• APPLICATION FORM FOR BOOK GRANT


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  • FileName: form_GRANT.pdf [read-online]
    • Abstract: APPLICATION FORM FOR BOOK GRANTName of the Student :___________________________________________________________________________FIITJEE Enrolment No. ____________________Batch No. ______________Year of studying _________________

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APPLICATION FORM FOR BOOK GRANT
Name of the Student :___________________________________________________________________________
FIITJEE Enrolment No. ____________________Batch No. ______________Year of studying _________________
AIR No._______________in IIT-JEE held in ________________________.
IIT where currently studying_______________________Entry No.________________Branch__________________
Semester for which Book Grant is claimed _____________________Amount_______________________________
I have purchased the following books for the semester for which necessary receipts are enclosed and I am
submitting this application form duly certified by the professors.
Certified that the Books are
Sl.
Name of the Book Price Name of the Teacher/Professor prescribed by me (Signature of the
No.
Teacher/Professor)
Mathematics
1
2
3
4
Physics
1
2
3
4
Chemistry
1
2
3
4
Total :-
STAMP OF IIT
Dated :______________ Signature of the Student
Permanent Residential Address (in Capital letters) : - Name :- _________________________
________________________________________ Address ( in Capital Letters) : -
________________________________________ ________________________________
________________________________________ ________________________________
E-mail ID:________________________________ ________________________________
Phone & Fax (with STD code)________________ ________________________________
In case of change in information, please inform us or email at [email protected]
In case cheque is to be sent at location other than Permanent Residential Address
-----------------------------------------------------------------------------------------------------------------------------------------------------------
FOR OFFICE USE
Passed for payment of Rs.________________
(Rupees_____________________________________________) (Authorised Signatory)
Paid vide Cheque No._____________dated __________for Rs.____________drawn on Canara Bank, Hauz Khas
Market Branch, New Delhi-110016.
(Sr. Accountant) (Dy. Manager - Accounts)
____________________________________________________________________________________________
ICES House, Sarvapriya Vihar (Near Hauz Khas Term.), New Delhi-16, Ph:26515949, 26569493, Fax: 26513942


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