ROOTS FOUNDATION

Scholarship Application Form

Application No:
Date:

Personal Details

Full Name of the Student
Mobile No.
Date of Birth
Age
Gender

MaleFemale Other

Physically Challenged

YesNo


If yes, specify:
Religion

Hindu Christian Muslim Other

Family Details

RelationshipNameOccupationAnnual Income
Father
Mother
Guardian

Educational Details

ExamYearSchool/CollegeMarks/Grade
SSLC/10th
PUC/12th
Other
First Graduate from the Family

Yes No

Courses you want to study1)

2)
Siblings studying in private institutions

Yes No

If Yes, studying with a scholarship?

Yes No

If No, how are you paying the fees?

Parents Bank Loan Other Loan

Scholarship / Financial Aid

Receiving any other scholarships/aid?

Yes No

If Yes, name of scholarship/organization
Amount received per year