|
Name of Applicant(Student)
*
(First Name)
(Last Name)
|
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Address
*
|
City
*
Pin
*
|
|
State
*
Mobile
|
Phone
|
|
Date of Birth
*
|
Email
*
|
|
If maintaining account with our Bank
Account No.
|
Branch Name
|
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Details of branch nearest to your place of Domicile
Branch Name
*
|
|
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Parent/Guardian/Husband
|
Relationship with applicant
|
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Occupation
|
Annual Income Rs.
|
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Address
|
City
Pin
|
|
State
|
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Details of Last Qualifying Examination
Examination Passed
|
Name of the Institution
|
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Year of Passing
|
% of marks
|
|
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Detail of basis of admission in the course
|
Name of Entrance Test
|
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Course Details
Course applied
*
|
Duration
|
|
Name of the Institution
*
|
|
Address
*
|
City
*
Pin*
|
|
State
*
Country
|
Nature of course
|
|
Course Expenses
Total Course expenses(Fee+Hostel expenses,etc)
* Rs.
|
Own Contribution(Margin)
* Rs.
|
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Loan amount required Rs.
|
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Required loan amounts upto Rs 4 lacs |
|
Required loan amounts above Rs 4 lacs and upto Rs 7.5 lacs |
|
Required loan amount is above Rs 7.5 lacs |
|
For loan amounts above Rs. 4 lacs and upto Rs.7.5 lacs, please furnish details of guarantor
|
|
Name of the Guarantor
*
|
|
Address
*
|
City
*
Pin
*
|
|
State
*
|
|
For loan amount exceeding Rs 7.50 lac, please furnish details of security offered
|
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Nature of security
|
Location
|
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Approximate value of security
|
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Note :- Field with (*) mark is mandatory. |
