TaRVara - dakshana.org · 9th(FA2) I D 10 3 out of O students 1 Oth(SA1) C 4 out of J students...
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2017 TaRVara Please complete the following information in CAPlTALS:ue blue/block Boll pint pen) [i7l! it. FiI.• 1 II munnom JNV Roll No: 'H *Fi rs t Name Middle Nam Last Name Gender: M Z F LII (Tick appropriate) Category :!GENLIIILOBCLIJ I SC LII [ - iiP I PD: YES [1 NO t (Tick appropriate) Test centre code [3J Applying for: Engineering J MediccilLTick appropriate) As per class 10 CBSE Registration The Dakshana Foundation Application to Become a Dakshana Scholar Dakshana Scholars are brilliant, but impoverished students who aspire to attend a premier engineering/medical college, but cannot afford to be coached professionally by a world-class coaching institute. The Dakshana Foundation provides comprehensive scholarships to gifted/impoverished adolescents who meet our criteria. These scholarships include 100% of coaching fees and books. In order to be eligible to apply for becoming a Dakshana Scholar, you must be invited to appear for and qualify in the Navodaya Dakshana Selection Test (NDST). The decision of Dakshana in this regard is final. Dakshana reserves the right to validate the information provided through various sources including NVS records, Principal and school staff interviews, peer, neighbours, school alumni and direct verifications. Should any information be found to be willfully falsified, Dakshana reserves the right to deny acceptance as a Dakshana scholar and /orterminate coaching at anytime after it has started. I hereby do attest that all of the information submitted in this application is correct and authentic and that I meet all of the criteria mentioned to apply for being named o Dakshana Scholar: ............. Student Signature J. 1 ...o Date Poge I o 4
Transcript of TaRVara - dakshana.org · 9th(FA2) I D 10 3 out of O students 1 Oth(SA1) C 4 out of J students...
2017
TaRVara Please complete the following information in CAPlTALS:ue blue/block Boll pint pen)
[i7l! it. FiI.• 1 II munnom JNV Roll No:
'H *First Name
Middle Nam
Last Name
Gender: M Z F LII (Tick appropriate)
Category :!GENLIIILOBCLIJ I SC LII [-iiP I PD: YES [1 NO t (Tick appropriate)
Test centre code [3J Applying for: Engineering J MediccilLTick appropriate)
As per class 10 CBSE Registration
The Dakshana Foundation
Application to Become a Dakshana Scholar
Dakshana Scholars are brilliant, but impoverished students who aspire to attend a premier
engineering/medical college, but cannot afford to be coached professionally by a world-class coaching
institute. The Dakshana Foundation provides comprehensive scholarships to gifted/impoverished
adolescents who meet our criteria. These scholarships include 100% of coaching fees and books. In order
to be eligible to apply for becoming a Dakshana Scholar, you must be invited to appear for and qualify in the
Navodaya Dakshana Selection Test (NDST). The decision of Dakshana in this regard is final.
Dakshana reserves the right to validate the information provided through various sources including NVS
records, Principal and school staff interviews, peer, neighbours, school alumni and direct verifications.
Should any information be found to be willfully falsified, Dakshana reserves the right to deny acceptance as
a Dakshana scholar and /orterminate coaching at anytime after it has started.
I hereby do attest that all of the information submitted in this application is correct and authentic and that I
meet all of the criteria mentioned to apply for being named o Dakshana Scholar:
............. Student Signature
J.1 ...o
Date
Poge I o 4
PLEASE DO NOT LEAVE ANY BLANK COLUMNS IN THE QUESTIONS BELOW; PUT "NIL" or "0" WHERE
IT IS RELEVANT.
TI..E.TI\ .L.Wv1 Rs. ...... .3Q.Q............................. Father/Guardians Full Name Occupation Typical Monthly Income
Fatr's E' ucation Level Language(s) e.g. BA, 12th Pass, 10th Pass, Illiterate etc.) your father can read and write
I.\.L N.1..L Father's Employer! Organisation Name Designation
If your father is a farmer, how much land is owned (.re.... hectares).
131I US.E....W. ..E. Rs. ............. NJIL Mothers Full Name Occupation Typical Monthly Income
........................................................................................................ Mother's Education Level Language(s) (e.g. BA, 12th Pass, 10th Pass, Illiterate etc.) your mother can read and write
N.L N..L Mother's Employer/Organisation Name Designation
N. ................................................................................... Rs No. of Other Adult(s) in Household Occupation Typical Monthly Income
Rs..... Rs 3..QO............................ Rs. ...... OQC) Total Approximate Value of Total Typical Monthly
Total Household
All Household Assets Household Income
Cash Savings (Except Household Cash Savings)
ED.................... Is your parents home
Approximate area of
Number of owned or rented?
Parents Home (sq. Ft.)
bedrooms
Rs Monthly rent, If home is rented
EL..... School State
Your live in: 0 Rural Area
VID/\\AY1,HJ1..!rMVl Current School Name School District
Rs................................................ Monthly school fees
Urban area Semi-urban area (Tick appropriate)
Are you disabled or physically challenged ? Yes [ J No
N '- If yes, please specify the medical disability.............................
Please answer the following with a Yes or No. Does your family have?
Air conditioner Scooter(s)/Motorcycle(s) Landline Phone Car(s)
t...o Fridge Computer Washing machine Mobile phone
Aaki5ara Page 2 .4 4
9th(FA2) I D 10 3 out of O students
1 Oth(SA1) C 4 out of J students
1Oth(SA2) tOl L 10 10 P out of 9 C students
Leave blank, if results are awaited.
Please enter your complete home address and write clearly in Capital Letters; if column is not relevant to your address, put "Nil. Pin Code is required.
..PH1 House Number: Post Office Name:
K/t1J/1M Street/Road Name: Tehsilfraluka Name:
POP .. ... ..... ............... k.AM1]VI Village/City Name: District Name:
Other Relevant Address Info/Nearest Landmark:
UN State Name:
5.0.131 ............................ Pin Code #:
Your mobile phone
Your home phone
91 33.L ..G.................................................... Fathers mobile phone
Mothers mobile phone
Your email address 1
Your email address 2
V.
Father's email address Mother's email address
............................................ q..... co Best way to contact you Family or neighbour's mobile phone and/or email address
iaRFana
Page 3 of 4
Please write essay (in English or Hindi) Between 300 - 500 words which begins with
I'd like to become a Dakshana Scholar and hopefully attend Engineering/Medical college because .............
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s. .............. ............. WOW. ....................................................?.................... Cleat'.............. .. .. ............ ......
- ................ .............. .......... ....................................... . ............. ......
..................... .......... ............... ±Z.. ............... Lcrn
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TarVana
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Pal ................. to ...............................
p5.cv'* .......................... cc •...MQ1,
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(You can use this form or a separate piece of paper. Please submit the essay in your own
handwriting)
AaVara
