GOVERNMENT OF GUJARAT Submit Date :

Application No:
PM -YASASVI Post Matric Scholarship for OBC, EBC and DNT 242500000000885296
Students
Fresh Application

Student Basic Details

Name of Student : THAKOR DISHA SHAILESHJI

Name of Student (As per Aadhar) : THAKOR DISHA
Mother's Name : MUNJLABEN THAKOR
Date of Birth : 21/11/2007 Gender : Female
Category : SEBC Religion :Hindu
Caste : Thakor OhDs^ 

Aadhaar Status Verified: Yes(25/10/2024 18:09:45)

Ration Card No. : 104007009112507 Ration Card Member No. : 104007009112507005

Name As Per Ration Card: (Thakor Disha / OhDs^ˆUbh
EKYC Status As Per Ration Card: Yes EKYC Date: 24-09-2024
Aadhar Number Matched With Ration Card: Yes
Consent Status: I hereby give my consent to use my personal data available with food and civil supply department. I hereby give my consent to
government of Gujarat for fetching my identity for the purpose of post matric scholarship.

Annual Income of Parents/Guardian/Husband (Rs): 144000 Habitation Type: Urban

Mobile Number : 9586950072 E-mail Address : [email protected]
Aadhar No : 63xxxxxx4358 Parent/Guardian occupation: Casual Labour ġND\ȩl^


Is Orphan: NO Day Scholar / Hosteller : Day Scholar

Marital Status : Unmarried Hostel Type:

Current Address: Permanant Address:

State Gujarat State Gujarat

District Mahesana District Mahesana

Taluka Mahesana Taluka Mahesana

Village Village
PinCode 384002 PinCode 384002

Address:RAMBAUGH TB HOSPITAL ROAD MEHSANA Address:RAMBAUGH TB HOSPITAL ROAD MEHSANA

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 63xxxxxx4358 Bank name : -
NPCI Date : 10/25/2024 12:00:00 AM NPCI Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 20xxxxxx4037 IFSC Code : BARB0INDMEH
Student Name(As per Bank Name): DISHA SHAILESHJI THAKOR

Name of Bank : BANK OF BARODA

Branch Name & Address : I.E.MEHSANA BRANCH

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 I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.

Student Academic Details

Present Course/Class/Trade Type: 11th Std/12 Std

Present Course/Class/Trade Name : 11TH

Present Course/Class/Trade Year : 11TH

Studying in : Gujarat Enrollment No:

Present Institute District : Mahesana Present Institute : SHREE S.V. SHAH VIDHYA VIHAR (24040408123)

Admission Type : Regular Seat(Government Quota) Present Branch Course : -

Enter Your Research/Thesis Subject :

Present Class Start Date : 15-Jun-2024 Present Course Completion Date : 31-May-2025

Fees Amount
Admission Fees (Rs) 0
Tution Fees (Rs) 0
Misc.Fee(NonRefundable Fees) 1
Exam Fees(Rs) 0

Total (Rs) 1

Previous stream :10TH Previous Class/Course : 10th

Previous Passing Year : 2024 Previous (%) : 50.00

Educational Break : No No. Of. Year in Break :

Previous Education Detail

Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH GENERAL A1195583 2024 50

Disablity Detail
Is Disability : No Type of Disability : -

Percentage of disability : - Required Guide/Coaching Guide: No

Guide Name: -
Guide Address: -

List of documents which you have attached :

I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.

Date : 25/10/2024

Place : Signature of the applicant

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It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
all the Documents has been checked.

It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority

Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.

This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2024
-2025. If student will irregular, than we will immediately reported to the said authority.

The actual School/College/University year began on __________________ and will be ended on _____________________

Signature Of Head Of The School/College/Institute/University With Official Seal

Place :

*Note : Stamp Signature will not be accepted

Date :

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