SHUCHITA Scholarship Registration Form

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SHUCHITA Scholarship Registration Form

* Indicates required question

Email *

Your email

Name *

Your answer

Date of Birth *

MM

/

DD

/

YYYY

Are you a person with disability of *

Your answer

which categary type of disability

MIld

Moderate

Severe

Profound

Other:

Clear selection

How Many Percentage(%)of Disability

Your answer

Cast

Sc

St

OBC

Gen

Other

Specify

Other:

Clear selection

Which course you are prusuing *

Your answer

Which Institution you are studying *

Your answer

Do you have BPL certificate *

No

Yes

Mobile Number *

Your answer

Address *

Your answer

Submit

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