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Build India Scholarship Scheme - Application Form

Personal Data

Full Name
Father's Name
Sex Male          Female
Mailing Address
 
 
 
  Pin State
Email Address
Date of Birth (DD/MM/YYYY)
Height (cms) : Weight (kg) :
Vision (if normal (i.e.6/6), type 0 or leave it blank) Left Eye :         Right Eye :

Educational Qualification

College / Institute Name
University Name
Expected Month/Year of Completion of Course (MM/YYYY)
Qualification
Discipline   Civil   Mechanical   Electrical
Details of Marks Obtained
* Note: Diploma Engineer who had been directly enrolled into 2nd year (BE / BTech) can enter the final exam marks of Diploma Degree in both Sem 1 & Sem 2 and need to enter the Aggregate in the Aggregate column
Semester Marks Scored Maximum Marks
I

II
III
IV
V
VI

Aggregate (Semester. I to VI) %
(if the marks are in CGPA convert into % and enter.
Do not enter avg CGPA)

Preferred Centre for Written Tests (Give your nearest Test Centre)
Preferred Centre to pursue M.Tech Programme (If selected) Option 1 Option 2 Option 3 Option 4  
Special Merit Awards
(Max 300 Chars)
Extra-curricular Activities
(Max 300 Chars)

Declaration

I declare that the information given above is true to the best of my knowledge.  Any false or incorrect information furnished above will result in disciplinary action being taken against me including removal from selection process.

Disclaimer: On-Line Application validation rules are designed based on the Advertisement requirement. Candidates are advised to read the advertisement carefully and refer "How to Apply" page on the main page. Application submitted through On-Line form does not imply that candidate has fulfilled all the criteria given in the advertisement and Application is subject to subsequent scrutiny and the application can be rejected if found to be ineligible at any point of time.

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