JEE/NEET Scholarship Form

JEE / NEET Scholarship Application

Subject *

JEE NEET

Student Name *

Student Contact Number *

Date of Birth *

Gender *

Father Name *

Father's Contact Number

Mother's Name *

Mother's Contact Number *

State *

District *

Category *

Schooling *

Complete School Name *

Current Class *

Number of NEET/JEE Attempts *

Last NEET/JEE Score

10th Passed Year *

10th Percentage

12th Passed Year *

12th Percentage

Father's Occupation *

Mother's Occupation *

Monthly Family Income *

Referred By Any Senior Student?

Physically Challenged? *

Yes No

Is any parent a Govt employee? *

Yes No

House rented? *

Yes No

BPL Certificate Available? *

Yes No

Supported files: JPG, PNG. Max 1 GB.

Full Family Photo *

Your Photo *

Your House Photo *