Education Loan / Gift Scholarship

    Fields marked in Red are mandatory.

    Basic Details

    Applicant Name:

    Date of Birth:

    - -

    Sex:

    Address:

    Door:

    Building:

    Street:

    Locality:

    Area:

    City:

    State:

    PIN:

    Landmark:

    Landline Telephone:

    Mobile Telephone:

    Email ID:

    Marital Status:

    Educational Achievements:

    Class / Level

    Name of School / College

    Board / University

    Stream / Subjects

    Passing Year

    Percentage

    Rank

    10th / S.S.E.

    12th / S.S.L.C.

    Undergraduation / Graduation

    Postgraduation

    Other

    Proposed Course of Study:

    Proposed Course of Study:

    School / College / University:

    Duration of Course (Months):

    Breakup of Fees:

    Fees already paid:

    Scholarship type:

    Scholarship received in Previous Years:

    Scholarship received in Current Year:

    Non-Academic Achievements:

    Other Distinctions / Scholarships:

    Are you earning?:

    Particulars of Family Members

    S. No.

    Full Name

    Age

    Relationship

    Occupation

    Employment / Business, Annual Income)

    1.

    2.

    3.

    4.

    5.

    6.

    References

    S. No.

    Name

    Residence Address

    Residence Telephone

    Office Address

    Office Telephone

    Email ID

    1.

    2.

    Declaration:

    The Trustees of the Parsi Zoroastrian Anjuman of Secunderabad & Hyderabad reserve the right of withholding and/or discontinuing the help sanctioned at any time without assigning any reason(s). If the student makes any false statement or fails to keep PZASH informed of his /her correct address from time to time or withholds information about any further help of assistance or scholarships, which he/she has received from School/College or any other source, the help which he/she may be receiving from PZASH may be forthwith discontinued & he/she may be liable for legal proceedings. The student shall furnish PZASH any further information and all supporting documents (original or copies) as and when asked for.

    I, (the applicant) a Parsi/Irani Zoroastrian do hereby declare that the statements herein made by me are correct & true to the best of my knowledge & belief.

    • Applicant will be required to sign on the printed copy of this application.

    • Parent / Guardian of Applicant will be required to sign on the printed copy of this application.