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Build India Scholarship Scheme - XI Batch - Application Form

Personal Data
Full Name
Father's Name
Sex Male          Female
Mailing Address
 
 
 
  Pin State
Email Address
Date of Birth (DD/MM/YYYY)
Height (cms) : Weight (kg) :
Vision (if normal (i.e.6/6), type 0 or leave it blank) Left Eye :         Right Eye :

Educational Qualification
College / Institute
University
Location of University City  
State
Expected Month/Year of Completion of Course (MM/YYYY)
Qualification
Discipline   Civil   Mechanical   Electrical

Details of Marks Obtained

Semester Marks Scored Maximum Marks
I

II
III
IV
V
VI

Aggregate (Semester.I to VI) %
(if the marks are in CGPA convert into % and enter.
Do not enter avg CGPA)
Preferred Centre for Written Tests (Give your nearest Test Centre)
Special Merit Awards
(Max 300 Chars)
Extra-curricular Activities
(Max 300 Chars)

Declaration

I declare that the information given above is true to the best of my knowledge.  Any false or incorrect information furnished above will result in disciplinary action being taken against me including removal from selection process.