Shree Navgam Visanagar Vanik SamajMumbai : 6/8, Anantwadi, Nagar Nivas, Bhuleshwar, Mumbai - 400 002. I Tel.: 2206 3802

Kandivali : C-301, Gokul Heights, Mathuradas Road, Kandivali (West), Mumbai - 400 067. Tel. 022-2808 4024 / 25

Virar : C-301, Vithal Nagar, Ram Mandir Road, Virar (West), Thane - 401 303. Mob.: 93254 73822

PRATHMIK SHIKSHAN YOJANA - 2016

Stu

dent

Inf

orm

atio

nD

ecle

rati

on

Student Name :

Date :Vasti Patrak No. :Application Form : Mumbai Kandivali Virar Other

Pin Code :

( First Name ) ( Father / Mother Name ) ( Surname )

( First Name ) ( Father / Mother / Husbnd Name) ( Surname )

Nativ Place :

Resi. Address :

Date of Birth :

Mobile No.:

Age : E-mail ID :

Tel. : (O.) Tel. : (R)

To,

The Education Committee, SNVVS.

I/We hereby apply for the financial aid under Prathmik Shikshan Yojana-2016 as per details mentioned in the Form.

We have read and understood rules of this Yojana and we agree to abide by the same and amendment made thereto

from time to time. We hereby declare that the information provided in this application is true, complete and authentic to

best of our knowledge. We understand that any misrepresentation of facts is ground for rejection of this application.

Oth

er D

etai

ls

Educ

atio

nal

Det

ails

S

choo

l Fee

sB

ank

Det

ails

of S

tude

nt o

r Pa

rent

sFo

r O

ffic

e U

se Received Application Form from Mr./ Ms.

for Prathmik Shikshan Yojana along with (A) True Copy of Mark Sheet (B) Receipt of Fees Paid

(C) Cancelled Cheque.

Other Education Aid :

Name of Trust / Source :

Any other Education aid received and /or to be received from any Trust / sources. Yes No. If Yes, Amount :

No. of Family Members :

Last Standard you Passed : % / Grade

Earning Members : Annual Family Income :

School Name : Medium :

Total Yearly Fees :

Currently In which Standard : Gujarati English Other

Account Name :

Bank Name :

Branch Address :

Account No. :

IFSC Code :

Receipt

Receiver’s Signature Receiver’s Name Date

Particulars

School Tution Fee

School Term Fee

School Admission Fee

Computer Fee

Total Fees

Amount

SÉɱÉÖ ´ÉºÉâ G«ÉÉÅ yÉÉàùiÉ©ÉÉÅ +§«ÉÉ»É HùÉà UÉà +{Éà HÅ> ¶ÉɳɩÉÉÅ

Uà±±ÉÒ G«ÉÉ yÉÉàùiÉ{ÉÒ ~ÉùÒKÉÉ ~ÉÉ»É HùÒ ? (©ÉÉHǶÉÒ÷{ÉÒ ]àùÉàKÉ +É~É´ÉÒ W°ùÒ Uà.)

Dec

lera

tion +ùY ~ÉmÉH {ÉÅ.

lÉÉ.´É»lÉÒ ~ÉmÉH J©ÉÉÅH.

»ÉÖ[É ¸ÉÒ,+É +ùY ~ÉmÉH +{ÉÖ»ÉÉù ©ÉÉùà {ÉÒSÉà WiÉÉ´Éà±É ¡É©ÉÉiÉà ¶ÉäKÉÊiÉH »É¾É«É{ÉÒ W°ùlÉ Uà, »É©ÉÉW{ÉÒ +É +ùY{ÉÉ »É´Éâ yÉÉùÉ yÉÉàùiÉÉà lÉoÉÉ Ê{É«É©ÉÉà +{Éà lÉà©ÉÉÅ ¾´Éà ~ÉUÒ Wà £àù£Éù oÉÉ«É lÉà »É´Éâ ©É{Éà ©ÉÅWÖù Uà. {ÉÒSÉà Ê´ÉNÉlÉÉà WiÉÉ´É´ÉÉ©ÉÉÅ +É´ÉÒ Uà, Wà ©ÉÉùÒ XiÉ ¡É©ÉÉiÉà »ÉÉSÉÒ Uà.

©ÉÖÅ¥É> : 6/8, +{ÉÅlÉ´ÉÉeÒ, {ÉÉNÉù Ê{É´ÉÉ»É, §ÉÖ±Éà¹Éù, ©ÉÖÅ¥É> - 400 002. £Éà{É : 2206 3802

HÉÅÊq´É±ÉÒ : »ÉÒ-301, NÉÉàHÖ±É ¾É>÷»É, ©ÉoÉÖùÉqÉ»É ùÉàe,HÉÅÊq´É±ÉÒ (´Éà.), ©ÉÖÅ¥É> - 400 067. £Éà{É & 2808 4024/25

Ê´ÉùÉù : »ÉÒ-301, Ê´Éd±É {ÉNÉù, ùÉ©É©ÉÅÊqù ùÉàe, Ê´ÉùÉù (´Éà»÷), 401 303. £Éà{É : 93264 73822

¸ÉÒ {É´ÉNÉÉ©É Ê´É»ÉÉ{ÉÉNÉù ´ÉÊiÉH »É©ÉÉW

+{«É+ùY ~ÉmÉH: ©ÉÖÅ¥É> HÉÅÊq´É±ÉÒ Ê´ÉùÉù

»ÉÒ. {ÉÅ.

lÉÉ.

HÖ©ÉÉù / HÖ©ÉÉùÒ {ÉÒ yÉÉàùiÉ{ÉÒ

lÉÉ. 1-6-2016 +ùY »´ÉÒHÉù{ÉÉù{ÉÒ »É¾Ò

+ùY ~ÉmÉH: +{«É©ÉÖÅ¥É> HÉÅÊq´É±ÉÒ Ê´ÉùÉù

+Éà£

Ò»É A~É«ÉÉàN

É ©ÉÉ÷

à

Ê´ÉvÉoÉÇ{ÉÒ »É¾Ò

Pin Code :

( First Name ) ( Father / Mother Name ) ( Surname )

´É«É : E-mail ID :

Ê´ÉvÉoÉÔ{ÉÖÅ {ÉÉ©É :

»Éù{ÉÉ©ÉÖÅ :

´ÉlÉ{É :

W{©É lÉÉùÒLÉ :

£Éà{É {ÉÅ.£Éà{É {ÉÅ. Éà.{ÉÅ.©É

Ê´ÉvÉoÉÔ {É

Ê´ÉN

ÉlÉ

(Ê´Év

ÉoÉÔ{

ÉÉ ©ÉÉ

lÉÉ / Ê~É

lÉÉ+

à §Éù

´ÉÉ{ÉÖÅ)

¡ÉÉoÉÊ©ÉH ¶ÉäKÉÊiÉH «ÉÉàW{ÉÉ-2016

§ÉiÉ´ÉÉ{ÉÖÅ ©ÉÉy«É©É : NÉÖWùÉlÉÒ +ÅOÉàY <lÉù

¶ÉɳÉ{ÉÒ ´ÉÉʺÉÇH ÷«ÉÖ¶É{É /£Ò : ÷©ÉÇ £Ò +{Éà +àe©ÉÒ¶É{É £Ò HÉà©~«ÉÖ÷ù £Ò +§«ÉÉ»É LÉSÉÇ:

HÖ±É ©ÉÉÅNÉiÉÒ : ¥ÉÒY »ÉÅ»oÉÉ Hà ´«ÉÎGlÉ ~ÉÉ»Éà ~ɾà±ÉÉ ©Éqq ©É³Ò Uà / ©É³´ÉÉ{ÉÒ Uà.

©Éqq ©É³Ò ¾Éà«É lÉÉà Hà÷±ÉÒ ?

»HÖ±É £Ò (¡ÉÉoÉÊ©ÉH ¶ÉäKÉÊiÉH «ÉÉàW{ÉÉ 2016) ©ÉÉ÷à{ÉÒ +ùY ©É³à±É Uà.

©ÉÉlÉÉ Ê~ÉlÉÉ Ê´ÉvÉoÉÔ

©ÉÉlÉÉ/Ê~ÉlÉÉ {ÉÉ©É

´«É´É»ÉÉ«É HÖ÷ÖÅ¥É{ÉÒ ´ÉÉʺÉÇH +É´ÉH HÖ÷ÖÅ¥É{ÉÉ Hà÷±ÉÉ ©ÉÉiÉ»ÉÉà{Éà Ê{ɧÉÉ´É´ÉÉ ~Éeà Uà.

¾ÖÅ ¸ÉÒ {É´ÉNÉÉ©É Ê´É»ÉÉ{ÉÉNÉù ´ÉÊiÉH »É©ÉÉW{ÉÉà »É§ÉÉ»Éq UÖÅ / {ÉoÉÒ (»É©ÉÉW{ÉÉ »É§ÉÉ»Éq ¾Éà´ÉÖÅ W°ùÒ Uà.)

¾ÖÅ {ÉÒSÉà »É¾Ò Hù{ÉÉù, ÊSÉ. {ÉÉ ©ÉÉlÉÉ / Ê~ÉlÉÉ UÖÅ, +{Éà A~Éù

SÉàH HÉà{ÉÉ {ÉÉ©Éà Xà>+à Uà.

~ÉÖ° {ÉÉ©É

»ÉÅ~ÉÚiÉÇ »Éù{ÉÉ©ÉÖÅ

£Éà{É {ÉÅ.

WiÉÉ´Éà±É Ê´ÉNÉlÉÉà ©ÉÉùÉ XiÉ´ÉÉ ¡É©ÉÉiÉà »ÉÉSÉÒ Uà +{Éà ©ÉÉùÉ +ÉÊoÉÇH »ÉÅXàNÉÉà{Éà ±É>{Éà ©ÉÉùÉ ~ÉÖmÉ/~ÉÖmÉÒ +§«ÉÉ»É ©ÉÉ÷à »É¾É«É{ÉÒ W°ù Uà.

lÉÉùÒLÉ ©ÉÉlÉÉ - Ê~ÉlÉÉ{ÉÒ +ÉLÉÒ »É¾Ò

For

Off

ice

Use

Onl

y

Cheque / NEFTin the Name of :

Bank :

Encl

osur

e /

Decl

arat

ion

of

Stud

ent o

r Par

ents

/ Sig

natu

re

True Copy of Mark Sheet Original Paid Receipt of Fees Cancelled Cheque Copy

I am Father/Mother of and I confirm that information provided in this Application Form is correct in all respect.

I give my consent to Credit the fund directly in Account details provided.

Date : Parent Signature

SBT / BOB Cheque No. / UTR Date Approval Signature

1) If any person gives donation of Rs. 1,00,000/- in any particular year, then in that case his name will be associated

with the Yojana for that year.

2) If any person gives Rs. 3,000/- or more, then he will be considered as Education Donor. List of all such donors will be

published in Utthan.

1) 50% of Annual Fees or Rs. 6,000/- whichever is less.

2) In case of Widow’s child student (No Earning Member) will get additional Rs. 1,000/- (It should not be more then yearly fees)

3) Fees of Rs. 2000/- or less amount will get 100%. (Full Fees)

1) Student / Parents applying under Prathmik Shikshan Yojana should be Member of SNVVS.

2) This Yojana is for students from 1st to 10th Standard.

3) Application for the Students in Nursery, Senior KG & Junior KG can be submitted, but allocation may be done on

Number of Applications and Funds available.

4) Certified True Copy of Mark Sheet and Original Receipt of Fees Paid to be submitted with the Application. In case if you

received or applied to any other Trust / Organization for financial aid, then kindly provide the details for the same.

5) From Total Yearly Fees we will only consider School Tuition Fee, School Terms Fee, School Admission Fee and Computer Fee.

6) Separate Form should be filled for each student.

7) Form should be complete in all respect along with Bank details.

8) Amount will be directly remitted to account details provided by the applicant.

Timeline :

Appeal :

Student willing to take benefit under Saraswati Karkirdi Yojana-2016 should submit their application form dully filled with all supportingon or before 31st July, 2016. in any of the Samaj Office.

Education Committee Sanchalak, SNVVS

Krunal S. Shah - 098 1919 1599

General

Information :

Prathmik Shikshan

Yojana Criteria :

Aid Amount :

We believe that it is a moral responsibility of all students who are taking aid under Saraswati Karkirdi Yojana, contribute to SNVVS in the best possible way as and when you start carrier and get the opportunity. Your small contribution will lead to Education of few more students.

Rules for Prathmik Shikshan Yojana - 2016

Particulars

School Tution Fee

School Term Fee

School Admission Fee

Computer Fee

Total Fees

Amount Claimed Amount Approved

Student Name : Application Form : Mumbai Kandivali Virar Other

+É «ÉÉàW{ÉÉ{ÉÉà ±ÉÉ§É ±Éà´ÉÉ >SUÒlÉÉ Ê´ÉvÉoÉÔ+Éà+à +ùY~ÉmÉH »ÉÅ~ÉÖiÉÇ Ê´ÉNÉlÉ´ÉÉù q»lÉÉ´ÉàW »ÉÉoÉà »É©ÉÉW{ÉÒ +Éà£Ò»É©ÉÉÅ lÉÉ. 31-7-2016 »ÉÖyÉÒ©ÉÉÅ ~ɾÉàSÉÉe´ÉÉ Ê´É{ÉÅlÉÒ.

yÉÉàùiÉ :

lÉÉ.

Ê´ÉyÉ´ÉÉ / Ê´ÉyÉÖù +{«É »É¾É«É

Ê´ÉvÉoÉÔ{ÉÖÅ {ÉÉ©É

»É¾É«É ©ÉÉ÷à +ùY{ÉÒ ùH©É ©ÉÅWÖù Hùà±É ùH©É

+ÅHà (°~ÉÒ«ÉÉ)

LÉÉlÉàqÉù{ÉÖÅ {ÉÉ©É SÉàH {ÉÅ. ¥ÉáH

~ÉÉ»É Hù{ÉÉù{ÉÒ »É¾Ò

©ÉÖÅ¥É> : 6/8, +{ÉÅlÉ´ÉÉeÒ, {ÉÉNÉù Ê{É´ÉÉ»É, §ÉÖ±Éà¹Éù, ©ÉÖÅ¥É> - 400 002. £Éà{É : 2206 3802

HÉÅÊq´É±ÉÒ : »ÉÒ-301, NÉÉàHÖ±É ¾É>÷»É, ©ÉoÉÖùÉqÉ»É ùÉàe,HÉÅÊq´É±ÉÒ (´Éà.), ©ÉÖÅ¥É> - 400 067. £Éà{É & 2808 4024/25

Ê´ÉùÉù : »ÉÒ-301, Ê´Éd±É {ÉNÉù, ùÉ©É©ÉÅÊqù ùÉàe, Ê´ÉùÉù (´Éà»÷), 401 303. £Éà{É : 93264 73822

¸ÉÒ {É´ÉNÉÉ©É Ê´É»ÉÉ{ÉÉNÉù ´ÉÊiÉH »É©ÉÉW¥É

àáH{ÉÒ Ê´ÉN

ÉlÉ

LÉÉlÉàqÉù{ÉÖÅ {ÉÉ©É

¥ÉàáH {ÉÖÅ {ÉÉ©É úÉÉÅSÉ

+àHÉA{÷ {ÉÅ. +É«É.+à£.+à»É.»ÉÒ. HÉàe {ÉÅ.

+Éà£

Ò»É A~É«ÉÉàN

É ©ÉÉ÷

à HÖ±É ©ÉÉÅNÉiÉÒ

¡ÉÉoÉÊ©ÉH ¶ÉäKÉÊiÉH «ÉÉàW{ÉÉ-2016

1) °*. 1,00,000/- {ÉÖÅ qÉ{É +É~É{ÉÉù qÉlÉÉ{ÉÖÅ {ÉÉ©É +à ´ÉºÉÇ{ÉÒ ¡ÉÉoÉÊ©ÉH ¶ÉäKÉÊiÉH «ÉÉàW{ÉÉ »ÉÉoÉà XàeÉ´ÉÉ©ÉÉÅ +ɴɶÉà.2) °*. 3,000/- Hà lÉàoÉÒ ´ÉyÉÖ qÉ{É +É~É{ÉÉù qÉlÉÉ ¶ÉäKÉÊiÉH qÉlÉÉ NÉiÉɶÉà.

1) A~ÉùÉàGlÉ «ÉÉàW{ÉÉ©ÉÉÅ »É¾É«É ±Éà{ÉÉù Ê´ÉvÉoÉÔ{ÉÉ ´ÉɱÉÒ+Éà »É©ÉÉW{ÉÉ »É§«ÉÉà ¾Éà´ÉÉ £ùY«ÉÉlÉ Uà.2) +É «ÉÉàW{ÉÉ 1 oÉÒ 10 yÉÉàùiÉ »ÉÖyÉÒ{ÉÉ Ê´ÉvÉoÉÔ ©ÉÉ÷à Uà.3) {É»ÉÇùÒ, »ÉÒ{ÉÒ«Éù Hà.Y. +{Éà WÖ{ÉÒ«Éù Hà.Y.{ÉÉ ¥ÉɳHÉà+à +ùY Hù´ÉÒ ~ÉiÉ +ùY{ÉÒ »ÉÅL«ÉÉ +{Éà £Åe {Éà +ÉyÉÉùà £É³´ÉiÉÒ Hù´ÉÉ©ÉÉÅ +ɴɶÉà. £É³´ÉiÉÒ {É ~ÉiÉ oÉÉ«É.4) £Ò ±Éà{ÉÉù Ê´ÉvÉoÉÔ+à £Ò §Éùà±ÉÒ +ÉàùÒY{É±É ù»ÉÒq lÉà©ÉW ©ÉÉHǶÉÒ÷ »É©ÉÉW©ÉÉÅ +É~É´ÉÉ{ÉÒ ù¾à¶Éà +{Éà lÉà+Éà+à lÉà ©ÉÉ÷à ¥ÉÒY HÉà> »ÉÅ»oÉÉ©ÉÉÅ +ùY HùÒ ¾Éà«É +oÉ´ÉÉ ©Éà³´ÉÒ ¾Éà«É lÉà{ÉÒ Ê´ÉNÉlÉ +É~É´ÉÉ{ÉÒ ù¾à¶Éà.5) £Ò ©ÉÉ÷à +ùY Hù{ÉÉù Ê´ÉvÉoÉÔ+à »É©ÉÉWà +É~Éà±É £Éà©ÉÇ «ÉÉàN«É ùÒlÉà §ÉùÒ{Éà ©ÉÉàH±É´ÉÉ{ÉÖÅ ù¾à¶Éà. qùàH Ê´ÉvÉoÉÔ ©ÉÉ÷à +±ÉNÉ £Éà©ÉÇ §Éù´ÉÉ{ÉÖÅ ù¾à¶Éà.6) »É©ÉÉW ´ÉºÉÇ{ÉÒ 50 ÷HÉ £Ò +oÉ´ÉÉ °*. 6000/- ¥Éà ©ÉÉÅoÉÒ Wà +ÉàUÖÅ ¾Éà«É lÉà +É~ɶÉà. 7) NÉÅ. »´É. ¥É¾à{ÉÉà{ÉÉ (PÉù©ÉÉÅ ¥ÉÒWÖÅ HÉà> H©ÉÉ{ÉÉù {É ¾Éà«É) ¥ÉɳHÉà{Éà ¡ÉÉoÉÊ©ÉHlÉÉ +É~É´ÉÉ©ÉÉÅ +ɴɶÉà +{Éà lÉà+Éà{Éà °*. 1000/- ´ÉyÉÉùÉ{ÉÉ +É~É´ÉÉ©ÉÉÅ +ɴɶÉà. (Wà ´ÉÉʺÉÇH £ÒoÉÒ ´ÉyÉÉùà {É ¾Éà´ÉÉ Xà>+à)

8) 2,000/- °Ê~É«ÉÉoÉÒ +ÉàUÒ £Ò ´ÉɳÉ{Éà ~ÉÖùÒ £Ò +É~É´ÉÉ©ÉÉÅ +ɴɶÉà.9) £Ò {ÉÒ +ÉHÉùiÉÒ©ÉÉÅ +àe©ÉÒ¶É{É £Ò, ÷©ÉÇ £Ò, ÷«ÉÖ¶É{É £Ò +{Éà HÉà©~«ÉÖ÷ù £Ò {ÉÒ ´ÉÉʺÉÇH NÉiÉlÉùÒ{Éà W y«ÉÉ{É©ÉÉÅ ±Éà´ÉÉ©ÉÉÅ +ɴɶÉà.

+É «ÉÉàW

{ÉÉ {ÉÉà ±Éɧ

É ±Éà{É

Éù Ê´ÉvÉoÉÔ{ÉÉ ´ÉeÒ±ÉÉà+

à {ÉÒSÉà ©ÉÖW

¥É{ÉÉ Ê{É«É©ÉÉà{É

ÖÅ ~ÉɱÉ{É H

ù´ÉÖÅ

W°ù

Uà.

lÉÉ. 1-6-2016ʱÉ. ¶ÉäKÉÊiÉH »ÉÊ©ÉÊlÉ ´ÉlÉÒ

JÖiÉÉ±É +à»É. ¶Éɾ (98191 91599)