Application Form 2024-25

This document is the application form for scholarships under Project Shiksha of Fusion Finance, implemented by Synergie. Your application for this scholarship is free and voluntary. Please read and fill out this form completely and submit all documents. Incomplete application forms will be rejected.

1 About the Student

name of the student
date of birth
gender
Female Male Others
mobile number
aadhar number
email
State / District
PIN CODE
Other DetailsCheck-mark if applicable
- Specially abled
- Single Parent
- Both Parents Deceased
Father/Guardian Name
mobile number
Occupation
Mother Name
Have you received this scholarship before?

Yes No
What was the Scholarship amount received?

2 Academic Details

Present Class
Present Class Stream
Annual Fees
School/College Type
Name of school/college
complete address of school/college
State / District
pin code
Contact number of school College

3 Bank Details of Applicant

Account holder's nameThe account should be in the student’s name alone or jointly with either parent
bank name
account number
ifsc code

4 Mandatory Documents Checklist

Please provide self-attested copies of the following documents.

Recent photograph of the student
- + Upload
Marksheet Front - Academic year 2023-24
- + Upload
Marksheet Back - Academic year 2023-24
- + Upload
Aadhar Card of the Student - Front
- + Upload
Aadhar Card of the Student - Back
- + Upload
Aadhar Card of the Father - Front
- + Upload
Aadhar Card of the Father - Back
- + Upload
Aadhar Card of the Mother - Front
- + Upload
Aadhar Card of the Mother - Back
- + Upload
PROOF OF Family INCOME (Upload any one)
- + Upload
Declaration from School/CollegeDownload sample declaration format
- + Upload
Bank passbook or cancelled cheque
- + Upload
Fee receipt Academic year 2024-25
- + Upload
Attendance Certificate from School/College
- + Upload

5Mode of Application

How did you apply for this scholarship?

Staff Name

Staff Contact Number

Employee State

Employee Location

By submitting this form, I accept the following terms:

I understand that applying for this scholarship does not guarantee selection.
All the documents submitted are genuine, and all the information shared is true, to the best of my knowledge. I understand that if at any point any document is found to be false, the scholarship benefits may be withdrawn.
By submitting this application form and supporting documents, I authorize Synergie and Fusion Finance to store, process, transfer, and use the information provided for the purpose of the scholarship and any other reasonable and lawful purposes.
I understand that Fusion Finance reserves the right to stop this scholarship at any time. In such an event I will have no claims on Fusion Finance or Synergie.