FORM

F-7

(F7)
CENTRAL BOARD OF SECONDARY EDUCATION
MERIT SCHOLARSHIP SCHEME FOR
PROFESSIONAL STUDIES AIEEE EXAMINATION
2010

Registration No.
(To be filled by
CBSE)

(PLEASE SEE ATTACHED INSTRUCTIONS)

1.

Name of Applicant (as per class XII

certificate)
Mothers Name

2. Date of Birth
(DD/MM/YYYY)
____/_____/_________

3. Roll No. (Class

XII)

5.

4.
Fathers Name
7.
No. of
Brothers____(excluding you)
8. No. of Sisters _____(excluding
you)
Nationality ______________

Address for correspondence 6. Year & Board of

Passing Class XII
________________
9. Sex (Tick)
Male

Female
State
10. Category (Tick)
Pin code
GEN/ OBC/ SC/ ST/ PH

12. Phone Number (with STD code)

______/____________
Mobile No. ________________________

1
Email Address
1.
1
Particulars of Savings Bank Account
3.
Account Number
a)
(Applicant only)
Name of the Bank
b) & Address (City and
State)
c) Bank Code Number
Name and Address of
present
1 College/Institution
admitted
for
4. where
Professional
Studies(AIEEE)

_____________________________________________________________________
_____________________District
____________________State
_______________

AIEEE (Final) Roll No.

Year of Selection _______ All India Rank _________

Course Name ___________________ Duration of Course __________

1
5.

Type of Institution : Central/ State Govt./ Private etc. (Tick)

Year of Study (I/ II/ III/ IV) (Tick)

1.

Enclosure attached
1
6.

1
7.

2.
3.

Is the candidate in receipt

of any other S/ship? If yes,
particulars should be given
i/n monthly amount & date
from which the S/ship is
being drawn

Copy of rank card

Yes/ No
Copy of Admission slip
Yes/ No
In case you are Single Girl Child of parent, submit an
Affidavit duly sworn in before the First Class Judicial Magistrate/
SDM/ Executive Magistrate, as per prescribed format
(Send fresh original affidavit even if already sent for SGC (X) Scholarship)
Yes/ No

Yes/ No

1
Signature of Applicant
8.

1
9.

Recent Color
Photograph of the
Applicant attested
and stamped by
Head of Institution
where student is
presently studying

Note:

________________ Date ___________

The facts stated above are hereby certified to be true and correct.
The character, regularity of attendance and good conduct of the
applicant is also certified.

Signature of Head of the Institution

Name
Telephone & Mobile No.
Email ID
Seal

Application will be rejected, if all the columns are not

filled.

INSTRUCTIONS FOR FILLING FORM F-7

CBSE MERIT SCHOLARSHIP SCHEME FOR PROFESSIONAL COURSES AIEEE
Eligibility
(i)
Should be an Indian national.
and
(ii)
Rank in the Merit List of AIEEE 2010 conducted by CBSE,
and
(iii) Pursuing professional course in engineering in any Central University/Institution
controlled or aided by Central Government/AIEEE participating Institutions.
and
(iv) 10% of the total scholarships will be awarded to those who are
otherwise eligible and are the only girl child in the family.
No. of Scholarships
Value per month
Duration
eligibility)

350 only
Rs. 1000/Four years (To be renewed on year to year basis subject to

Signature
All the applications must be signed by the applicant. Unsigned applications will be
rejected.
Attestation
All the applications must be certified by the Head of the Institution where the
admission has been taken alongwith his/her signature and stamp.
Bank Account Details
Applicants should write their Bank Account number with detailed address of the Bank
along with the Bank Code the Bank.
Documents to be sent with the Application

An attested copy of rank obtained.

An affidavit from the parent if the candidate is the only child of her parents on a nonjudicial stamp paper of Rs.10/- duly sworn in before First class Judicial
Magistrate/SDM/Executive Magistrate should be submitted along with the application.
AIEEE Score Card & Admission Slip indicating name of engineering college and
stream/course in which admission taken.
Where to send the Applications
The duly filled in proforma be sent in an envelope super scribing APPLICATION FOR
MERIT SCHOLARSHIP FOR AIEEE SCHOLARSHIP 2010 (F7) to the SECTION
OFFICER (SCHOLARSHIP), CBSE, SHIKSHA KENDRA, 2 COMMUNITY CENTRE,
PREET VIHAR, DELHI 110 092 by Regd Post.

Change in Address
Any change in address must be immediately reported to Section Officer (Scholarship),
CBSE,
Shiksha Kendra, 2 Community Centre, Preet Vihar, Delhi-110092
Note:

Applicant is entitled to receive only one scholarship from CBSE at a time. If the
applicant has received scholarship from any other scheme she has to refund
one scholarship, failing which action will be taken as per rules.
Scholarship will be sent to the correspondence address of applicant mentioned
in application form. List of eligible applicant who are being sent scholarship will
be displayed / updated on website regularly.

Last Date of Receipt of Application

31st DECEMBER 2010

FORMAT OF AFFIDAVIT
(ON NON-JUDICIAL STAMP PAPER OF RS.10/- SWORN BEFORE
I CLASS JUDICIAL MAGISTRATE/SDM/EXECUTIVE MAGISTRATE)

I ___________________ s/o,d/o _____________ r/o __________________ do hereby

solemnly affirm and declare as under:1) That _____________________ is my only one daughter and her date of
birth is ______________________.
2) That I am the father/mother and Ms. ____________________ is my only
daughter.
3) That I have no other child except my above named daughter.

DEPONENT
VERIFICATION
VERIFIED AT ON THIS ______________ DAY OF ____________ AND THE
CONTENT
OF THIS AFFIDAVIT ARE TRUE AND CORRECT AND NOTHING MATERIAL HAS
BEEN
CONCEALED.

DEPONENT
(Strike off whichever is not applicable)