Lord Buddha Education Scholarship 2015

Lord Buddha Education Scholarship 2015
SCHOOL CATEGORY APPLICATION FORM
Conducting Organization: National Bureau of Professional Testing, Education Division
PERSONAL AND CONTACT DETAILS:
1.
NAME: Mr. / Miss............................................
8. ADDRESS: ....................................
2. FATHER’S NAME: .............................................
.....................................................
3. MOTHER’S NAME: ...........................................
....................................................
4. DATE OF BIRTH: ...............................................
9. TOWN/CITY: ................................
5. GENDER:
10. STATE: ........................................
Male
Female
STUDENT’S
PHOTO
6. EMAIL- ID: .......................................................
11. PINCODE: ....................................
7. MOBILE: ...........................................................
12. STUDENT’S SIGNATURE: ..........................................
SCHOOL AND CLASS DETAILS:
1. CLASS: .............................................................
2. SCHOOL NAME: ..............................................
........................................................................
3. AFFILIATION: CBSE
ICSE
STATE BOARD........................................
4. TOWN/CITY: ...................................................
5.
TEST DATE: 20-09-2015
FEE DETAILS:
(For FEE payment, check instructions at the end of form)
1. Application Fee: Rs 200
Mode of Payment (Tick)
NEFT/NET BANKING
Cash Deposit at Union Bank
IMPS
Payment via ATM
Any Other............................................
2. Date of Fee Payment: .....................................
3. Place: ..............................................................
4. Transaction/Journal Number: ........................
........................................................................
INSTRUCTIONS:
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The completed application form should be sent to the address below or submitted to school coordinator or Principal.
NATIONAL BUREAU OF PROFESSIONAL TESTING, GCS-16, PLOT No: CGH-3,
GOLD CREST TOWER, Vaibhav Khand, Indirapuram, GHAZIABAD, UP-201014
Please fill all details clearly with black/blue ball pen, before submitting/sending.
Fee payment details: Payment of application fee is to be done:FOR THE CREDIT OF/ BENEFICIARY: NATIONAL BUREAU OF PROFESSIONAL TESTING
ACCOUNT NUMBER
: 640301010050050 (CURRENT ACCOUNT)
BANK NAME
: UNION BANK OF INDIA, KAUSHAMBI BRANCH, GHAZIABAD 201001 (U.P)
IFSC CODE
: UBIN0564036
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Keep a copy for future reference.
This is hand fill form for school Category of LORD BUDDHA EDUCATION SCHOLARSHIP 2015.
Please do not attach anything with this APPLICATION FORM.
Filling all particulars is compulsory.