kerala shops and commercial establishment workers - application for educational scholorship
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Kerala Shops and Commercial Establishment Workers - Application for Educational ScholorshipTRANSCRIPT
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Kerala Shops and Commercial Establishment Workers Welfare Fund Board (Website: www.peedika.kerala.gov.in)
tIcf tjm]vkv Bâv Itagvky FÌm_vfnjvsaâvkv sXmgnemfn
t£a\n[n t_mÀUv
APPLICATION FOR EDUCATIONAL SCHOLORSHIP hnZym`ymk kvtImfÀjn¸n\pÅ At]£
1. Name of Student/ hnZymÀ°nbpsS t]cv :
2. Address/taÂhnemkw :
3. Phone No./ t^m¬ \w. :
4. Male/Female / kv{Xo/]pcpj³ :
5. Name of the course applied for Scholorship/ kvtImfÀjn¸n\v thn At]£n¡p¶ tImgvknsâ t]cv.
:
6. Details of examination passed / ]mkmbn«pÅ ]co£bpsS hniZmwiw.
Name of Exam ]co£bpsS t]cv
Name of affiliated University/Board
A^nentbäv sNbvXn«pÅ bqWnthgvknän/ t_mÀUv
Month and Year of passing examination
]co£ ]mkmb hÀjhpw amkhpw
7. Marks scored in the examination/ ]co£bv¡v hnZymÀ°n IcØam¡nb amÀ¡v. Subject Marks scored Maximum marks Percentage hnjbw IcØam¡nb
amÀ¡v IqSnb amÀ¡v iXam\w
BsI/Total
8.
Name of the parent of the applicant and Membership number / At]£Isâ AÑsâ /A½bpsS t]cpw AwKXz \¼cpw. (Photocopy of ID Card to be enclosed)
:
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9. Name and Address of the Establishment presently working and its Welfare Fund Registration No. / \nehn tPmen sNbvXp hcp¶ Øm]\ ¯nsâ t]cpw hnemkhpw t£a\n[nbnse cPnÌÀ \¼cpw.
:
The facts mentioned above are true to my knowledge. If I am selected for the
scholarship I promise that I will abide by the conditions stipulated in the scheme.
Cu At]£bn apIfn ]dªn«pÅ Imcy§Ä kXyamsW¶v Rm³ {]kvXmhn¡p¶p. Cu kvtImfÀjn¸n\v Rm³ XncsªSp¡s¸SpIbmsW¦n CXv kw_Ôn¨pÅ hyhØIfpw \n_Ô\Ifpw A\pkcn¨v s]cpamdmsa¶v CXn\m {]XnÚ sN¿p¶p.
Name and Signature of the Student hnZymÀ°nbpsS H¸pw t]cpw
Place/Øew: Date/XobXn:
Affidavit of the Parent c£IÀ¯mhnsâ kXy{]kvXmh\
I ……………………………………(Name and address) am a member of Kerala Shops and Commercial Establishments Workers Welfare Fund Board and my registration number is ………………………. Sri/Kum…………………………………… is my son/daughter. The facts mentioned in the application are true.
Rm³ …………………………………… (t]cpw taÂhnemkhpw) tIcf tjm]vkv Bâv Itagvky FÌm_vfnjvsaâvkv sXmgnemfn t£a\n[n t_mÀUnse …………………………………… \¼cpÅ AwKamWv. {io./Ipamcn. ……………………………………sâ aI\mWv/aIfmWv. Cu At]£bn ]dªn«pÅ Imcy§Ä kXyamWv.
Signature of the Parent. c£IÀ¯mhnsâ H¸v
Place/Øew: Date/XobXn:
At]£tbmsSm¸w lmPcmt¡ tcJIÄ
1. Attested copy of SSLC Certificate. 2. Attested copy of Mark list of the qualifying exam. 3. Photocopy of Shop Board Membership Card.