EDUCATIONAL LOAN APPLICATION FORM

The Branch Manager,
Bank of Baroda,
______________ Branch,
____________________.
Dear Sir,
I/ my ward have / has secured admission to ________________ course conducted by
_________________School/ University / College/ Institute located at ______________.
For my / his / her education we request you to provide us financial assistance of
Rs_____________(Rs._________________________________________________)
the details of which are as given in this request application.
We undertake to repay the loan in ____________monthly installments beginning
____________months starting after –1- year after the course period or –6- months after
the borrower (student) getting the job.
Please complete all sections in BLOCK LETTERS and tick √ boxes wherever
applicable
(A) PARTICULARS OF THE STUDENT:
Name:_________________________________________________________________
Date of Birth:_________(DD) _______(MM)__________ (YYYY) Age:
Address:_______________________________________________________________
(Overseas address if student going for overseas studies)_________________________
PIN : _______________________
Telephone:____________ Fax:____________________ Mobile No. _______________
Nationality: ___________ Marital Status:_____________ Caste/Religion_____________
Life Insurance Policy details (if any):____________________________
EDUCATIONAL DETAILS : Please enclose mark lists of the examination passed
Examination Institution/University
from which passed
Year
Passing
Number of
Attempts
Percentage
of marks
Class
Obtained
Specialisation
if any
SSC
HSC
Degree
Post
Graduate*
Any Other *
• To be specified in the column "Specialisation"
PARTICULARS OF SCHOLARSHIPS / PRIZES WON FOR ACADEMIC DISTINCTION:
Examination Specify the academic distinction
for which the scholarship prize
Name of the
Scholarship
Amount of
Scholarship
Duration of
Scholarship
Bank of Baroda
HEAD OFFICE : MANDVI, BARODA
APPLICATION FORM FOR
EDUCATIONAL LOAN
Please paste
a recent
photograph of
student
Please paste
a recent
photograph of
student
was awarded Prize Rs.
From To
Any other information (Extra curricular activities and distinction awards received
if any):___________________________________________________________
PARTICULARS OF THE COURSE FOR WHICH THE LOAN IS REQUIRED
Name of the course:___________________________________________________________
University Institution:__________________________________________________________
Course/Institution is affiliated
To/recognized by
Duration of the course:________________________________________________________
Part time / Full time :__________________________________________________________
Correspondence / Distance Education
Expected per month income after completion of the course Rs:_________________________
In case of studies abroad state the details of R.B.I. approval (if necessary). Details of Foreign
Exchange required, Copies of Passport, Visa and other details to be submitted.
PURPOSE OF THE LOAN: (Rs. in '000)
Require
ment for
Fee Payable
to College/
School/
Institution
Examination
/Library/
Laboratory/
fees
Cost of Books/
Equipments/
instruments
/Uniforms
Caution
deposits/
building
fund/
refundable
deposit
Other Edu.
Exp.
(e.g. Study
tours,
projects,
thesis etc.)
Lodging
/Boarding
Travel
Exp/
passage
money
Total
Expen
ses
1st Year
2nd Year
3rd Year
4th Year
5th Year
Source of finance : Details of Scholarship / Loans / Own Funds
Loan amount Own Sources Scholarship Total
1st
2nd
3rd
4th
5th
(B) GUARDIAN'S / PARENT'S/GUARANTOR'S PARTICULARS: (If guardian & guarantor are
different separte sheet showing these particulars for each to be obtained)
Name :________________________________________________________________
Relationship with Student:_________________________________________________
Date of Birth:_____________ (DD)_______(MM)_______(YYYY) Age :
PAN/GIR No.:_______________. Driving License No:_______________
Passport No(If any) _________________________________
Residential Address (For Correspondence - with proof of residence)
______________________________________________PIN_____________________
Telephone : _______________ Fax:________________ Mobile No. _______________
Permanent Address:_____________________________________________________
______________________________________________PIN:____________________
Telephone : _______________ Fax:________________E-Mail. __________________
Whether residing in Own/Rented Accommodation: Since When residing :
Interest during study period will be serviced - Yes / No
Sex: Male Education : SSC Any Other Information
Female Under Graduate
Marital Status Graduate
Single Post-Graduate
Married Doctorate
Divorced If Professional : Doctor
Widowed Architect
No. of Dependents
(Excluding Spouse)
CA
No. of Children MBA
Engineer
Lawyer
Others
If Salaried : If Self Employed / Professional / Business
Name of the Organisation_____________________ Name of the Company________________
Designation Executive Managerial Clerk Office Address______________________
_________________________________
Department PIN_______________________________
Office Address:___________________________ Tel: ____________ Fax:______________
___________________PIN__________________ E-mail:____________________________
Tel: ___________Extn No.______ Fax:________ Business
Details
Pvt. Ltd Parnership
E-mail:_________________________________ Proprietorship Others
Working with Govt./Public
Sector
Public Ltd Established since:_____________________
Pvt. Ltd Partnership MNC Designation Executive Managerial
Proprietorship Gross Monthly Income:__________________
Year in Current Business:
>5 3-5 1-3 <1
Working Since:_____Retirement Age:________
(Greater) (Less)
Income Details of Parent / Guardian : Any other earning
member in the family
1. Gross Monthly Income Rs
(Proof to be submitted)
2. Net Monthly Income
3. Appr. Monthly house hold expenses
4. Monthly repayment of other loan
amount
5. Net Surplus available
6. Net Income of other family
member/s
(Excluding Co-applicant &
Guarantor)
(Relation with the
student________)
About Bank Account (including credit facilities if any)
Deposits
Name of the Bank,
Branch, Address &
Telephone No
Type of A/c
& A/c No.
No. of years
account held
Balance
Outstanding
Remarks
Loans
Name of the Bank
Branch &
Telephone No
Type of
Loan &
Limit
Security When sanctioned
& Repayment
Schedule-Amount
of Installment
Balance
Outstanding
Overdues
if any
Credit Card Details ________________________________
Credit Cards Owned:__________ Card Issuer___________ Colour Tv
Card No.______________________________ Refrigerator
Bank of Baroda Account No. _______________ CA/SB Two Wheeler
Since (in Years):__________________________ Cellular Phone
Computer
Washing Machine
Car
Other Assets
Landed Property
Branch Name:________________________
(Details to be submitted)
DECLARATION BY THE APPLICANTS:
1. The particulars furnished above are to the best of my/our Knowledge true and
correct.
2. The advance, if granted, will be utilized for the purpose for which it is granted.
3. I/We hereby authorize the bank to pay the fee and other amounts as may be
payable directly to the institution concerned.
4. I/We undertake to submit the receipt for all the disbursements made from the
loan account.
5. I/We undertake to inform the progress of studies of the student in respect of
education for which loan is applied.
6. I/We shall-keep the bank informed of my activities/Income/Scholarship etc.
during the tenure of the loan.
7. Immediately on securing job by the student, I/We undertake to inform the
employment details.
8. I/We undertake to maintain a Saving Bank Account and /or Deposit Account
with your Bank exclusively.
9. I/We will not / have not borrow/ed from any other Bank or any other source
during the currency of the advance without you prior consent in writing.
10. I/We undertake to meet any contingent expenses to continue the course of
study.
Date : ___________________ Yours faithfully,
Place : ___________________
STUDENT PARENT/GUARDIAN
I am willing to stand as guarantor.
Place : _______________________
Date : _______________________
Signature of the Guarantor/s