stipend form - Bansal Classes Bhubaneswar

STIPEND ENQUIRY FORM

Name

Class

Contact number

Father's Name

Father's Contact no

Postal Pin

District

Preferred study center

School Name

Career Goal)

Applied In Any Other Scholarship Exam

Name Of Exam & Rank

Would like To Pursue Engg/Med Coaching (Name of Institute)

My Favourite Subject(Put 1,2 ,3 As Order Of Preference)

Declaration

I SOLEMNLY AND SINCERELY DECLARE THAT THE ABOVE STATED PARTICULARS ON THIS APPLICATION ARE TRUE & I MAKE THIS DECLARATION CONSCIENTIOUSLY BELIEVING THE SAME TO BE TRUE. I AM HAPPY TO ACCEPT THE TERMS AND CONDITIONS OF STIPEND SCHEME OF BANSAL CLASSESES AND LOOKING FORWARD TO FACULTY INTERACTION ON DATE & TIME AS DEEMED SUITABLE BY BANSAL CLASSES.