The Godavari Sugar Mills’
Somaiya Grameen Vikas Kendra, Sameerwadi Taluk : Mudhol
Dist : Bagalkot
Pin – 587 316
Phone- (08350) 260046 / 47 / 48 ===================================================
Application for Scholarship under a project
Paste here a passport size colour photo
Help A Child To Study 1. Name of the Student (In capital letters) 2. Name of the course completed:
3. Name of the present course:
4. Name of your parent / guardian 5. Occupation of your parent / guardian
Relation
6. Total annual income of the parent / guardian 7. Permanent Address: House No.
Street Name / Location:
At / Post: Pin code:
Taluk:
District:
Phone No. with STD code (Mention neighbor’s no. with their name if you do not have)
8. Name & Address of the School / College in which he / she studied At / Post: 9. Details of marks obtained in SSLC / II PUC / Degree
Taluk:
Courses (SSLC / II PUC / Degree)
District:
Total marks obtained
Percentage of marks
10. Name & address of present college At / Post:
Signature of the student
Taluk:
District:
Signature with seal of Present college Principal 1