APPENDIX – A

TAMIL ANDU ADI-DRAVIDAR WELARE HIGHER EDUCATIONAL SPECIAL

SCHOLARSHIP/LOAN SCHEME ADMISSION REPORT

I …………………………………………………….son of Daughter of ………………………………………………………... (Mother’s Name & Father’s Name)

Joined …………………………….class of ……………………………………………………………………….……………………………..

Course as a regular student in the ………………………………………………………………………………….…………………..

(Name of the Institution) ……………………………………………..on ………………………………………….. I am residing in the College Hostel / residing in an approved …………………………………………………

……………………………………………………….

2. The Higher Educational Special scholarship award under the scheme has been

Sanctioned to me vide Distric Adi-Dravidar and Tribal Welfare Officer Letter No…………………………………

Dated

SIGNATURE OF THE STUDENT. DATED : PLACE :

COUNTERSIGNED BY THE HEAD OF THE INSTITUTION

SEAL / STAMP. 50/12-1

KUMAR.M MURUGAN.S

01-07-2019 B.Sc / M.Sc / MA / BA etc.

The Gandhigram Rural Institute (Deemed to be University)

Gandhigram 2019-2020

Institute Hostel

Gandhigram

----------

kumar.m

Registrar

HOD

Seal with Signature

Gandhigram01.07.2019

2

APPENDIX – B

(Government of Tamil Nadu)

Adi-Dravidar and Tribal Welfare Department.

............................... Section / Branch

PASSPORT

SIZE

PHOTOGRAPH

WITH

SIGNATURE

TAMIL ANDU ADI-DRAVIDAR AND TRIBAL WELFARE HIGHER EDUCATIONAL

SPECIAL SCHOLARSHIP/LOAN SCHEME APPLICATION FORM.

1. Name in full (in CAPITAL letters :

2. Place and Date of birth :

3. Nationality and the State to which you belong :

4. Full Address-

a) Present :

b) Permanent :

5. Married of Single :

6. (a) Father’s name in full : (b) Mother’s name in full :

(c) Nationality and State to which

he/she belongs :

(d) Occupation : Mother Father

---

KUMAR.M

10.05.2000

Indian - Tamil Nadu

D.No.8/42, Soundharam Nagar,Gandhigram post, GandhigramDindigul - 624302

Married (or) Single

Murugan.S

Malliga.M

Indian - Tamil Nadu

House Wife Agriculture Cooly

3

Address- Mother Father

(i) Present :

(ii) Permanent:

7. (a) Guardian’s name in full:

(if different from Mother & Father) (b) Occupation : (c) Address :

Present : Permanent : If dead please state the last address and occupation before death. Cross if the father/mother is the guardian.

8. Total monthly income from all Sources of parents / guardian.

9. Particulars of School/Colleges/University etc. Where you studied.

(Any break in the educational carrier should be indicated in the remarks column.)

_________________________________________________________________________________

Name of the Date of Date of Year of completion Remarks. College/ entering leaving of Institution certificate/degree. _________________________________________________________________________________

D.No.8/42, Soundharam Nagar, Gandhigram post,

Gandhigram, Dindigul - 624302

If you stay with Guardian House write Guardian Address

Rs. 75,000/- to 2,00,000/- PA

Govt. School, DGL 2016-2017 Mar.2017 Certificate Nil

Govt. Hr. Sec. SchoolDGL

2018-19 Mar. 2019 Certificate Nil

SSLC

HSC

4

10. Particulars of all examinations passed commencing with the

Matriculation of equivalent examination.

(if this space is not sufficient, the additional sheet may be attached)

_________________________________________________________________________________ Name of University / Year of Roll Class or subjects Examination. Board. Passing. No. Division with taken Percentage of marks & rank if any. ________________________________________________________________________________

11. (a) Name and address of the

Institution where the student has been admitted in the current academic year :

(b) Date of admission : (c) Course, year of study and subjects taken : (d) No. Of years reuired for the Completion of the course:

12. (a) Whether the course is a Regular full time course :

(b) Evening course : (c) Part-time course :

SSLC State Board Mar.2017 123456 1st class 3 Subjects

HSC State Board Mar.2018 654321 1st Class 4 Subjects

The GRI (DU) Institute Studying in 1st year B.Sc, / M.Sc, / BA / MA

The Gandhigram Rural Institute (Deemed to be University)

Gandhigram, Dindigul - 624302

2019-2020

01.07.2019

B.Sc, / M.Sc / BA / MA

3 years / 4 years / 5 years

Yes, Regular

5. 13. Whether the student is residing-

(a) In a college hostel :

(b) In a private hostel :

(c) The place of staying is : Approved lodge

(d) It is relatives house (or) staying with relatives :

(e) Date of admission :

(f) Monthly rate of charges :

14. If the applicant is in receipt of any other Scholarships of financial assistance from a State Government / University or any other institution or person, full particulars should be given including the monthly rate and the date of award, etc.

15. Amount of Higher Educational Special Scholarship/Loan required : 16. List of documents : (a) (b) (c) (d) (e) (f) 17. I hereby declare that the statements made by me in this application

form are true ot the best of may knowledge and belief. I further agree to abide by the terms and conditions of the award if I am selected for the Higher Educational Special Scholarship / Loan applied for

SIGNATURE OF THE STUDENT.

Yes, Institute Hostel

01.07.2019

Rs.1000/-

If you received / Not received

UG Rs.7,500/- (or) PG Rs.8,000/-

10th Mark sheet & 12th Mark Sheet

Last studied TC Copy

Community Certificate copy

Attanance Certificate copy

Aadhaar card copy

Bank book front page copy

Current year Income certificate copy

Kumar

6. 18. TO BE FILLED UP BY THE HEAD OF THE INSTITUTUION;-

(a) If the student is hosteller or day- scholar.

(b) If hosteller, the date of admission in the hostel.

(c) Name of the hostel

(d) If dayscholar did he apply for admission in the hostel and refused admission for want of accommodation.

(e) If the course is a regular full day course. Evening course /

Part-time course.

(f) Monthly rate of Boarding / Lodging charges.

(g) Cost of books

(h) Cost of instruments

(i) Other items. PLACE : DATED :

SIGNATURE OF THE WARDEN

NAME OF THE HOSTEL WITH SEAL.

Hosteller

01.07.2019

Ladies Hostel (or) Boy's Hostel

----

Regular

Gandhigram

01.07.2019 Hostel Warden

7. 19. (APPLICABLE TO CANDIDATE ALREADY ENROLLED IN AN INSTITUTION) Certified that Thiru/Tmt./Selvi ..................................................................................................... .................................................................................................................................................................. was admitted into my College / Institutiton (Name) ................................................................................. as a regular full time student in Class ..................................................................................................... .................................. on................................200 . PLACE : DATED :

SIGNATURE OF THE HEAD OF THE INSTUTION (SEAL)

Kumar.M, D/o Murugan.S, 8/42, Soundharam Nagar,

Gandhigram post, Gandhigram, Dindigul - 624302

The Gandhigram Rural Institute (Deemed to be University)

1 st B.Sc / M.Sc / BA / MA etc

01.07.2019

Gandhigram

01.07.2019

Registrar

HOD

Seal with Signature

8 APPENDIX – C This form is a specimen and similar form which may be typed must be submitted by each scholar every year on the announcement of annual examination results through the Principal of the institution last attached. This report must be forwarded to the District Adi-Dravidar and Tribal Welfare Officer who is administering these awards.

***

TAMIL NADU ADI-DRAVIDAR AND TRIBAL WELFARE HIGHER EDUCATIONAL SPECIAL SCHOLARSHIP / LOAN

Annual Progress Report of the scholar for 200...................... to 200 .............

1. Name of the Scholar : (in Block Letters). 2. Name of University/Institution/ : College. 3. Name of Examination passed in : March -- April 200.......... 4. Date on which the scholar’s : Examination was over (including practical’s). 5. Class/division secured (if only grades : are allotted the explanation of those grades as given in the marks sheet must attached). 6. Marks secured : 7. Percentage of marks : : 8. Class to which promoted / : Admitted during 200....................

9. Date of joining this class (if the class : Has not started the likely date of

start of the class).

10. Total duration of the course in which : Studying or to which admitted after

Passing the examination mentioned In Col. 3

2019 2020

KUMAR.M

The Gandhigram Rural Institute(Deemed to be University)Gandhigram - 624302

19 /

/ /

April / 2019

BA / MA / B.Sc / M.Sc

1st Class

1200/950

/ 19

79.16 %

1st year B.Sc /M.Sc/BA/MA

01.07.2019

9. 10. (a) No. of years completed already : (b) No. of years yet to be completed : (c) Period of course in the present year : 11. Year in which the final Universitity : Examination on completion of the full Course will be held. 12. Character and conduct of the scholar : (General review) 13. Whether the scholar is in receipt of : Any scholarship / stipend / Free

Studentship / emolument etc. From any Source except the Hither Educational Special scholarship: if so, the nature and amount of such scholarships(s)

12. A scholar can accept fee concession : Along with Tamil Nadu Adi-Dravidar

and Tribal Welfare Higher Educational Special Scholarship /Loan. Specific recommendations of the Principal / Head of the institution/etc. For the continuation of the Tamil Nadu Adi-Dravidar and Tribal Welfare Higher Educational Special Scholarship /Loan.

SIGNATURE (FULL NAME OF THE PRINCIPAL OR

HEAD OF THE INSTITUTION)

PLACE ...............................

DESIGNATION : DATED...............................

(OFFICE SEAL)

----

Three years / Two years

1st year

April, 2019

Good

Received (or) Not

Yes,

Recommenced

Registrar

HOD

Seal with signature

10

CASTE, INCOME AND CITIZENSHIP CERTIFICATE

Note:

I. This certificate is to be submitted along with the application by only those applicants

who belong to the Scheduled Caste / the Scheduled Tribe / the

Scheduled Caste Converts.

II. The certificate should be signed either by a Member of parliament belonging

to Tamil Nadu or a Member of State Legislative Assembly or council to the

residents within his Constituency or Chairman of Municipal council or

Chairman, Panchayat Union Council or a Honorary Magistrate to the residents

within his jurisdiction or a Municipal Commissioner or an Officer of the

Revenue Department not lower Rank than a Deputy Tahsildar or Sub-Magistrate

of District Welfare Officer or an Inspector of Police or a Block

Development Officer or a Gazetted of State Government.

III. This certificate is a very important document and the scholarship is

awarded mainly on the Basis of this certificate. This issuing authority

is therefore advised to issue this certificate with due caution so that the

scholarship really goes to the students who actually belongs to either

of the classes specified above.

Certify to the best of my knowledge that--

1. Thiru/selvi/Tmt…………………………….....……………………………………………………..

Son/daughter/wife of Thiru……………….................…........………………………………………..resident

Of……………………………………......…………………………………………………..is a Citizen of India,

And belong to the……………………………….......................…………………………………………..

……………………………………………..

2. His/her sub caste is …………………………………………………………and religion is

……………………………………………………………….

11.

3. His / Her father / guardian / Husband is a permanent resident of village

.................................................................Taluk.........................................................District....................

State...............................................................................

4. The total annual income from all sources of both the parents/Guardian /

husband in the preceding year ending 31st March in 200 .

is Rs. .......................................

Signature ..............................................................

Name (in block letters) ........................................

Designation ..........................................................

Full Address..........................................................

* SEAL

* Please write whether the applicant belongs to Scheduled Caste / scheduled Tribe.

* A certificate not bearing the seal of the issuing authority, if that be a gazetted or any

Specially authorised officer, will not be accepted. Others may also affix their seals if

Available.

Enclosed Income & Cast Certificate

D.E.C. 1-1,46,006---2010-«.¸¢.«., ÒШ¸

¾Á¢ú¿¡Î «ÃÍ

À¢üÀÎò¾ôÀ𧼡÷ ÁüÚõ º¢ÚÁ¡ý¨Á¢É÷ ¿Äò ШÈ/Á¢¸ô À¢üÀÎò¾ôÀ𧼡÷

ÁüÚõ º£÷ ÁÃÀ¢É÷ ¿Äò ШÈ

¯¾Å¢ò ¦¾¡¨¸ Å¢ñ½ôÀõ Ò¾¢ÂÐ º¡¾¢ :

¦º¡ó¾ Á¡Åð¼õ : ÀÊôÒ:

À¢Ã¢× : À¢.Å./Á¢.À¢.Å.º£.Á.

(§Áø¿¢¨Äô ÀûÇ¢ ÁüÚõ «¾üÌ §ÁüÀð¼ ÀÊôÒ)

À¢Ã¢× -- '«'

1. Á¡½Åâý ¦ÀÂ÷ .. .. .. .. 2. ¸øÅ¢ ¿¢¨ÄÂò¾¢ý ¦ÀÂÕõ Ó¸ÅâÔõ .. .. .. 3. ¸¼ó¾ ¬ñÊø ÀÊò¾ ÅÌôÒ .. .. .. .. 4. ¿¼ôÒ ¬ñÊø ÀÊìÌõ ÅÌôÒ ÁüÚõ ¸¡Ä «Ç×.

(«) ¦ºýÈ ¬ñÊø ÅÕ¨¸ô À¾¢× Å¢Ø측Î, º¡ýÚ¼ý 5. ¸¼ó¾ ¬ñÎò §¾÷Å¢ø §¾÷ ¦ÀüÚûǣá? ¦ÀüÈ ºÃ¡ºÃ¢ Á¾¢ô¦Àñ (ÀðÊ嬀 þ¨½ì¸×õ) («) ¸¼ó¾/¿¼ôÒ ¬ñÊø ¯¾Å¢ò ¦¾¡¨¸ ¦Àüȡá? ¬õ ±É¢ø «¾ý Å¢ÅÃõ. 6. ÀÊôÒô À¢Ã¢× ºõÀó¾ôÀð¼ ШÈ¢ý ²üÀ¢¨Éô ¦ÀüÚûǾ¡? 7. þ§¾ ÀÊôÀ¢üÌ þ¾Ã Шȸû ãÄõ ¯¾Å¢ò ¦¾¡¨¸ ¦ÀüÚûǣá? 8. ¾Á¢ú¿¡Î ¸øÅ¢ Å¢¾¢¸Ç¢ýÀÊ «¨Ã/ÓØì ¸ð¼½î ºÖ¨¸ ¦ÀÈò ¾Ì¾¢¯ûÇÅá? ÀÊôÒì ¸ð¼½ Å£¾õ (ÓØì ¸ð¼½õ/ «¨Ãì ¸ð¼½õ) 9. «ÃÍ / Àø¸¨Äì ¸Æ¸ò §¾÷×ìÌ Ó¾ø Өȡ¸ «ÛôÀôÀθ¢È¡Ã¡? §¾÷×ì ¸ð¼½õ ±ùÅÇ×?

D.B.C. 1-1.

Reg.No Cell No.

Hindu - Vanniyar

Madurai

1st year B.Sc Chemistry

(BC)

RADHA.SThe Gandhigram Rural Institute (Deemed to be University)Gandhigram.+21st year B.Sc Chemistry (Three years course)

90%

Yes

(Enclosed last year mark sheet)

Yes (or) No (If yes, give details)

(Enclosed Attanance Certificate)

Yes, Approved course

Yes (or) No

Yes

Yes, Exam Fee Rs.2,200/- (for two semester)

2

10. ¸øÅ¢ ¿¢¨ÄÂò¾¢üÌõ Å¢ñ½ôÀ¾¡Ã÷ ź¢ìÌõ þ¼ò¾¢üÌõ ¯ûÇ ¦¾¡¨Ä× 11. Å¢ñ½ôÀ¾¡Ã÷¸û ÅÂÐõ, À¢Èó¾ ¿¡Ùõ .. 12. ¸øÅ¢ ¿¢¨ÄÂò¾¢ø Á¡½Å÷ §º÷ó¾ ¿¡û .. 13. Ţξ¢Â¢ø §º÷ó¾ ¿¡û .. 14. «Ãº¢ý À¢üÀÎò¾ôÀ𧼡÷ ¿Äò ШÈ, Á¢¸ô À¢üÀÎò¾ôÀ𧼡÷ ÅÌôÒ, ¬¾¢ ¾¢Ã¡Å¢¼÷ ¿ÄòÐ¨È ²üÀ¢¨Éô ¦ÀüÈ Å¢Î¾¢Â¡? ¸øÅ¢ ¿¢¨ÄÂòмý þ¨½ó¾ Ţξ¢Â¡? 15. Ţξ¢¨Â Å¢ðÎ ¿£íÌõ §¾¡Ã¡ÂÁ¡É ¿¡û 16. Ţξ¢Â¢ø ÅÝÄ¢ì¸ôÀÎõ ¯ñÊ, ¯¨ÈÔû ¸ð¼½ Å£¾õ.

Á¡½Å÷ ¨¸¦Â¡ôÀõ Ţξ¢ì ¸¡ôÀ¡Ç÷ ¨¸¦Â¡ôÀõ

60 KM

18 / 13-05-2001

01.07.2019

Age.

01.07.2019

30.04.2020

Institution Hostel

Radha.S Hostel Warden

Seal with Signature

HOD

Seal with Signature

3

À¢Ã¢× -- '¬'

ÅÕÁ¡É --- º¡¾¢î º¡ýÈ¢¾ú 17. ¦Àü§È¡÷ / ¸¡ôÀ¡Ç÷ ¦ÀÂ÷ ¾ó¨¾ ¾¡ö ¸¡ôÀ¡Çâý (¦Àü§È¡÷ ¯Â¢Õ¼ý þø¨Ä¦ÂÉ¢ø ¦Àü§È¡÷ þÈó¾ ¿¡û ÌÈ¢ôÀ¢¼ôÀ¼ §ÅñÎõ.). («) º¡¾¢ / Á¾õ .. .. .. .. (¬) ¦º¡ó¾ Á¡Åð¼õ .. .. .. 18. ÅÕÁ¡É Å¢ÅÃí¸û ¸¼ó¾ ²ôÃø 1-Ä¢ÕóÐ Á¡÷î 31 Ũà ¦ÀüÈ ¸¼ó¾ ¬ñÎ ÅÕÁ¡Éõ.

åÀ¡ö. ¿¢Äò¾¢ý ãÄõ .. .. .. .. ¿ý¦ºö ²ì¸÷ ¿¢Ä «Ç¨Å/°÷ Òý¦ºö ²ì¸÷ ¿¢Ä «Ç¨Å ţθǢý ãÄõ .. .. .. .. .. ¦¾¡Æ¢ø ãÄõ .. .. .. .. .. Ţ¡À¡Ãõ ãÄõ ÅÕÁ¡Éõ .. .. .. .. µöç¾¢Âõ .. .. .. .. .. (µö× ¦ÀüÈ ¾¡û) þ¾Ã ÅÕÁ¡Éõ .. .. .. .. .. _______________________________ ¦ºýÈ ¬ñÊø ¸¢¨¼ò¾ ¦Á¡ò¾ ÅÕÁ¡Éõ .. _______________________________ Å¢ñ½ôÀ¾¡Ã÷ Ó¸Åâ ¾ü§À¡¨¾Â ¿¢Ãó¾Ã Ó¸Åâ. Ó¸Åâ. ¦º¡ó¾ °÷ .. .. ..

Åð¼õ .. .. .. Á¡Åð¼õ .. .. .. «Õ¸¢ø ¯ûÇ «ïºø ¿¢¨ÄÂõ

¦Àü§È¡÷ («) ¸¡ôÀ¡Ç÷ ¨¸¦Â¡ôÀõ (þòмý þ¨½ì¸ô Àð¼ ¯Ú¾¢ Á¡½Å÷ ¨¸¦Â¡ôÀõ. ¦Á¡Æ¢¨ÂÔõ ¾Ã §ÅñÎõ). D.B.C.1-2.

D.No.1-3-7/15, South street,Madurai.BC - Vanniyar

Madurai

95,000/-

95,000/-

/

D.No.1-3-7/35, South street,Madurai south, Madurai.

Pin. 625502

Radha.S Saravanan

4

¯Ú¾¢¦Á¡Æ¢.

Å¢ñ½ôÀ¾¡Ã÷ §Á§Ä ÌÈ¢ôÀ¢ðÊÕìÌõ º¡¾¢Â¢É÷ ±ýÚõ «ÅÃÐ ¬ñÎ ÅÕÁ¡Éõ

å.----------------------------±Øò¾¡ø (----------------------------------------------------------------------------------------------------------) ±ýÚ º¡ýÈÇ¢ì¸ôÀθ¢ÈÐ. ¸¢Ã¡Á ¿¢÷Å¡¸ «ÖÅÄ÷ ÅÕÅ¡ö ¬öÅ¡Ç÷ º¡ýÚ ÅÆíÌõ «ÖÅÄâý ¨¸¦Â¡ôÀõ. ¿¡û: ¦ÀÂ÷ : À¾Å¢ô ¦ÀÂ÷ : Óò¾¢¨Ã : («ÖÅĸ Óò¾¢¨Ã) À¢ý ÌÈ¢ôÒ : ¿¢¨ÄÂ¡É º¡¾¢î º¡ýÚ ¦ÀüÈÅ÷¸û «¾ý ¦ƒÃ¡ìŠ ¿¸ø «ÛôÀ¢É¡ø §À¡Ðõ. ¬É¡ø

ÅÕÁ¡Éî º¡ýÚ «ÛôÀ §ÅñÎõ.

¿¢¨ÄÂ¡É º¡ýÚ þøÄ¡¾Å÷¸û §Áü¸ñ¼ ÀÊÅò¾¢¨É â÷ò¾¢ ¦ºöÐ º¡ýÚ ¦ÀüÚ «ÛôÀ

§ÅñÎõ.

Herewith enclosed copy of the Income certificate(Latest received copy)

5

«ÖÅĸì ÌÈ¢ôÒ.

1. Á¡½Åâý ¦ÀÂ÷ .. .. ..

À¾¢§ÅÎ ±ñ :

2. ÀÊôÒô À¢Ã¢× / ÅÌôÒ .. ..

Àì¸õ ±ñ :

3. º¡¾¢Ôõ, ¬ñÎ ÅÕÁ¡ÉÓõ .. ..

¦¾¡¼÷ ±ñ :

4. ¦º¡ó¾ Á¡Åð¼õ . .. ..

Å¢ñ½ôÀ¾¡Ãâ¼É¢ÕóРŢñ½ôÀõ.....................................................¸¡Äí¸¼óÐ ÅóÐûÇÐ. Ţξ¢ ź¾¢Ô¼ý/Ţξ¢ ź¾¢ ¿£í¸Ä¡É ¯¾Å¢ò ¦¾¡¨¸ å. ¨À. («) ¯ñÊ, ¯¨ÈÔû ¸ð¼½õ å.--------- Å£¾õ .. .. Ó¾ø Ũà ¾¢í¸ÙìÌ. (¬) Òò¾¸ Å¢¨Ä Á¾¢ôÒ, º¢ÈôÒì ¸ð¼½õ .. .. ÁüÚõ ¸üÀ¢ôÒì ¸ð¼½õ. (þ) §¾÷×ì ¸ð¼½õ. .. .. __________________________

¦Á¡ò¾õ ... __________________________

¿¡û: ¸øÅ¢ ¿¢ÚÅÉò ¾¨ÄÅ÷ ¨¸¦Â¡ôÀõ, Óò¾¢¨Ã.

RADHA.S---

---

---

B.Sc Chemistry / 1st year

BC / Rs.95,000/-

Madurai

-----

2500 25,000/-July April

3,500/-

2,200/-

30,700/-

01.07.2019

Registrar

HODSeal with Signature

6

ÌÈ¢ôÒ -- þÄÅºì ¸øÅ¢ò ¾¢ð¼ò¾¢ý¸£ú (Free Education Scheme) ºÖ¨¸¸û ¦ÀÈ Å¢ÕõÒõ Á¡½Å÷¸û ÁðÎõ ¸£úì¸ñ¼ º¡ýÈ¢¾Æ¢¨É «Ç¢ì¸ §ÅñÎõ. º¡¾¡Ã½ (State Postmatric Scholar ship) ¯¾Å¢ò ¦¾¡¨¸ìÌ þó¾î º¡ýÈ¢¾ú «Ç¢ì¸ §Åñʾ¢ø¨Ä.

º¡ýÈ¢¾ú

«Ãº¡¨É ±ñ¸û 81 ÁüÚõ 82, À¢.Å. ÁüÚõ Á¢.À¢.Å. ¿Äò ШÈ, ¿¡û: 26--4--1990 ÁüÚõ

«Ãº¡¨É ±ñ 79, À¢.Å. ÁüÚõ Á¢.À¢.Å. ¿Äò ШÈ, ¿¡û: 9--11--1991--ýÀÊ þÄÅºì ¸øÅ¢ò ¾¢ð¼ò¾¢ý¸£ú À¢üÀÎò¾ôÀ𧼡÷ /Á¢.À¢.Å. / º£÷ÁÃÀ¢É÷ ÌÎõÀò¨¾î §º÷ó¾ Ó¾ø Өȡ¸ ãýÈ¡ñÎ þÇí¸¨Äô Àð¼ôÀÊôÒ / ¦¾¡Æ¢ü Àð¼ôÀÊôÒ À墀 þÕìÌõ Á¡½Å÷/Á¡½Å¢/ ¦ºøÅý/¦ºøÅ¢........................................................................................................................................................... ¾¡ö/¾ó¨¾/¾¢ÕÁ¾¢/¾¢Õ.............................................................................................................................................. ±ýÀÅ÷.......................................................................................................................................................................... Ó¸Åâ¢ø ź¢ìÌõ ÌÎõÀò¾¢ø Àø¸¨Äì ¸Æ¸ô Àð¼õ ¦ÀüÈÅ÷¸û ¡Õõ þø¨Ä ±Éî º¡ýÈ¢¾ú ÅÆí¸ôÀθ¢ÈÐ.

Á¡½Å÷ ÁüÚõ «Åâý ¦Àü§È¡÷¸û «Ç¢ò¾ ¸£úì¸ñ¼ Å¢ÅÃí¸û ÁüÚõ ÅÕÅ¡öò ШÈ

«¾¢¸¡Ã¢¸Ç¢ý Å¢º¡Ã¨½ «È¢ì¨¸¸Ç¢ý «ÊôÀ¨¼Â¢ø þóòî º¡ýÈ¢¾ú ÅÆí¸ôÀθ¢ÈÐ.

ÀÊôÒ

Å⨺ ±

ñ.

¦ÀÂ

÷.

¯È× Ó

¨È ¾

ó¨¾/¾¡ö

/

º§¸¡¾

Ãý/º§¸¡¾

â.

Àð¼õ ¦

ÀüÈÅ÷.

Àð¼ô

ÀÊôÒ

À¢øÀÅ

÷

¾¢Õ

Á½

õ Ò

âó¾Åá

?

«øÄÐ þ

ø¨Ä¡?

¯Â¢Õ

¼ý þ

Õ츢ȡÃ

¡?

«øÄÐ þ

ø¨Ä¡?

(1) (2) (3) (4) (5) (6) (7)

1

2

3

4

5

6

7 Ш½ Åð¼¡ðº¢Â÷/Åð¼¡ðº¢Â÷.

þÕôÀ¢¼õ Åð¼õ :

¿¡û : Á¡Åð¼õ :

(If your first graduate in your family then enclose a copy of First Graduate Certificate)

7

À¢Ã¢× -- 'þ'

Á¡½Å÷ «Ç¢ì¸ §ÅñÊ ¯Ú¾¢¦Á¡Æ¢

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º¡ýÈ¢¾ú ¦ÀüÈ¢ÕôÀ¾¡¸ô À¢ÈÌ Å¢º¡Ã¨½Â¢ý §À¡Ð ¦¾Ã¢Â Åó¾¡ø (I.P.C) Ì.¾.Å¢.¦¾¡.À¢Ã¢× 420-ý Àʧ¡ ÁüÚõ «¾¨Éî º¡÷ó¾ þ¾Ã ºð¼ Å¢¾¢¸Ç¢ýÀʧ¡ ±ýÁ£Ð ¿¼ÅÊ쨸 ±ÎòÐ즸¡ûÇÄ¡õ ±ýÈ ¿¢Àó¾¨ÉìÌ ¯ðÀθ¢§Èý.

Á¡½Åâý ¨¸¦Â¡ôÀõ. ¦Àü§È¡÷ «øÄÐ ¦Àü§È¡÷ þø¨Ä¦ÂýÈ¡ø ¸¡ôÀ¡Çâý ¨¸¦Â¡ôÀõ. þ¼õ : ¿¡û :

Madurai

01.07.2019 Radha.S

Radha.S Saravanan

Madurai

01.07.2019

8

Ó츢 ÌÈ¢ôÒ¸û.

¯¾Å¢ò ¦¾¡¨¸ Å¢ñ½ôÀô ÀÊÅò¨¾ ¿¢¨È× ¦ºöÔõ Óý Á¡½Å÷/Á¡½Å¢Â÷ ÀÊòÐò ¦¾Ã¢óÐ ¦¸¡ûÇ §ÅñÊ Ó츢Âì ÌÈ¢ôÒ¸û.

1. þó¾ Å¢ñ½ôÀ¢ò¨¾ Á¡Åð¼í¸Ç¢ø ÀÊìÌõ Á¡½Å÷¸û Å¢ÎôÀ¡Î ²Ðõ þýÈ¢ ¿¢¨È×

¦ºöÐ ¦¾¡¼÷Ò¨¼Â ¸øÅ¢ ¿¢ÚÅÉò ¾¨ÄÅÕìÌ «ÛôÀ §ÅñÎõ.

«ÛôÀ §ÅñÊ ¸¨¼º¢ ¿¡û.

1. ÀûÇ¢ô ÀÊôÒìÌ §ÁüÀð¼ ƒ£ý ¾¢í¸Ç¢ø ¾¢Èì¸ôÀð¼¡ø ¬¸ûð 15 ¬õ ¿¡û. ÀÊôÒ Àð¼ô ÀÊôÒ, ¦¾¡Æ¢üÀ¢üº¢ ƒ£¨Äò ¾¢í¸Ç¢ø ¾¢Èì¸ôÀð¼¡ø ¬¸ûð 31 ¬õ ¿¡û. ¸øæâ¸û.

2. Àð¼ §ÁüÀÊôÒ, ÁÕòÐÅõ, ¦ºô¼õÀ÷ 30 ¬õ ¿¡û. ²¨É ¦¾¡Æ¢ø, ¦À¡È¢Â¢Âø ¸øæâ¸û. 2. þó¾ Å¢ñ½ôÀò¨¾ ¸¢ÕòÐÅ Á¾ò¨¾î º¡÷ó¾ À¢üÀÎò¾ôÀð¼/Á¢¸ô À¢üÀÎò¾ôÀð¼ º¡¾¢/

º£÷ ÁÃÀ¢¨Éî §º÷ó¾ Á¡½Å÷¸Ùõ ¯¾Å¢ò ¦¾¡¨¸ ¦ÀÈ ÀÂýÀÎò¾Ä¡õ. 3. ¦ºýÈ ¬ñÊý þÚ¾¢ò §¾÷Å¢ø 40 Å¢Ø측ΠÁ¾¢ô¦Àñ¸ÙìÌì ̨ÈÅ¡¸ Á¾¢ô¦Àñ¸û

¦ÀüÈÅ÷¸ÙìÌ ¯¾Å¢ò ¦¾¡¨¸ «Ç¢ì¸ôÀ¼Á¡ð¼¡Ð. º£÷ ÁÃÀ¢É÷ º¡¾¢¨Âô ¦À¡Õò¾ÁðÊø «õÁ¡ÉÅ÷¸û ¦ºýÈ ¬ñÊø þÚ¾¢ò §¾÷Å¢ø ÓبÁÂ¡É §¾÷ ¦ÀüÈ¢ÕôÀÐ ÁðΧÁ §À¡ÐÁ¡É¾¡Ìõ. ̨Èó¾ «Ç× Á¾¢ô¦Àñ¸Ç¡É 40 Å¢Ø측Π±ýÀÐ þÅ÷¸û ¦À¡ÕðÎ §Áü¦¸¡ûÇôÀ¼Á¡ð¼¡Ð.

4. À¢üÀÎò¾ôÀ𧼡÷/ÁüÚõ Á¢¸ô À¢üÀÎò¾ôÀ𧼡÷ ÅÌôÒ/º£÷ ÁÃÀ¢É÷ ¿Äò Ð¨È þÂìÌ¿÷¸û/Á¡Åð¼ À¢üÀÎò¾ôÀ𧼡÷ ¿Ä «ÖÅÄ÷ þ¨º× þýÈ¢ Á¡½Å, Á½Å¢Â÷ ¾íÌõ Ţξ¢¨Â Á¡üÈ¢ì ¦¸¡ûÇì ܼ¡Ð.

5. ¯Ú¾¢î º¡ýÈ¢¾ú, ÅÕÁ¡Éõ ÁüÚõ º¡¾¢î (À¢Ã¢× '«') º¡ýÈ¢¾ú ¦¸¡Îì¸ò ¾Ì¾¢ ¯¨¼Â «ÖÅÄ÷¸û :-

(«) ¾Æ¢ú¿¡Î «Ãº¢ý '«' ÁüÚõ '¬' À¢Ã¢× «ÖÅÄ÷¸û, Ш½ Åð¼¡ðº¢Â÷ À¾Å¢ìÌì

̨È¡¾ ÅÕÅ¡öò Ð¨È «¾¢¸¡Ã¢, º¡÷ ÌüÈÅ¢Âø ¿£¾¢À¾¢, ¸¡Åø Ð¨È ¬öÅ¡Ç÷, Åð¼¡Ã ÅÇ÷ «ÖÅÄ÷ þÅ÷¸Ç¢ø ¡áÅÐ ´ÕÅáø ¦¸¡Îì¸ôÀÎõ º¡ýÈ¢¾ú¸û ÁðÎõ ²üÚ즸¡ûÇôÀÎõ.

(¬) §Áü¸ñ¼ ¯Ú¾¢î º¡ýÈ¢¾Æ¢ø ¸¢Ã¡Á ¿¢÷Å¡¸ «ÖÅÄ÷, ÅÕÅ¡ö ¬öÅ¡Ç÷ ¬¸¢§Â¡Ã¢ý Å¢º¡Ã¨½ «È¢ì¨¸Â¢ýÈ¢ ̈ ¸¦Â¡ôÀÁ¢Îõ «¾¢¸¡Ã¢¸û Å¢ñ½ôÀ¾¡Ã¨Ãô ÀüȢ ÓØ Å¢ÅÃí¸¨Çò ¾É¢ôÀð¼ ӨȢø «È¢ó¾¢ÕôÀ¾¡¸×õ, þùÅ¢ñ½ôÀòÊø «Å¨ÃôÀüÈ¢ ¾ÃôÀðÊÕìÌõ ±øÄ¡ Å¢ÅÃí¸ÙìÌõ ¾¡§Á ÓØô ¦À¡ÚôÒ ²üÀ¾¡¸×õ ¸Õ¾ôÀÎÅ¡÷. ¾ÅÈ¡É º¡ýÚ ¦¸¡Îò¾¾¡¸ô À¢ýÉ÷ ¦¾Ã¢Â Åó¾¡ø º¡ýÈ¢¾Æ¢ø ºÃ¢Â¡É Å¢º¡Ã¨½Â¢ýÈ¢ì ¨¸¦Â¡ôÀÁ¢ð¼ «¾¢¸¡Ã¢Á£Ð «Å÷ À½¢ÒâÔõ ШÈò ¾¨ÄÅ÷ ãÄÁ¡¸ ´ØíÌ ¿¼ÅÊ쨸Ôõ ±Îì¸ôÀÎõ.

(þ) ¿¢¨È× ¦ºöÂôÀð¼ Å¢ñ½ôÀò¾¢ø «Êò¾§Ä¡, ¾¢Õò¾§Ä¡, §º÷ò¾§Ä¡ þÕó¾¡ø

º¡¾¢îº¡ýÈ¢¾ú ÅÆíÌõ «ÖÅħà «ó¾ó¾ þ¼ò¾¢ø ´ôÀõ þ¼§ÅñÎõ.

___________

Indicate your community BC/MBC/DNC Fresh ( ) Renewal ( )

Institute Name

Academic Year 2019-20

Course/Programme *

Year * I / II / III / IV / V

Studying Course Type* Self Support (or) Regular

Lateral Entry Yes (or) No Date of Admission (dd-mm-yyyy)

01.07.2019

Student Register No.

(Given by Institution)*Student Unique ID* (only

Renewal student)

Name of the Applicant *

Father /Parent / Guardian Name * Mother Name *

Occupation*

Date of Birth (dd-mm-yyyy)* (x calendar)

Gender * Male / Female

Community * Caste *

Annual Family Income * Rs.

Admission Mode* Government (or) Payment First Graduate Availed * Yes (or) No

10th

Register No * 12th

Register No *

Email ID* Mobile No*

Taluk * Taluk

District * District

Pincode * Pincode

Account No * Bank Name * CANARA BANK

Bank Address

IFSC Code * MICR Code *

Aadhaar Number *

Enrolment ID /Enrolment

Number/Aadhaar NumberEnrolment Date/Time

Hosteller * Yes/No

If Yes Paid Hostel / Free Hostel

Hostel Name

Date of Joining

Date of Leaving

Signature of the Student Signature of the HOD

Date:

HOSTEL DETAILS

Encl: Enclose the attested xerox copy of mark sheet,etc

Fresh students:

1. SSLC mark sheet, 2. H.Sc mark sheet, 3.UG.Degree Certificate, 4. P.G. Degree Certificate, 5. T.C & Conduct Certificate,

6. Community Certificate,7. Income Certificate, 8. Attendance certificate, 9. Aadhaar card 10. Bank pass book copy &

10. Disability Certificate if any

Renewal students:

1. Community Certificate 2. Income Certificate 3. Attendance certificate, 4. Aadhaar card & 5.Bank pass book copy.

Ladies Hostel/Dr.S.Radhakrishnan Hostel/ BC Govt. Hostel

THE GANDHIGRAM RURAL INSTITUTE (Deemed to be University) :: GANDHIGRAM - 624 302

POSTMATRIC SCHOLARSHIP CODING SHEET -2019-20

[ 3 Digit(City Code)+ 3 Digit(Bank Code)+3 Digit(Branch Code) ] e.g. 625015050 for Canara Bank - Gandhigram .

Income certificate period should not exceed 6 months at the time of admission

Permanent Address: Address for Correspondence *

The Gandhigram Rural Institute (Deemed to be University) Gandhigram.

BANK DETAILS

01-07-201930.04.2020

B.Sc Chemistry

19180001RADHA.S Saravanan.R Kavitha.SDaily Wage worker

13-05-2001

BC Vanniyar95,000/-

456789 321456radhas1@gmail.com 9876543210

D.No.1-3-7/15, South street,Madurai

Madurai southMadurai625501

0985101002348Madurai south branch, Madurai - 625501CNRB0000985 621501780

Seal with signature01.07.2019

9874 5632 1003

Radha.S

Indicate your community SC/ST/SCC Fresh ( ) Renewal ( )

Institute Name

Academic Year 2019-20

Course/Programme *

Year * I / II / III / IV / V

Studying Course Type* Self Support (or) Regular

Lateral Entry Yes (or) No Date of Admission (dd-mm-yyyy)

01.07.2019

Student Register No.

(Given by Institution)*Student Unique ID* (only

Renewal student)

Name of the Applicant *

Father /Parent / Guardian Name * Mother Name *

Occupation*

Date of Birth (dd-mm-yyyy)* (x calendar)

Gender * Male / Female

Community * Caste *

Annual Family Income * Rs.

Admission Mode* Government (or) Payment First Graduate Availed * Yes (or) No

10th

Register No * 12th

Register No *

Email ID* Mobile No*

Taluk * Taluk

District * District

Pincode * Pincode

Account No * Bank Name * CANARA BANK

Bank Address

IFSC Code * MICR Code *

Aadhaar Number *

Enrolment ID /Enrolment

Number/Aadhaar NumberEnrolment Date/Time

Hosteller * Yes/No

If Yes Paid Hostel / Free Hostel

Hostel Name

Date of Joining

Date of Leaving

Signature of the Student Signature of the HOD

Date:

HOSTEL DETAILS

Encl: Enclose the attested xerox copy of mark sheet,etc

Fresh students:

1. SSLC mark sheet, 2. H.Sc mark sheet, 3.UG.Degree Certificate, 4. P.G. Degree Certificate, 5. T.C & Conduct Certificate,

6. Community Certificate,7. Income Certificate, 8. Attendance certificate, 9. Aadhaar card 10. Bank pass book copy &

10. Disability Certificate if any

Renewal students:

1. Community Certificate 2. Income Certificate 3. Attendance certificate, 4. Aadhaar card & 5.Bank pass book copy.

Ladies Hostel/Dr.S.Radhakrishnan Hostel/ BC Govt. Hostel

THE GANDHIGRAM RURAL INSTITUTE (Deemed to be University) :: GANDHIGRAM - 624 302

POSTMATRIC SCHOLARSHIP CODING SHEET -2019-20

[ 3 Digit(City Code)+ 3 Digit(Bank Code)+3 Digit(Branch Code) ] e.g. 625015050 for Canara Bank - Gandhigram .

Income certificate period should not exceed 6 months at the time of admission

Permanent Address: Address for Correspondence *

The Gandhigram Rural Institute (Deemed to be University) Gandhigram.

BANK DETAILS

B.Com (Cooperation)

19180001

MALLIGA.M

KUMAR.M

MURUGAN.S

Agriculture Cooly

02 - 06 - 2000

SC Adi Dravidar

72,000/-

123456 654321kumarm@gmail.com 9876543210

8/42, Soundharam nagar, Gandhigram post,Gandhigram, Dindigul - 624302

AthoorDindigul624302

8500108000123Gandhigram University Branch, Gandhigram - 624302CNRB0008500 625015050

7894 5612 3000

01.07.2019

April - 2020

Kumar.MSeal with signature01.07.2019

KUMAR.M

MURUGAN.S

Agriculture Cooly

8/42, Soundharam Nagar, Gandhigram post, Gandhigram Dindigul - 624302.

BA/MA/B.Sc/M.Sc etc.,

UG Degree (or)

PG Degree

REG. NO: Cell No.

Day Time

Three years course

The Gandhigam Rural Institute(Deemed to be University)

Gandhigram

01 07 2019

Mar. 2016 123456

1. SC - Hindu - Sub-Cast name2. SCC - Cristian - Sub-Cast name3. ST - Hindu - Sub-Cast name

Rs.72,000/- PA

2016-SSLC Govt. School, DGL Yes / No 95%

2018-HSC Govt. Hr. Sec. School, DGL Yes / No 90 %

2019 - UG The Gandhigram Rural Institute (DU) Studying 1st year

8500108000123

CANARA BANK

GRI (DU) Branch

625015050

CNRB0008500

9876543210

kumar.m

Gandhigram

01.07.2019

1 Ravi.M B.Sc Maths 2017 Rs.5,000/-

3 Revathi.M +1 2018 Rs.2,500/-

2 Kumar.M B.Com 2018 Rs.6,100/-

-------

--------

murugan.s

Gandhigram

01.07.2019

01.07.2019

04/2019

Yes (or) No

Ladies (or) Boy Hostel

Institution Hostel

------

------

------

------

------

01.07.2019

Hostel Warden Signature with seal

95%

Good

Yes, Recommended

RegistrarWarden HOD

Seal with Signature Seal with Signature

Any brack of study, Enclosed Certificate

Aadhaar card copy

THE GANDHIGRAM RURAL INSTITUTE (DU)

GANDHIGRAM, DINDIGUL - 624 302

1

SC Hindu - Adi Dravidar

M Male

K U M A R . M

2 0 1 6

1 2 3 4 5 6

M U R U G A N . S

7 2 0 0 0 /- PA

8/42, Soundharam nagar, Gandhigram (PO)

Gandhigram, Dindigul

624302

+2

1

+2

03.07.2018

B.Com 1 st year

Co-operation

1st year

0 1

0 72 0 1 9

0 1

0 7

--

6 Institution Hostel

0 42 0 2 0

----

-----

8500108000123

GRI (DU) Branch

625015050

CNRB0008500

9876543210

---------------

-------------------

Registrar

Warden HODSeal with signature Seal with signature