PART-II
CENT SCHOOL
(For Common Application Form, Guarantor’s Consent Letter & Acknowledgement-Please fill PART-I)

Sl No Particular Details
(I) INFORMATION ON SCHOOL NAME
ADDRESS
AFFILIATED TO
(II) PERSONAL BACKGROUND OF THE STUDENT
1 Students name in full
(In block letters beginning with surname)
2 Date of Birth
3 Age
4 Nationality
5. Sex Male/Female
6. Present Class
Examination School from which passed Year of passing Percentage of marks obtained Class/Grade obtained

7. Particulars of Scholarships/prizes won, if any, for academic distinction
Examination Academic distinction for which the Scholarship/ Prize awarded Name of the
Scholarship/prize Amount of
Scholarship/
prize

(III) PARTICULARS OF PARENTS/GUARDIAN (BORROWER)
8. Name of Father /Guardian in full
9. Age
10. Relationship with Student
(in case of Guardian)
11. Category SC/ ST/ OBC /MINORITY COMMUNITY/OTHERS
12. Name of Mother
Occupation
Income
13 Present Address

14. Permanent Address

15. No. of dependents
Children
Others
16. Present Accommodation Own/Rented/Family/Employer’s
17. Occupation Service/Self-employed/Business
/Professional/Others
18. Name/Address of Employer/
Business

19. Annual Gross Income/Salary Rs.
20. Annual Income from sources
Other than the occupation Rs.
21. Total Annual Income from
All sources (enclose evidence) Rs.
22. Annual Net Income/Salary Rs.
23. Particulars of Assets held Including real property

24. Particulars of Liability if any

25. Banking with
Name of the Bank
Branch
Account SB A/c CD A/c

(III) COST OF COURSE Amount (Rs.)
Particulars 8th Class 9th Class 10th Class
26. Fees – Tuition/Exam./Computer /Hostel etc.
27. Books/Uniform/Study Tour etc
28. Deposit – Caution/Refundable /Building Fund
29. Bicycle/Moped
30. Others
(IV) SOURCE OF INCOME
31. Contribution of parent/Guardian and/or other members of the family/relatives towards total expenses
32. Scholarship Available
33. Amount of loan required from the Bank

I/We have attached copies of following documents :-

a) Mark Sheet of last Examination.
b) Schedule of Expenses for the 8th, 9th & 10th Class.
c) Passport size photographs of Parent/Student (2 copies)
d) Proof of the Income.
e) Latest Salary Certificate and Form No.16 for salaried persons.

DECLARATION

I/We hereby declare that the information furnished against the foregoing items is true to the best of my/our knowledge and belief and binding on me/us. Further, the above particulars shall form the basis of any loan Central Bank of India may decide to sanction to me/us. The loan amount will be used for the purpose for which it is granted.

Signature of Father/Guardian:

Signature of Guarantor(s) : 1.

2.

Place :
Date :