Education Relief Form New 1 to 4 2023

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SHREE PATAN JAIN MANDAL

77, PATAN JAIN MANDAL MARG, MARINE DRIVE, MUMBAI – 400020.


PHONE: 22811346 MOBILE : 08779161209
EMAIL: patanmandal@gmail.com • www.patanmandal.org
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REGD. UNDER PUBLIC TRUST ACT, REGD NO. A-738 (MUMBAI) & A-791 (PATAN)• REGD. UNDER SOCITIES REG. ACT.REGD.NO. 690

EDUCATION SAHAY APPLICATION – Std. I to IV 2023-2024


Prerak Data : Maulikkumar Divyabalaben Navinbhai Shah Primary Education Sahay
Haste: Shri Mahendra Popatlal Shah
Sahyogi Data : Smt. Sadhnaben Mahendrakumar Shah – Primary Education Sahay
To.
Hon Secretary, Education Committee Family ID No. :
Shree Patan Jain Mandal
1 PERSONAL DETAILS : FILL IN BLOCK LETTERS
STUDENT’S FULL NAME

APPLICANT’S FULL NAME

MOHOLLA NAME

Applicant’s Aadhar Card No.

Res. Full Address: Res. Tel. No.:

Mobile No.:

E-Mail:
2 DETAILS OF FAMILY Total Members Studying Earning
MEMBERS

Full Name Age & Relation Occupation Monthly


DOB Income
A Applicant

3 DETAILS OF STUDY
School’s Full Name
Last Exam Std. Pass / Fail / Promoted
Total Marks Obtained Out of Marks %
Current Study Std.

Education Fee Rs. Term Fee Rs. Other Exp Rs.

Total Yearly Fee


4 REFERENCE
Full Name, Address & Moholla : Res. Tel. No.

Mobile No.

E-mail:

• Taken Education Help from Mandal in Last Year YES / No. Rs. : ………………………..

• Taken Education Help from any other Trust or Sangh YES / No. Rs. : ………………………..

Note: Education Committee was decided to sanctioned amount will be transfer in School’s Bank
Account. It is Compulsory to provide School’s Bank Details as per given below.

BANK DETAILS OF THE SCHOOL


A/c. Name :

Bank Name - Branch:

Bank A/c. Number IFSC Code :

It is Compulsory to Attach School Bonafide Certificate with Fees Structure


BANK DETAILS OF THE APPLICANT

A/c. Holder’s Name :

Bank Name : Branch :

A/c. No. : IFSC Code :

Note: Please attach applicant’s cancelled cheque or xerox of cheque with Application.
Please Attach copy of last mark sheet and fee receipt

Signature : Student’s Father’s/Guardian’s :


Date :

FOR OFFICE USE ONLY

Received Date ………………………….…… Signature ………………………... Sanction / Reject

Sanction Amount Rs. ……………………….. Date ………………………………

Signature Hon. Secretary Education :………………………………………………

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