Shri Sital Das Jain Foundation

KABiL Programme · 725, Model Town, Panipat 132103 · +91 87086 26933

Application for Financial Assistance

For applicants who cannot apply online. Please fill this form in capital letters and send a photo/scan on WhatsApp to +91 87086 26933, or submit a printed copy. Attach: 10th marksheet, fee structure, and a masked Aadhaar (first 8 digits hidden).

Applicant & Contact

Name of Student

Date of Birth

Gender

Mobile Number

Last 4 digits of Aadhaar

Permanent Address

Correspondence Address

Family & Financial

Father's Name

Father's Occupation

Mother's Name

Mother's Occupation

Annual Family Income (₹)

Govt. Family ID

House (Own / Rented)

Facilities at home (AC / Four-wheeler / None)

Course & Institute

Institute Name, City, State

Admission Number

Course

Course Year

Annual Fee (₹)

Concession from Institute/Govt. (₹)

Amount Required (₹)

Percentage in previous two years

10th Class & Referral

10th Exam Year

10th Percentage

Referred by Principal? (Yes / No)

Name of Principal

Declaration

I confirm the above information is true. I understand that continuation of financial assistance depends on the student's performance, the final decision rests with the Trustees, and all payments are made directly to the institute. I have 80% or above in the preceding qualifying exam and belong to a low socio-economic background.

Applicant's Signature & Date

Principal's Signature & Stamp