S.No(for official use only):
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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
who passed SSC in March 2005 with a
minimum of first class) Use only Capital letters
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Name |
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Surname |
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Date of Birth (DD/MM/YYYY) |
/ /19 |
Sex (M/F) |
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Father’s Name |
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Occupation |
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Mother’s Name |
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Occupation |
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Family Income PER YEAR (Attach Certificate) |
Rs. |
Religion |
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Caste (Attach Certificate) SC–A/B/C/D or BC-C |
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Sub caste |
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Address for Communication |
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House No. |
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Tel. with STD |
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Mandal/Taluk |
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District |
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State |
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Pincode |
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Education-SSC (Attach
SSC Certificate) |
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Class Obtained |
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Marks Obtained/Total Marks |
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Name of the School |
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Street/Town/village |
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Mandal/Taluk |
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District |
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State |
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Pincode |
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HM/Principal Name |
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Tel. with STD |
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Education-Intermediate (Attach Study Certificate) |
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Subjects/Group opted |
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Name of the College |
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Mandal/Taluk |
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District |
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State |
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Pincode |
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Principal Name |
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Tel. with STD |
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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
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(Paste Photo Here) |
Signature |
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Place |
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Date |
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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