††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† S.No(for official use only):

Ambedkar Scholarships

302,CHANDRA GANGA ENCLAVE BRUNDAVAN COLONY,DR.A.S.RAO NAGAR,E.C.I.L.POST,HYDERABAD-500 062 (Application for Dalit students whopassed SSC in March 2005 with a minimum of first class)†††††††††† ††††Use only Capital letters

Name

 

 

Surname

 

Date of Birth (DD/MM/YYYY)

†††††††† /††††††††††† /19

Sex (M/F)

 

Fatherís ††Name

 

Occupation

 

Motherís Name

 

Occupation

 

Family Income PER YEAR (Attach Certificate)

Rs.

Religion

 

Caste (Attach Certificate) SCĖA/B/C/D or BC-C

 

Sub caste

 

Address for Communication

House No.

 

Tel. with STD

 

Street/Town/Village

 

Mandal/Taluk

 

District

 

State

 

Pincode

 

Education-SSC (Attach SSC Certificate)††††††††††††††††††††††††††††††††††

Class Obtained

 

Marks Obtained/Total Marks

††††††††††† /

Name of the School

 

Street/Town/village

 

Mandal/Taluk

 

District

 

State

 

Pincode

 

HM/Principal Name

 

Tel. with STD

 

Education-Intermediate (Attach Study Certificate)

Subjects/Group opted

 

Name of the College

 

Street/Town/Village

 

Mandal/Taluk

 

District

 

State

 

Pincode

 

Principal Name

 

Tel. with STD

 

Essays: Write 3 essays in your own words on the following topics on a separate paper in Telugu/English(it is a must to receive scholarship): Please write your name and address at the top of each sheet of paper

  • What do you know about Babasaheb Ambedkar, his life and mission?
  • What do you plan to achieve in life? How and Why?
  • How do you plan to help others in your adult life?

 

 

 

 

††††††

†††††† (Paste Photo Here)

 

 

 

 

 

 

Signature

 

 

 

Place

 

 

Date

 

Important Notes: 1. Attach Xerox copies of certificates wherever mentioned.††

2. Please send applications by ordinary POST only †††

3. Selected candidates will be informed by post. No other communication is entertained. ††

4. For further details please write to us at ambedkarscholarship@yahoo.com

www.ambedkarscholarship.org