JAYA SATYA PRAMODA NIDHI (Regd Trust) (A Division Of Satya Pramoda Foundation)

JAYA SATYA PRAMODA NIDHI (Regd. Trust)
(A Division Of Satya Pramoda Foundation)
Regd. Office: Uttaradi Math, Pooja Mandira, Uttaradi Math Road
Basavanagudi, Bangalore-560004
(Established by Sri Sri 1008 Sri Satyapramoda Teertharu)
________________________________________________________________________
11) Currently Studying: ……………………………………………………………..
12) Marks and Percentage Obtained in SSLC/PUC 1 st Year Examination: ………………..
13) Class Admitted: Class: .......................... Roll No.: .................... Division:
..............................
14) If poor academic performance, give reasons. (If necessary use extra paper)
.............................................................................................................................................
...........
15) Fees paid to the college for this academic year: .............................. (Attach attested
copies of receipts)
Amount yet to be paid: ........................... (Attach original estimated expenditure
statement)
16) Have you received financial assistance from any other sources? (If yes give details)
.............................................................................................................................................
............
.............................................................................................................................................
............
17) Give the details of extra curricular activities (If participated in Taluk, Dist. or higher
level. Enclose the attested copies of certificates).....................
.....................................................................................................
.............................................................................................................................................
............
18) Attach following documents with the application. Tick mark (√)
i) Attested copy of fee receipts. How many receipts? Rs.
ii) Attested copy of SSLC marks card/Puc 1 st year (Send provisional
marks card, if original marks card is awaited)
Date:
Signature of Student
____________________________________________________________
Carefully read the details given overleaf before filling the application form.
Duly filled in application forms should be sent on or before 31.07.2010 to
“Jayasatyapramoda Nidhi”, C/o Uttaradi Math, 5 th Cross Road, Shankarpuram,
Basavanagudi, Bangalore – 560 004
DONATE TO EDUCATE THE NEXT GENERATION