INSTRUCTIONS
1. Incomplete or incorrect forms would be rejected so ensure that you have provided all the correct valuable details.
2. The annual income of the applicant’s family should be below 2.50 lack (from all the sources). An income certificate certified by the District Magistrate should be attached alongwith as a proof of the same.
3. Send all your documents along with scholarship form in single pdf file on rcs.positive@gmail.com (Physical form are not accepted)
4. Scholarships are limited given on merit bases
5 chandigarh, Haryana, himachal pradish, Punjab, delhi, uttarakhand , jammu & Kashmir students are eligible for scholarship Checklist of the Documents: 1. All the detailed mark sheets
2. Aadhar card
3. Fee slips (of your current course)
4. ID card (issued by College or University)
5. Medical Certificate (issued by C M O )
6. Income Certificate (issued by the District Magistrate)
For further details and queries contact
AmrinderSingh 9815805420
Mohit K Saini 9466224738
Email: rcs.positive@gmail.com

Application form                                                                     Affix arecent passport size colored photo _______________________

ROTARY CHANDIGARH SHIVALIK
SCHOLARSHIP FOR VISUALLY IMPAIRED STUDENTS 2023-24
1. Name of Student* _______________________________
2. Father’s Name* _________________________________
3. Mother’s Name* ________________________________
4. Date of Birth* ___/___ /________Gender* M / F
5. Mobile No* _______________________________
6. Email ID*__________________________________
7. Address*___________________________________________________________________ State*________________ District* ______________ Postal code* ________
8. Details of Class/Course in which the applicant is currently enrolled:
a. Name of the College/University:________________________________________ Department:_________________________________
Course Name:__________________________________________

b. Date of Admission:________________________________________________________
c. Details of admission/tuition fee deposited for the year ________________________________
9. Annual family income from all sources (in Rs) _______________
10. Are you getting financial support/Scholarship from someone else Yes / No
11. Fill in the following table with your academic detailsc(from matriculation or equivalent up to the previous course)-
Sr. No. Examination  Name of the School/ University  Affiliated Board/ University  %age/ CGPA

Signature of the Applicant