Submit Date : 15/12/2023

Application No:
GOVERNMENT OF GUJARAT 232400000001845488

VKY-157 Food Bill Assistance in College Attached Hostels

Fresh Application

Student Personal Details

Name of Student : BUBADIYA VIPULBHAI JAGABHAI
Name of Student (As per Aadhar) : Vipulbhai Jagabhai Bubadiya
Mother's Name : Seliben Jagabhai Bubadiya
Date of Birth : 01/01/2004 Gender : Male
Category : ST(7ȵkɅl‡ISKWĤiS  Religion :Hindu
Caste : Dungari bhil Ȯk5F^Ž[j_ 

Aadhaar Status Verified: Yes(15/12/2023 13:40:00)

Annual Income of Parents/Guardian/Husband (Rs): 46000 Habitation Type: Rural

Mobile Number : 9512066390 E-mail Address : [email protected]
Aadhar No : 74xxxxxx6277 Parent/Guardian occupation: Agriculture(EpSj
Is Orphan: NO Day Scholar / Hosteller : Hosteler
Marital Status : Unmarried Hostel Type: Private Hostel
Current Address: Permanant Address:
State Gujarat State Gujarat

District Sabarkantha District Sabarkantha

Taluka Himatnagar Taluka Khedbrahma
Village Village Pathora
PinCode PinCode 383270
Address:AT Berna Address:PATHORA

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 74xxxxxx6277 Bank name : -
Mandate Date : 12/15/2023 12:00:00 AM Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 80xxxxxx3186 IFSC Code : BARB0DBAGIY
Student Name(As per Bank Name): VIPULBHAI JAGABHAI BUBADIYA

Name of Bank : BANK OF BARODA

Branch Name & Address : AGIYA

I hereby accept that
1.Details provided by me are correct to best of my knowledge
2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.

Student Academic Details

Present Course/Class/Trade Type: Information Technology

Present Course/Class/Trade Name : BCA (Bachelor Of Computer Application)

Present Course/Class/Trade Year : 3RD YEAR(5th Semester/6th Semester)

Courtesy :: National Informatics Centre, Gujarat Page 1 of 3 232400000001845488 Print Date :13/02/2024
 Studying in : Gujarat Enrollment No: BCA33421008693

Present Institute District : Sabarkantha Present Institute : GROW MORE INSTI OF COMP APPLI (BCA)

Admission Type : Regular Paid Seat (Self Finance) Present Course Branch : -

Present Class Start Date : 15-Jul-2023 Present Course Completion Date : 30-Apr-2024

Hostel Detail
Is Hostel run by Department No

Is Hostel attached With College Yes

Free facilities provided by Hostel? No

Previous stream :BCA (Bachelor Of Computer Application) Previous Class/Course : 2ND YEAR(3rd Semester/4th Semester)
Previous Passing Year : 2023 Previous (%) : 68.50

Are You Employed in any Organization/Establishment with leave without pay? : No

Previous Education Detail

Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH General A4190150 2019 45.83

11th Std/12 Std 12TH Arts G13477 2021 48.28

List of documents which you have attached :

1 Caste Certificate From the Competent Authorities

2 First Page Of Bank PassBook/Cancelled Cheque

3 Fee Receipt of Current Course Year

4 Self Attested Certificate of Previous academic marksheet

5 Income Certificate From the Concerned Authorised Authority/Persons

6 Hostel Certificate(Only For Hosteller Student)

I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.

Verify Mobile Number: Yes 13/02/2024

Place : Signature of the applicant

Date : 13/02/2024
It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and all
the Documents has been checked.

It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority

Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.

Courtesy :: National Informatics Centre, Gujarat Page 2 of 3 232400000001845488 Print Date :13/02/2024
 This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2023
-2024.If student will irregular, than we will immediately reported to the said authority.

The actual School/College/University year began on __________________ and will be ended on _____________________

Date : Signature Of Head Of The School/College/Institute/University With Official Seal

Place :

*Note : Stamp Signature will not be accepted

Courtesy :: National Informatics Centre, Gujarat Page 3 of 3 232400000001845488 Print Date :13/02/2024