Dakshin Gobindapur, P.S. – Sonarpur, Kolkata – 700145
Phone No: 033-2437-9913 Fax No: 033-2437-9913 E-mail: info@svist.org
Website: www.svist.org
Application Form for Free Studentship
1.
Name of student
2.
Address
Pin
Contact No. of Student
3.
Whether belongs to SC/ST/OBC/Minority
(Produce paper document)
Contact No. of Parents
4.
a. Name of the course c. Year
5.
a. Father’s Name
6.
b. Mother’s Name b. Stream d. Class Roll No c. Guardian’s Name
(In case father/mother is not alive or he/she does not bear the education expenses) d. Address e. Father’s / Mother’s / Guardian’s Occupation
(Attested copy of Income certificate as per information given overleaf)
Pin
Yearly Income
7.
Last year’s class
8.
Academic Record of
Previous year (HS/10+2)
Mathematics
Promoted to class
Physics Chemistry
9.
Name of the Stipend / Scholarship / Free Studentship enjoyed last year
English
10. What was the Monthly / Yearly Value Rs.
11. Did you have any back paper(s) in the last Semester Examination?
Yes
If yes, what are those papers
Declaration
Total
No
Percentage (%)
I do herby solemnly declare that: a. I neither applied nor received Financial Assistant or Scholarship from any organization during the current academic year. b. The Free Studentship is granted to me by the College on the basis of declaration above; the College will have every right to cancel the Free Studentship at any time and to initiate legal proceeding for false declaration given by me.
Date
Countersigned by Father / Mother / Guardian Signature of the Applicant

(a) Income certificate from the employer (with office seal) for the employed person and for the non- salaried person from the Gazetted Officer / Block Development Officer / Sub. Divisional
Officer/ or Higher Officer. Submission of copy of Income Tax Return may also be accepted as proof of Income.
(b) Copy of Mark Sheet of All Examinations passed.
It may be noted that at the time of Interview/ Selection all the original documents of the attested copies are to be produced.