii) Disability Percentage (Please enclose an aHcstcd copy of the disnbil ity certificate)

6. Educational Qualifications: -

Exnminution Numc of the Nnmc of the Mnjor Aggregate mnrks Clnss/

Passed lr~s titution l3onrd/ Univers ity Subjects obtained & % Division

thereof"

Class VIII

Matric/ Secondary

Sr. Secondary/ln~ermediate

.. . Grudunlion

Others

• In case of grndcs, p lco~c 1\lcntion cquivnlcnl% of ll!Urks nnd nlso enclose nuthcntlcntcd

convers ion formula

- - -

7. Family Income per annum ( in Rs.) _(plcn!>c enclose Income Ccr1 ificntc)

8. (i) Course arplie<.ll()(' (corllplctc..: lltlllH!) --------~-­

(ii) t\cndcJ11ie Scs~iun - - ------- ­

(iii) Duration

(iv) Date of Admission-- -·- ----··- ----­

9. Name and address of the institution where course will be under-taken:­y

\

I 0. Whether hostcllcr or(u duy ::;t:lwlar please spcci l'y________ (I I' hostdlcr, please

specify whcilwr provided by the institution or own nrrnngcmcnt nnJ nddrcss of the

hostel):

________________(please enclose certificate)

11 . !$tails of Scholarship/Stipend/financial assistance being received for the same course (if·.:

any).

12. i\ny other inl'on11ntion npplicHJI! wishes tu pmvith: .

I hereby declare that information provided above is true to the best of my knowledge and I am

nwnrc thnt prov iding wrong inronnnli nn will 111nke rnc liable to lcv,al ncrion nnd recovery of

scholarship amount.

Name & Signature of the applicant

Date:

Place:

Enclosures:

I.

2.

3.

4.

5.

-----------------------

--------------

----------------

g · ·

(TO BE FILLED IN BY INSTITUTION)

Reco mmenda tion of the iustilul iou

(only one application per student is to be recommended)

I. Certified that Sh ri!Kum./Sml. I II Ill

------1"· is studying Year Year Year

course of which is

(please tick the relevant or specify) Diplorna/Dcgrcc!fG

level study/any other (please specify I

·r. ) and is presently studying in -

IV Ycnr

(Tick whi~hcvcr is applicable)

The duration of the course is

2. Thci~nformation furnished above by the student is in order and correct a~ per records of the

Institution.

3. The student is receiving scholarship/linancinl aid/stipend from -------- - /not

rece1vmg any scholar:ship/financial aid/stipend from nny other source ns per records of the

lm:titutc

4. General conduct of the student is satisfactory/ unsatisfactory

(please strike out whichever is not upplicoblc)

Signature & Name of !-lead of Institution Registrar/Dean

Da te:

Place:

Seal of the Institution

,. J

------------------------------------------------------

- --------

--------------- ------------

---------------------

·- ------- ­

Anncxurc-B

PAI~T-B

Application for Continuat ion/Renewal of awa rd of Nationnl Schola rship fo r Persons with

Disabilities (2013-14)

(All information should be given either in English or in Hindi only) ~

1. Name (as in Matriculation certificate/school records)

I \

2. Address

r. State Pin

Tcle no.(ifany)___ _ _ ___ _

3. Date of Birth

4. Sex please specify (M-Male, F-Fcmalc) :

5. (~ Type of disabi l ity (P lease specify) -----------­.r

(I) Orthopaedically Handicapped, (2) Hearing Handicapped, (3) l3lindncss or Low

Vision, (4) O ther disabilities e.g. Cerebral Palsy, Mental Retardation, Profound or Severe

Hearing Handicapped

G. Educntionnl Quuli licntions: •

Examination

Passed

Name of the

Institution

Name of the

Board/ University

Major

Subjects

Aggregate

obtained

t hcrco~

marks

& %

Class/

Divisi.on

Class VIII

Matric) Secondary

<

Sr. Secondary/ Intermediate .. .'

Graduation

Others

• In cnsc of grudcs, plcusc mcn!1on cquiVtdcnt% of rnurk.s unu ulso enclose uulhcnltculcd

conversion formula

-------------

/ I -

) .I - ..._

7. J1mily Income pL'r annurn (in l~s.)_ _______(plcusc enclose lnt:olllL' Ccrtilicmc)

8. (i) Course applied for (complete name) -----------­

(ii) /\endemic Session ____________ __

(iii) Duration _______

(iv) Dntc of Admission

9. Name and address of the institution where course will. be under-taken. ?

------·------.----- - ···---- ··-" ·-· -- .... __, __..,.____ ---· .. ---.. --- - -· I ,I0. Whether hostc'ller or a flay scholar, please specify______ (If hostcllcr please I ' I·: specify whether provided by the institution or own orrangcmcnt nnd address of the '

hostel):

_____________________(please enclose certi ficate)

II. Details of Scholarship/Stipend/financial assistance being received for the same course (if

any) .

ll(a). If in receipt of Scholarship from the Ministry oJ Social Justice & Empowerment,

please indicate the year and registration number of the application (if any) \ .

12. Any <llhcl' in 11.)1'111111 ion thnl the npplkn11l wishes to provide :

I hereby declare that information provided above is true to best of my knowledge and I am aware

that providing wrong information will make me liable to legal action ond recovery of scholarsh ip

amount.

Namf & Signature of the applicant

Datt:;:

Place:

Enclosures:

I.

2.

3.

4.

5.

--------------

(TO Ul~ FlLLI!:U IN UY INSTITUTION)

Hccommcndation of the in:-; titution

(only one npplication per student is lo he recommended)

I. Certified that Shri/Kum/Sm(___ -'--~----- is stud ying course of

which is (pkusc tick the relevant or specify) IJiplolll.u /IJcgrcc / f>G level---- ------- \

study/any other (please spedfy)--·---.. ----------------- ·- und is presently studying in---­

(Tick whichever is n~pl icnble) I'Year I"Year 11 11 Year ' IV Year J

The duration of the course is

2. The information furnished above by the student ls in order nnd correct ns per records of the

Institution. :"

3. The s(udent is receiving scholar:ship/ flnancial aid/stipend from ----- ----'/not

receiving any scholarship/financial aid/stipend from nny other source ns per records of the

Institute

4. General conduct of the student is satisfactory/ unsatisfactory

(plcnsc strllw out whichever 1:; not npplknlJlc)

Signnlurc & Nn111c of Ilend of

Institution /Registrar/Dean

Date:------ ­Place:------ ­

Sc~tl of the Institution