Electronic Clearing Service

ELECTRONIC CLEARING SERVICE

Particulars of Student

1. Name of student:

2. Roll Number & Branch:

3. Telephone No & E-mail ID:

4. AadhaarNo(Attach a Copy):

Particulars of Bank Account (Please attach a photo copy of cheque/ Bank Passbook)

5. Bank A/c Number (Linked/ Seeded with Aadhaar Card):

6. Bank Name:

7. Branch Address:

8. Bank Telephone No:

9. M.I.C.R. (9 digit number):

10. IFSC code of Bank:

11. Bank A/c type (Saving/Current):

Signature of Bank Authority

(Bank Seal)

Undertaking

Certified that my above mentioned Bank Account is Aadhaar seeded/Linked with the Aadhaar.

I do not wish to avail any Govt. Scholarship

Dated:Sign of students/ Beneficiary

GOVT. OF NCT OF DELHI

AMBEDKAR INSTITUTE OF TECHNOLOGY

ISO 9001:2008 CERTIFIED INSTITUTE

SHAKARPUR [EXTN.], DELHI-110092

Website:-

Tele:-011 22023594,22460311,22428339 FAX No:- -011 22023594

Undertaking from the student applying for MCM scholarship

I,S/O. WithBTE Roll no: , Class: Semester:______Hereby undertake that my parental/family income from all sources is not more than Rs.2.00 Lakh per annum and I have not applied /availing any other scholarshipfrom any organization.Further, I undertake that in case the information is found false then I will return the entire amount of scholarship with interest to the institute and any action can be taken against me by the competent authority of the institute.

Signature of the parent/Guardian Signature of the student

GOVT. OF NCT OF DELHI

AMBEDKAR INSTITUTE OF TECHNOLOGY

ISO 9001:2008 CERTIFIED INSTITUTE

SHAKARPUR [EXTN.], DELHI-110092

Website:-

Tele:-011 22023594,22460311,22428339 FAX No:- -011 22023594

APPLICATION FORM MERITSCHOLARSHIP

Name of the student : ______
Father’s Name : ______
Father’s Contact No. :______
Class in which studying : ______
Board Roll Number : ______
Address : ______

______

Mobile Number : ______
Percentage of marks : ______
Whether belong to SC/ST/OBC/Minority : ______

______

If yes, Details : ______

Signature of the student

Certified that mentioned Bank Account is linked with the Aadhaar.

Signature of class Proctor Signature of HOD

Signature of Scholarship In-Charge

List Of Attachments:-

Marksheet copy should be attested by Gazetted Officer.
Undertaking form.
ECS Performa along with Cancelled cheque. And Copy of bank pass book .

GOVT. OF NCT OF DELHI

AMBEDKAR INSTITUTE OF TECHNOLOGY

ISO 9001:2008 CERTIFIED INSTITUTE

SHAKARPUR [EXTN.], DELHI-110092

Website:-

Tele:-011 22023594,22460311,22428339 FAX No:- -011 22023594

Undertaking from the student applying for Merit scholarship

I,S/O. With BTE Roll no: ,Class: Semester:______Hereby undertake that I have not applied /availing any other scholarship from any organization. Further ,I undertake that in case the information is found false then I will return the entire amount of scholarship with interest to the institute and any action can be taken against me by the competent authority of the institute.

Signature of the parent/Guardian Signature of the student

GOVT. OF NCT OF DELHI

AMBEDKAR INSTITUTE OF TECHNOLOGY

ISO 9001:2008 CERTIFIED INSTITUTE

SHAKARPUR [EXTN.], DELHI-110092

Website:-

Tele:-011 22023594,22460311,22428339 FAX No:- -011 22023594

APPLICATION FORM MERIT CUM MEANS SCHOLARSHIP

1. Name of the student :______

2. Father’s Name :______

3. Father’s Contact No. :______

4. Class in which studying :______

5. Board Roll Number :______

6. Address :______

______

7. Mobile Number : ______

8. Annual Family Income:______

9. Percentage of marks :______

10. Whether belong to SC/ST/OBC/Minority: ______

If yes, Details :______

Signature of the student

Certified that mentioned Bank Account is linked with the Aadhaar.

Signature of class Proctor Signature of HOD

Signature of Scholarship In-Charge

List Of Attachments:-

1. Income Certificate from SDM office for proof of family income less than 2 Lakh.

2. Marksheet copy should be attested by Gazetted Officer.

3.Undertaking form.

4.ECS Performa along with cancelled cheque and Copy of bank pass book .