Application Form for Education Aid

Instructions for Filling the Aid Form

All fields are mandatory. If a field is not applicable, write “NA”.
Attach a handwritten or typed cover letter.
Attach a passport-size photograph in the required space.
If the applicant is working, enter the office address. If not working, enter the office address of the parent/guardian.
Fill all details in block letters.
If residential and correspondence addresses are the same, mention this in the relevant column.
Mention the identification proof submitted.
List existing educational qualifications only; do not include the course currently being completed. Attach supporting documents.
Attach a copy of the income certificate.
Documents required in Section 6 should be signed and dated by the applicant.
Provide two references who are not parents, guardians, or family members.
Print, complete, sign and date the form, attach attested documents, and submit it to the Urjaa Foundation representative you approached.
Carry the documents when called to collect the cheque for verification.

PLEASE COMPLETE ALL DETAILS IN BLOCK LETTERS AND TICK WHEREVER APPLICABLE

Passport-size Photo of Applicant JPG or PNG.

1. Personal Details of the Applicant

First Name *

Middle Name

Surname *

Name in Full of Parent/Guardian *

Relationship with the Applicant *

Residential Address of the Applicant *

Correspondence Address of the Applicant *

Mail ID of the Applicant *

Date of Birth (DD/MM/YYYY) *

Mobile No. *

Landline No.

Gender *

Identification Proof Submitted *

Caste *

Educational Qualifications *

2. Financial Information of the Parent/Guardian

Monthly Income of the Parents/Guardians *

Annual Income of the Parents/Guardians * Kindly attach income certificate.

Income Certificate *

3. Employment Details of the Parent/Guardian

Name and Address of the Employer / Self-employed *

Name of the Department *

Designation and Employee Number *

Number of Years of Present Employment *

In Case of ECB, Attach Certificate

Date of Retirement

4. Employment Details of Applicant, if Any

Employer’s Name and Address *

Duration *

Employment Type *

5. Details of the Proposed Course

Name of the Course *

Duration of the Course *

Name and Address of the Institution *

Documents Regarding the Course (Prospectus or Certificate from Competent Authority) *

Proof of Admission to the Course *

6. Documents to be Attached

Upload any available documents in the relevant fields below. No document upload is mandatory.

Mark Sheets of Last Qualifying Examination (PDF/JPG/PNG) *

Course Prospectus/Certificate from Institution (PDF/JPG/PNG) *

Proof of Admission to the Course (PDF/JPG/PNG) *

Proof of Residence (PDF/JPG/PNG) *

Copy of Scholarship / Aid Granted (PDF/JPG/PNG)

Two References with Their Name and Contact Number *

Reference 1 - Name *

Reference 1 - Contact Number *

Reference 2 - Name *

Reference 2 - Contact Number *

7. Declaration

Applicant’s Full Name *

Applicant’s Signature *

Date *

Place *

I have read and agree to the above declaration. I confirm that the information provided in this application is true and correct to the best of my knowledge.

Please accept the declaration to enable the submit button.