1PRIME MINISTER’S SCHOLARSHIP SCHEME ACKNOWLEDGEMENT SLIP OFFICE COPY Your Application Form dated_________ has been received on__________. The application will be examined for eligibility. The dak receipt number ____________ is to be mentioned for further correspondence with this office. Office Seal: (Signature of RSB) Tear off Tear off ACKNOWLEDGEMENT SLIP STUDENT COPY Your Application Form dated_________ has been received on__________. The application will be examined for eligibility. The dak receipt number ____________ is to be mentioned for further correspondence with this office. Office Seal: (Signature of RSB) Note: This copy duly stamped and signed by RSB given to the student by hand or by post. (Envelope enclosed along with the application may be used.) 2 MINISTRY OF DEFENCE Department of Ex-Servicemen Welfare PM’S SCHOLARSHIP SCHEME FOR DEPENDENT WARDS OF EX-SERVICEMEN / WIDOWS Brochure-Cum-Application Form For Academic Year 2009-10 Application Form consists of Col No 1 to 20, Renewal Form and list of RSB at state and UT level. (Brochure-Cum-Application consists of 31 pages) KENDRIYA SAINIK BOARD West Block-IV, Wing-VII, 2nd Floor R K Puram, New Delhi-110066 Website: www.mod.nic.in Tele : 011- 26715250 E-Mail :
[email protected] Note: This application form (page number 13 to 22 alongwith required documents only) is to be deposited by individual to RSB. Applications duly recommended by RSB’s shall only be considered by KSB. Therefore, candidates are advised not to forward applications direct to KSB as the same shall not be considered. 3 PRIME MINISTER’S SCHOLARSHIP SCHEME 1. Introduction. To encourage higher technical and professional education for the dependent wards of ESM and their widows (below officer rank only) and dependent wards / widows of exservicemen who died in harness due to causes attributed to military service, irrespective of the rank, Prime Minister’s Scholarship Scheme has been introduced from the Academic year 2006-07. 2. Scholarships Available. A total number of 4000 scholarships will be allotted. 3. Students eligible for the scholarship. (a) (b) (c) Note: (i) Dependent wards of ex-servicemen and their widows (below officer rank only) Dependent Wards/widows of ex-servicemen who died in harness due to causes attributed to military service, irrespective of the rank. The scheme is open only for widows and wards of ESM. The candidate irrespective of his marital status is eligible for PMSS. However, an earning / serving candidate is not eligible. (ii) For dependent wards of widows and widows of personnel died in harness due to causes attributable as at (b), there will be no rank restriction. 4. How to Apply For Scholarship. One candidate to submit only one application form for one course, if any candidate submit two application for more than one course, both the applications will be rejected. Forms are to be downloaded from the website www.mod.nic.in. Application forwarded on any other format will not be considered. Application to be forwarded on plain A4 size paper (typed or handwritten) in the prescribed format duly completed in all respects with superscription on the envelope “Prime Minister’s Scholarship Scheme.” Documents to be attached alongwith PMSS application form are as follows:(a) (b) (c) Photocopy of ESM valid I card duly certified by RSB / ZSB. Extract of ESM discharge book as per specimen. (Refer page number 22) Matriculation certificate duly attested. Wards/widows of defence personnel who died while in service for causes attributable to military service. . Selection Procedure. graduate level only under PMSS.e. 8. The facility under PMSS is restricted for professional courses only duly recognized by the respective Government regulatory bodies such as All India Council for Technical Education. Eligible Courses.4 (d) Minimum Entry Qualification certificate duly attested. Scholarship for Integrated Courses. (10+2 Marksheet or full Graduation Marksheet which ever is applicable) (e) (f) Bonafide studentship certificate from Collage in original as per specimen. (Refer page number 21) Demand Draft of Rs. 6. PRIORITY for Grant of Scholarship. Wards of ex-servicemen disabled in action and boarded out of service with disability attributable to military service.not made before 20th December 2009. B Tech. The candidates may avail only one time facility for first degree course (Professional) i. Applications will be short listed based on Ex-servicemen category (as given in para 6) and percentage of marks obtained in minimum entry qualification (MEQ). Wards/widows of Defence personnel disabled in service with disability attributable to military service. 5. etc. BBA. B Pharma. Order of preference for allotment of scholarships will be as under:Category 1 Category 2 Category 3 Category 4 Category 5 Category 6 7. Wards/ widows of defence personnel killed in action. UGC etc. B Ed. First year professional degree programme in BE. Medical Council of India. The scheme is open for courses mentioned above in recognized institutions (in India only). Note: Failure to attach any above mentioned documents / certificate will lead to rejection. MBBS. 30/. Wards of ex-servicemen (PBOR). BCA. Students studying abroad are not eligible for this scheme. duly recognized by the respective government regulatory bodies. Wards of ex-servicemen in receipt of gallantry awards. BDS. Students getting stipend for the professional degree course are also not entitled. such as All India Council for Technical Education. Medical Council of India etc. g. Before 31 December 2009 Finds his name in the list of 4000 successful candidates June 2009 selected for grant of PMSS. for MBBS and B E it is 10+2 where as it is graduation for B Ed and MBA. Minimum Eligible Marks in 10+2 or Graduation. 61% Applied for PMSS. September 2008 Marks in 10+2. 1500/.per month for girls Paid after successful completion of each academic year. 11. Granted fourth installment. a) The amount of scholarship would be as follows: (i) (ii) 12. RSBs will issue acknowledgement slip to the candidates at the time of submission of the application in person otherwise dispatch by post to them. Minimum educational qualification (MEQ) for entry to different professional course is different e. December 2009 Applied for second renewal of Scholarship by submitting October 2010 second year / second two semester result. Candidate shall submit new Renewal Form along with two acknowledgement slip and Bonafide Certificate duly signed by the Principal / Dean / Registrar of the institution / college to the respective RSBs either in person or by post for renewal of scholarship for the subsequent academic year. Two to five years as approved by the concerned regulatory body (Except one year for B Ed and five and half years for MBBS). Amount of Scholarship. Duration of Scholarship. Applied for first renewal of Scholarship by submitting first October 2009 year / first two semester result. Renewal of Scholarship. Rs. December 2010 Applied for third renewal of Scholarship by submitting third October 2011 year / third two semester result. For easy comprehension an illustration has been given below:Student admitted in B Tech. 1250/. A candidate must have minimum 60% marks in MEQ to be considered for scholarship. . Granted third installment. December 2011 Applied for fourth renewal of Scholarship by submitting October 2012 fourth year / fourth two semester result. RSBs will scrutinize and check the application forms and forward the same complete in all aspects to KSB immediately. Candidate to attach a self addressed envelope. duly stamped to receive the acknowledgement of renewal form by post. Granted second installment. 10. December 2012 * Dates given above are to illustrate an example for easy comprehension and the same may not be quoted as authority.per month for boys Rs.5 9. (Minimum Educational Qualification for Entry) should be 60%. Granted first installment. if any. (f) List of selected candidates will be forwarded to RSBs after the merit list is finalized by the BOO at KSB. (k) Candidature of a student shall stand automatically rejected if. In case. 5 each) blank envelopes of 27x12 cms and one stamped (Rs. “latest by 15th Feb 2010. failing which the scholarship will be held up. at any stage. This should be in uniformity with the discharge book / certificate of the ESM. The application will be received by the RSBs and will be acknowledged with a seal and date of receipt. (e) Candidates and RSB’s to note that all applications received after the due date will not be considered and returned unactioned. (d) The concerned RSBs may scrutinise / check the application forms with regard to their eligibility criteria from all aspects prior to forward the same to KSB. (i) The amount of scholarship. Particulars of all children should be indicated in column 17 of application form. (a) “PM SCHOLARSHIP SCHEME” is to be written in superscript on top of the Envelope for any correspondence with KSB & RSB. it is discovered that he / she has secured scholarship fraudulently by making false statement or misrepresentation of facts. (c) Applications alongwith relevant documents & certificates are to be deposited to respective Rajya Sainik Board. a student is liable to produce the same. (g) Three stamped (Rs. (j) The payment of scholarship will be granted after the successful completion of each academic year and on the submission of the renewal form (in original). 35) blank envelope of 35x25 cms are to be attached with each application so as to facilitate correspondence with the candidate by KSB/RSB. Incomplete application form and non submission of required document is liable to be rejected and will be returned unactioned. (h) The scholarship is admissible for only two children of ESM. (b) Checklist duly signed by student & parent is to be attached on the top of the application form. including any other scholarship or financial assistance from any other source will not exceed the total grant of assistance available under this scheme. Candidate shall have to refund the amount already given. KSB ask a student to submit the mark sheet for the full year. as per the percentages mentioned in ‘Criteria for eligibility’. .6 IMPORTANT INSTRUCTIONS FOR PM’S SCHOLARSHIP SCHEME Incomplete form / pages / column / documents will lead to rejection or returned to RSB unactioned. (p) In case of change of any address. (t) While filling the application form. leave 1 (one) box blank between 2 (Two) words. (s) The application form should be downloaded from the official website of MOD.e State Bank of Travancore. to facilitate transfer of the scholarship amount. the same can be obtained from the Secretary / Director Rajya Sainik Board. Government of India can suitably modify these instructions to remove anomalies. it is to be intimated immediately to Kendriya Sainik Board & Rajya Sainik Board in writing. as amended from time to time. Candidate to attach a attested photocopy of passbook. Always mention selection serial number.e. (o) The candidates should have secured a minimum of 60% marks at 10+2 / MEQ level or equivalent and have to secure minimum of 50% marks. . A person granted scholarship for one programme would not be entitled for scholarship for another programme. In case of any difficulty in obtaining the form. (n) All candidates to open individual bank accounts in the nearest State Bank of India branch or Punjab National Bank which has “electronic clearance system” / Core Banking. The Demand Draft should not be issued before 20th December 2009 (the Demand Draft is not refundable in any case). etc. name of applicant and ESM particular for any correspondence with KSB & RSB after getting selected for the scholarship. The definition is available in the guide book available with the RSB/ZSB. Column wise guidelines are explained further for filling up the application form. payable at New Delhi.mod. A joint account with parent will also fulfill the requirement.7 (l) The attached photocopies of the supporting documents should be duly attested by gazetted officer (unattested documents will not be considered). for successful implementation of the scheme. uninterrupted for continuation of scholarship in every year for the duration of course up to a maximum period of 5 years as prescribed for that programme of study. RSB / ZSB. Kendriya Sainik Board. A cancelled leaflet of a blank crossed cheque will duly authenticate the account number. showing name and account number of the individual.nic. i. Account number of the sister concern bank will not be accepted. (q) The Ministry of Defence. along with a Demand Draft (Repeat) Demand Draft only for Rs. (r) Ex-servicemen entitlement will be governed as per the existing definition of ex-servicemen. State Bank of Bikaner & Jaipur. course. then equivalent percentage (100 point scale) duly certified by the concerned college / Board must be furnished (RSB & KSB will not be calculating the percentage of marks). if any.in favour of Secretary. i. (m) If the marks in the qualifying examination are expressed in grades only. as may be necessary from time to time and will be applicable to all students under the scheme.in. college. the certificates are to be attached with the application form duly attested by Secretary. www. In case of legally adopted son/daughter or child born after retirement. (List of RSBs is attached along with the brochure) duly completed. The application form should be submitted to the respective Rajya Sainik Board.30/. Fill your name as in matriculation certificate only:(Not to be filled in any other format. (v) Column – 5. Category as per para 6 to be written (attach the required document.(10 June 1982) D 1 (iv) D 0 M 0 M 6 Y 1 Y 9 Y Y 8 2 Column – 4. Category (viii) 1 O N E Column – 8. Write your permanent address and correspondence address in block letters. Put a tick (√) mark as shown. Date of Birth as shown in matriculation certificate only. A blank space to be provided between names. (Example: . Full Particulars of Father/ Ex-Serviceman is to be mentioned as per the discharge book. (vii) Column – 7.8 COLUMN WISE GUIDE LINES FOR FILLING UP OF APPLICATION FORM (i) Column -1. (vi) Column – 6. √ Female Column – 3. from where your father / mother have registered and have obtained ex-servicemen / widow identity card. For Example:. Mention your Rajya Sainik Board and Zila Sainik Board name. Category 1 (One). if any).KAMLESH CHANDRA CHOUDHURY) .) 1st Name Middle Name Surname A S R J I A A N N Y G A H (ii) Male (iii) Column -2. Write phone number along with STD code and email ID for any query (email ID is must). Marks obtained (in words) (in figure) c. Tick as applicable. Duration of the course both in numbers and figures to be mentioned. Total Marks (in words) (in figure) b. E N E 3 N T E 3 T Y T E I I R G T H Y T T H 0 E T Y H U N D R E D H U O N U D S R A E N D D H (x) Column – 10.9 K A M L E S H 1 4 5 2 3 6 K C H A N D R A C H O U D H U R Y S E R G E A N T A I R F O R C E (ix) Column – 9. Leave blank space between words. Yes √ No (xi) Column – 11. (In figure) . For example 5 years 6 months. (Example:. % of marks scored (in words) (in figure) O T 1 N F 9 S P T 7 N W 2 I O 4 E O H 8 E O 0 N R 0 V I R . a.B TECH) B T E C H (xii) Column – 12. Marks to be shown in words and figures. The student is to specify the course which he / she is presently studying. Details of 10+2 or MEQ. 0 8 E A T I T 0 4 3 I N S T I T U T E Name of College A J M E R O F T E C H N O L O G Y Full Address of college P U S H K A J M E R R B Y P A S S A State Pin Code R 3 A 0 J 5 A 0 0 S 0 1 T 4 H A N Tel No. Write date of commencement & completion of course as shown (Course Commencement / Date of Admission) D 0 D 1 M 0 M 7 Y 2 Y 0 Y Y 0 7 (Course completion) D 3 D 1 M 1 M 2 Y 2 Y 0 Y Y 1 2 (xiv) Column . Name of Student Roll No. (with STD Code) 4 5 - 2 3 0 0 6 2 8 E-Mail ID (if any) a l i .10 Y 0 (In word) F I V M O N E T H Y S E A R S A N D S I X Y 5 M 0 M 6 (xiii) below: Column – 13. t _ a j c o M m e r @ r e d i f f m a i .14 Write the full name and address of the college with email ID and A J A Y S I N G H R A N A phone number of principal. Sl. 1 2. No. given by KSB 6359 Name of the brother/sister Satish Singh Rana Course of Study B Tech Academic year in which applied 2007-09 Amount received so far 15000 (xviii) Column .18 Please write the full details of bank account of the student and attach the photocopy of passbook and cancelled cheque as required to verify the correctness of the account number (individual student account is preferred. Name of account holder A J A Y S I N G H R A N A Bank Name I A Branch Name S T A T E B A N K O F I N D A J M E R . However. Furnish the particulars of your all children as per specimen Sl. Selection Serial No. Name of Child Prakash Singh Rana Satish Singh Rana Ajay Singh Rana Komal Rana Gender M M M F Date of Birth 10/10/1982 12/05/1984 03/07/1987 14/02/1989 Age 27 Years 25 Years 22 Years 20 Years (xvii) Column – 17.15 Write the regulatory body of your college. 4. a joint account with the father / mother is also accepted). Given details of the scholarship availed by your brother / sister in the past.11 College Website w w w . No. 3. c o m (xv) A Column . a i t a j m e r . if not availed write Not Applicable. 1. I C T E (xvi) given:- Column – 16. No. .12 Branch Address A J M E R E C H N O L O G Y I N S T I T U T E O F T State R A 0 J 1 A S 4 5 T - H A N 2 3 0 0 6 2 2 Bank Tel. Amount (Rs. (PLEASE ATTACH A PHOTOCOPY OF CHEQUE & PASS BOOK) Account No. 0 3 T 2 0 H I R T E Y B A N K O F I N D I A 3 1 5 0 Issue Date D D M M Y Y Y Y 1 4 1 2 2 0 0 9 Demand Draft No. 3 0 2 0 0 1 5 2 4 6 8 (xix) Column – 19.) in word Issuing Bank Name Issuing Bank Branch S T A J A T M E R Note: Application form from page number 13 to 22 along with required documents only to be forwarded. Fill up attached Demand Draft particulars.) in figure Amount (Rs. 3 0 2 0 0 1 5 2 4 6 8 REPEAT Account No. Branch Code 0 5 1 4 5 1 8 0 0 2 0 0 7 MICR (9 digit) No. This is an important document to be attached. (Application form without Demand Draft will not be processed and Demand Draft should not be made before 20th December 2009.g. graduation / diploma etc).) .13 CHECK LIST OF DOCUMENTS TO BE ATTACHED WITH THE APPLICATION FORM 1. (f) Attested photocopy of mark sheet of MEQ as applicable (e. Army / Navy / Air Force (e) Attested photocopy of matriculation or equivalent examination certificate for verification of date of birth. Candidates / ESM are to ensure that the following documents are attached (as applicable) along with the Application Form (non submission of these certificate will lead to rejection and application will be returned unactioned). (g) In case of MBA/MCA applicants. 10 plus 2. (i) (ii) (iii) (iv) (v) Category 1: Category 2: Category 3: Category 4: Category 5: Part II Order Part II Order Part II Order Part II Order Award Certificate Equivalent of other services i. In case the MEQ is graduation / diploma. 30/. (c) If child born after discharge then affidavit is to be submitted by ESM. i.(Rupees Thirty only) attached. (i) Demand Draft of Rs. (b) Extract of ESM discharge book as per specimen. attested copy of minimum entry qualification certificate.e Graduation (h) Bonafide studentship certificate to be issued by Registrar/Dean/Principal of College/Institution pertaining to course for which scholarship is claimed (As per specimen attach). that child is dependent on him and he / she is a ward of ESM. then complete mark sheet is required to be submitted.e. (d) Additional Certificates – Attested copy of following documents. (a) Attested copy of Ex-Serviceman/Widow I-card issued by RSB/ZSB. (Scholarship will not be sent in absence of photocopy of passbook) Date: _____________________ _______________________________ Full Name & Signature of Candidate Place: ____________________ _______________________________________ Checked / counter singed by ESM / Widow . account number with photograph of individual and cancelled leaflet cheque.14 (j) Photocopy of passbook showing name. & Name ......) 3.___. Put a tick mark (√) Male Female Date of Birth (please attach proof of age) (i. Recent Photograph Of Student (Write your name & ESM/widow particular on reverse) Note: 1. Checklist must be attached on the top of application duly tick marked.) 2.... NAME:First Name Middle Name Surname 2.... One candidate to submit only one application form for one course. Your Rajya Sainik Board or Zila Sainik Board (Where ESM is registered and obtained Exservicemen Identity card) RSB ZSB 5.) Please read column wise guide lines carefully before filing the application Application Form to be filled in Capital letters except email ID. Full Address: a) Present Correspondence Address: .) 4... 1..(Where you want your letter to be sent in case of selection / rejection) House No. Street No...15 Selection Serial Number .. 3..e : Matriculation certificate) DD MM Y Y Y Y 4. (To be allotted by KSB) APPLICATION FOR PRIME MINISTER’S SCHOLARSHIP FOR THE YEAR 200_ .... (Mention category as per Para 6 of the brochure and attach supporting documents duly attested). E-Mail (mandatory) 7. & Name Tehsil District State Pin Code 6. Street No. STD Code Land Line No. Mobile No. LEAVE BLANK SPACE BETWEEN WORDS . Telephone Number. Ex-servicemen Category .16 LEAVE BLANK SPACE BETWEEN WORDS Tehsil District State Pin Code b) Permanent Address :House No. Name of Course/MEQ b. Details of MEQ / course for qualifying examination for scholarship (10+2/equivalent or minimum entry qualification) a. / Private source for the course to which the scholarship applied for. Whether the applicant is in receipt of any other financial assistance/scholarship/ fellowship from any govt. Ex-serviceman’s Particulars:a) Name of ex-serviceman b) Service No.17 8. Total Marks (in words) (in figure) d. then state the amount and source Yes Amount Source No 11. Year in which exam passed c. Marks obtained (in words) (in figure) e. If yes. % of marks scored (in words) (in figure) 10. c) Rank d) Type of Service (Tick one) Army Air Force Navy 9. Name of the Course (as per specimen) LEAVE BLANK SPACE BETWEEN WORDS . 16. D D M M Y Y a) Course commenced on D b) Course completion date approximately 14. Name of College D M M Y Y Y Y Y Y Full Address of college State Pin Code Tel No. Duration of Course in Years and months in figure in words 13. degree courses are recognized by AICTE & UGC and all medical degree are recognized by Medical Council of India or Dental Council of India. (For example all engineering degrees and management 15. Details of College / Institute. Date of Commencement and Approximate Date of Completion. Name of Student Roll No. as reflected in the discharge certificate or attached by the RSB/ZSB/Record Office. (with STD Code) E-Mail ID (if any) College Website Regulatory bodies/ Council.18 12. LEAVE BLANK SPACE BETWEEN WORDS . specify as per case). Furnish particulars of all children in order of age. 19 Sl. No. Name of account holder Bank Name Branch Name Branch Address State Bank Tel. No. (Including yourself if granted earlier) Sl. REPEAT Account No. Selection Serial No. No. Details of Student’s Bank account for payment of Scholarship through Electronic Clearing Service. Details of brother/sister availing the PM’s Scholarship. (PLEASE ATTACH A PHOTOCOPY OF CHEQUE & PASS BOOK) Account No. given by KSB Name of the brother/sister Course of Study Academic year in which applied Amount received so far 18. Name of Child Gender Date of Birth 17. if any. LEAVE BLANK SPACE BETWEEN WORDS . Branch Code MICR (9 digit) No. Demand Draft No. __________________________________________________________ S/o / D/o Ex -____________________________________________________ has been checked.) in word Issuing Bank Name Issuing Bank Branch Issue Date D D M M Y Y Y Y 20. Details of Demand Draft. besides recovery of scholarship already paid.” Place: Date: Place: Date: (Signature of ward) ________________________ (Full Name of Ward) _______________________ (Signature of Parent) _______________________ (Full Name of Parent) ______________________ CERTIFICATE FROM RSB / ZSB “It is certified that PM Scholarship application form for academic year 20___ . Office seal: Director. I also undertake to abide by the conditions mentioned in the general instructions of the scheme.___ in respect of Mr. Declaration: “Certified that the particulars given by me in the application are correct and any false statement made by us will disqualify me / my ward for award of PM’s Scholarship Scheme. found correct as per check list provided by KSB and the applicant is eligible to apply as per rules of the scheme”.20 19. / Ms. Amount (Rs.) in figure Amount (Rs. RSB / ZSB Place : ________________ Date : ________________ . 3._____________________ is Bonafide student of __________________________________ college.___ and the course will be completed in the month of ____________ 20___ -___. He / she has joined this college in the academic year 20___ . It is certified that Ms.______________ Place:-_____________ . This is also certified that student is getting Rs. 2. This is also certified that _____________ course is a professional degree course and this college is approved by ________________________________________________. His / Her roll number is __________ and he / she is studying in the I / II / III / IV / V year or ______ semester of the One / Two / Three / Four / five years _______________ course in ____________________ branch (if any). / Mr .__________________ (If not getting write N/A) stipend from this Institute / College or any other sources. l Office Seal: Signature of Principal / Dean / Registrar Date:.21 SPECIMEN COPY OF BONAFIDE CERTIFICATE CERTIFICATE FOR PM SCHOLARSHIP 1. Date of Discharge _______________________________________ 8. Navy or Air Force) _______________________________________ 2. 2. Date of enrolment _______________________________________ 7. Regular _______________________________________ Reserve 11. ESM died on (if applicable) _______________________________________ 12. Trade _______________________________________ 6. Name & Initials _______________________________________ 5. Cause of death & _______________________________________ Whether Attributable 13. Rank _______________________________________ 4. No. Sl.22 SPECIMEN COPY OF EX-SERVICEMEN CERTIFICATE EX-SERVICEMEN CERTIFICATE (In lieu of Discharge Book) 1. Duration/Length of Service _______________________________________ 10. Reason for Discharge _______________________________________ 9. Particulars of dependent children:Name : : : : : : : : : : : : Gender Date of Birth . 3. Service No. 5. Type of Service (Army. 1. 4. _______________________________________ 3. mentioned for further correspondence with this office. The application will be examined for eligibility. It is certified that the above information is duly checked from the discharge book of Ex-servicemen and found to be correct. mentioned for further correspondence with this office. The application will be examined for eligibility. Office Seal: Dir RSB/ZSB/OI/C Record Office Date: ________________________ Place: ______________________ PRIME MINISTER’S SCHOLARSHIP SCHEME ACKNOWLEDGEMENT SLIP OFFICE COPY Your Renewal form dated_________ has been received on__________. The dak receipt number ____________ is to be .23 6. The dak receipt number ____________ is to be Office Seal: (Signature of RSB) Tear off Tear off ACKNOWLEDGEMENT SLIP STUDENT COPY Your Renewal form dated_________ has been received on__________. Name of the applicant (Ward/widow): 2.. given by KSB: 3. EVEN IT IS SUBMITTED EARLIER).. Name of account holder and account number .24 Office Seal: (Signature of RSB) Note: This copy duly stamped and signed by RSB given to the student by hand or by post. PROFORMA FOR RENEWAL OF SCHOLARSHIP UNDER PRIME MINISTER’S SCHOLARSHIP SCHEME (To be send only if selected for scholarship) 1.. Details of Bank account of SBI or PNB for Electronic Clearing Services ( (PLEASE ATTACH A PHOTOCOPY OF PASS BOOK.... CROSSED BLANK CHEQUE SHOWING YOUR ACCOUNT NUMBER TO BE FORWARDED.. & Name Tehsil & Post Distt RSB Pin Code 5.. Selection Serial Number...... Street No.... Selection serial No.. Particular of ESM: Name of ESM Rank Service Number 4..... Present address (where you want your letter is to be sent) (To be filled up only in case of change from previous address or write N / A) House No. / Mr . This is also certified that Ms.___ and the course will be completed in the month of ____________ 20___ .25 Place: ________________________________ Date: Full Name & Signature of the ward / widow It is certify that the information submitted by my child / Self is correct. Place : Date : _____________________________ Full Name & Signature of the Parent LEAVE BLANK SPACE BETWEEN WORDS SPECIMEN COPY OF BONAFIDE CERTIFICATE FOR RENEWAL CERTIFICATE FOR RENEWAL OF PM SCHOLARSHIP 1. He / she had joined this college in the academic year 20___ . His / Her roll number is __________ and he / she is studying in the I / II / III / IV / V year or ______ semester of the two / three / four / five years _______________ course in ____________________ branch (if any). ___________________________ __________ has successfully completed his / her 1st / 2nd / 3rd / 4th / 5th year and scored ________ % / Grade__________ (Total marks obtained were _____________ out of ____________) and he / she is continuing the course in 2nd / 3rd / 4th / 5th year . .___. It Is certified that Ms. 2._____________________ is a Bonafide student of __________________________________ college. / Mr. Candidate to attach a self addressed envelope. Hyderabad . MJ Road. Gruhakalpa Complex. II Floor.500 001 040-24736890 (O) 040-27990144 (R) 040-24747991 (F) 09440401470 (M) apsainik@gmail. duly stamped to receive the acknowledgement of renewal form by post. Secretariat Port Blair .744 101 secrsbandnic@gmail. (b) ________________________________ Full Name & Signature of the Candidate DEPTT OF SAINIK WALFARE/RAJYA SAINIK BOARDS Sl No Address of RSB Col KV Cherian (Retd) Secretary Rajya Sainik Board A & N Administration.26 Office Seal: Signature of Principal / Dean / Registrar Date: ________________ Place: _______________ CHECKLIST FOR RENEWAL OF SCHOLARSHIP DOCUMENTS TO BE ATTACHED: (a) A Bonafide certificate from the College/Institute indicating that the candidate continues to study in the subject course and showing his / her percentage of marks for which the Prime Minister’s Scholarship has been sought (As per the specimen attach).com Hyderabad ANDHRA PRADESH Brig CS Vidyasagar (Retd) Director Deptt of Sainik Welfare Block IV. Pl contact RSB Port BlairANDAMAN & NICOBAR ISLANDS (UT) 03192-235621 (O) 03192-235621(F) 03192-320360 (R) 09434281518 (M) 1 2 . Nampally.com For Detail. Rajpur Road. Govt of Arunachal Pradesh.160 022 zswochd@gmail. New Itanagar-791110 0360-2212282 (O) 0360-2290778 (R) 0360-2212282 (F) 0360-2213615 (F) 09436041927 (M) Guwahati0361-2522229 (O) 0361-2412196 (R) 0361-2522229 (F)
[email protected] 001 0771-2445165 (O) 0771-2427449 (O) 0771-2352529 (R) 0771-2420084 (F) 09893164219 (M) dsw. Saood.in Delhi8 DELHI Gp Capt RK Sharma (Retd) Secretary 011-23991876 (F) Rajya Sainik Board 011-23969260 (O) Opp Tis Hazari Court 09818953191 (M) No.27 Itanagar3 ARUNACHAL PRADESH Shri K Kholie Director Dte of Relief. Sector-21.1.com Raipur Col K L Yadav (Offg) (Retd) Director Deptt of Sainik Welfare. Patna – 800015 Patna 0612-2217301 (O) 0612-2217301 (F) 0612-2280333 (R) Chandigarh Lt Col Raj Kumar Singh (Retd) Zila Sainik Welfare Officer 6 CHANDIGARH (UT) 0172-2701947 (O) 0172-2700317 (O) 0172-2726325 (F) Zila Sainik Welfare Office (UT) 0172-2721064 (R) Opposite Aroma Hotel.cg@nic. Behind Home Guard Office Raipur . Rehabilitation & Settlement. Delhi-110 054
[email protected] Shri Md. BAS Director 5 BIHAR Sainik Kalyan Nideshalaya Home Deptt. Old Secretariat Barrack No. Lachit Nagar Guwahati . Chandigarh . CG Near Collectorate Parisar.10.781 007 7 CHHATTISGARH .in 4 ASSAM Cmde K C Choudhury (Retd) Director Dte of Sainik Welfare. Sainik Bhavan.09888880566 (M) D. 180005 01972-221854 (O) 01972-224659 (O) 01972-225961 (R) 01972-225643 (F) 09418090708 (M) Jammu 0191-2561547 (O) 0191-2465141 (R) 0191-2575362 (F) 09419180672 (M) Ranchi0651-2330178 (O) 0651-2330469 (R) 0651-2331434 (F) 09431105964 (M) jharkhand_skn@yahoo. Ahmedabad-380001 079-23251295 (O) 079-23251296 (O) 079-23251298 (O) 079-23251294 (F) 079-23245346 (R) 079-25508539 (O)
[email protected] Panchkula Brig KS Budhwar (Retd) Secretary Rajya Sainik Board Sainik Bhawan. Shaheed Capt Rohit Kaushal Marg.com Gandhinagar Lt Col Kishor Sinh Gohil (Retd) Director Distt Sainik Welfare office & Resettlement.177 001 Brig RS Langeh. Opp . Ground Floor. Jammu . VSM (Retd) Director Deptt of Sainik Welfare Ambphalla.in 9 GOA 10 GUJARAT 11 HARYANA 13 JAMMU AND KASHMIR 14 JHARKHAND Col AP Singh (Offg) (Retd) Director Sainik Kalyan Nideshalaya Ranchi (Jharkhand) .403 001 0832-2227138 (O) 0832-2443236 (R) 0832-2227138 (F) 09420686834 (M)
[email protected] 109 0172-2560462 (O) 0172-2562102 (R) 0172-2560462 (F) 0172-2560321 (O) 09888527189 (M) sainikparivar@yahoo. Sector 12. Bachat Bhawan. Relief Road.com Hamirpur12 HIMACHAL PRADESH Maj Jogi Dass Mankotia (Retd) Director Deptt of Sainik Welfare Govt of Himachal Pradesh Hamirpur .28 Panaji Maj Venugopal Nair (Retd) Secretary Deptt of Sainik Welfare Collectorate Building Panaji .Jyoti Sangh. Panchkula . Pune-411 001 18 MAHARASHTRA Imphal09862672547 (M) 19 MANIPUR Shillong0364-2225613 (O) 0364-2536574 (R) 0364-2225613 (F) 09436101551 (M) rsbmegha@rediff. No 58. Imphal-795004 Brig WJB Sturgeon.793 001 15 KARNATAKA 16 KERALA Shri KK Govindan Nair Director Deptt of Sainik Welfare Vikas Bhavan.com Thiruvananthapuram 0471-2304980 (O) 0471-2472401 (R) 0471-2304980 (F) 0471-2329279 (R) govindan. Fd Mshl KM Cariappa Road. Opp National War Memorial.695 033 17 MADHYA PRADESH Brig Pramod Kumar (Retd) Director Deptt of Sainik Welfare Southern Shopping Centre Guru Teg Bahadur Complex. TT Nagar. P. Bangalore .560 025 Bangalore080-25589459 (O) 080-28445706 (R) 080-25589459 (F) 09886205130 (M)
[email protected] Lt Col H Sharat Singh (Retd) Secretary Rajya Sainik Board Sainik Rest House Opp. Ghorpadi.NO 364. Lamphel Police Station.gov.com 20 MEGHALAYA .com Bhopal0755-2553992 (O) 0755-2666081 (R) 0755-2577209 (F) 09993030601 (M) dirrsb@mp. Thiruvananthapuram .in Pune020-26332763 (O) 020-26332764 (O) 020-26850613 (F) 09422314276 (M) dsw@mahasainik. Bhopal .nair@yahoo. YSM.29 Col CM Uthaiah (Retd) Director Deptt of Sainik Welfare & Resettlement. Bhavan. Solapur Road. Fd Mshl KM Cariappa. SM (Retd) Director Dte of Sainik Welfare Public Service Commission Building Beyond DC Building Shillong . New Market.B.462 003 Col Suhas S Jatkar (Retd) Director Deptt of Sainik Welfare Maharashtra State ‘Raigad’. Lawspet 09443228260 (M) Main Road. Chandigarh .com Chandigarh Brig IS Gakhal (Retd) Director Dte of Sainik Welfare. North Block.605 008 dswpuducherry@gmail. 119 Aizawl . Pakkamudayanpet. Puducherry . PB No. Lewis Road. Bhubaneshwar-751002 0674-2432268 (O) 0674-2435998 (F) 0674-2721156 (R) 09937940807 (M) rsbbbsr@gmail. Home Br.com 21 MIZORAM 22 NAGALAND 23 ORISSA 24 25 PUNJAB 26 RAJASTHAN . Sector 21-D.in Bhubaneshwar Col (Dr) DK Das (Retd) Secretary Rajya Sainik Board. Punjab Punjab Sainik Bhawan.com JaipurCol Phool Singh Mehla (Retd) (Offg) Nideshak Sainik Kalyan Vibhag Secretariat Building.302 005 0141-2227897 (O) 0141-2227650 (F) 0141-2356464 (R) 09314933120 (M) rajasthansainik@yahoo. Jaipur .796 001 0389-2322732 (O) 0389-2322732 (F) 0389-2325811 (R) 09436142593 (M)
[email protected] AizawlCol John Zama. Kohima . Home Deptt.797 001 0370-2270029 (O) 0370-2270029 (F) 0370-2221991 (R) 09436830124 (M) secyrsb-ngl@nic. Nageswar Tangi. Nagaland Civil Sectt.160 022 0172-2701845 (O) 0172-2740991 (R) 0172-2707345 (F) 09814297113 (M)
[email protected] KohimaBrig Brij Pal Singh (Retd) Secretary Rajya Sainik Board.. Tuikual ‘A’. SM (Retd) Director Deptt of Sainik Welfare & Res.com Puducherry PUDUCHERRY (UT) Col Jacob Mathen Anand (Retd) Director 0413-2253107 (O) Deptt of Sainik Welfare 0413-2250575 (F) Jawan Bhavan Complex. Kunjaban.com KolkataCol PR Pal (Retd) Secretary Rajya Sainik Board. YSM. Block 'F' (First Floor). P. Kaiserbagh. Writers’ Building Kolkata .248121 0381-2326507 (O) 0381-2323795 (F) 0381-2319005 (R) 09436510584 (M) rsb. Lucknow .Haathi Badkala Dehradun . Agartala . (Retd) Joint Director Dte of Ex-Servicemen’s Welfare 22.799 006 West Tripura Shri AK Chaturvedi.com Lucknow0522-2625354 (O) 0522-2625354 (F) 0522-2305107 (F) 0522-2391701 (R) 09415404142 (M) Dehradun0135-2744208 (O) 0135-2743773 (F) 0135-2741481 (O) 0135-2670813 (R) 09358254621 (M)
[email protected]. Raja Muthiah Salai.c om 28 TAMIL NADU Capt S M Aslam. Choolai Chennai . VSM (Retd) Director Nideshalaya Sainik Kalyan Uttarakhan. Nehru Office Complex.tripura@gmail. KC.700 001 033-22141347 (O) 033-22144643 (F) 033-22143220 (O) 09874535628 (M) rajyasainikboardwestbengal@gmail. PCS (Additional Charge) Director Dte of Sainik Kalyan Evam Punarvas.com Agartala Lt Col Mohit Ghosh (Retd) Secretary Rajya Sainik Board. Paljor Stadium Road.600 003 29 TRIPURA 30 UTTAR PRADESH 31 UTTARAKHAND 32 WEST BENGAL . Kariappa Bhawan. Kalidas marg P O.226 001 Brig AN Bahuguna. Gorkhabasti. Gangtok-737 101 03592-202534 (O) 03592-221456 (O) 03592-202156 (R) 03592-221456 (F) 09434448861 (M) Chennai044-26691747 (O) 044-26691342 (O) 044-22331052 (R) 044-26691886 (F) 09444823182 (M)
[email protected] Gangtok27 SIKKIM Lt Col PB Gurung (Retd) Secretary Rajya Sainik Board. ESM of these states can submit their Prime Minister application form to Gujrat RSB. .32 Note: Dadar Nagar Haveli: Daman & Div Lakshadweep: ESM of this state can submit their Prime Minister application form to Kerala RSB.