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.