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  1. 1. FORM F – 1 (F–1) CENTRAL BOARD OF SECONDARY EDUCATION MERIT SCHOLARSHIP SCHEME [ For SINGLE GIRL CHILDREN who have passed Class X from CBSE May 2011 & pursuing XI & XII from CBSE affiliated School ] (PLEASE SEE ATTACHED INSTRUCTIONS) Registration No. (To be filled by CBSE) 1. Name of applicant (as per Class X certificate) 2. Date of Birth (DD/ MM/ YYYY) ____/_____/________ 3. Roll No. (Class X) 4. Mother’s Name 5. Address for correspondence 6. Year of Passing class X 2011 CGPA Obtained _______ (As per statement of subject-wise performance issued by the Board.)7. Father’s Name 8. No. of Brothers ___ (excluding you) No. of Sisters ____ (excluding you) Nationality _____________ State Pin code 9. Category (TICK √ ) GEN/ OBC/ SC/ ST/ PH 10. Email Address 11. Phone Number (with STD code) _____/____________ Mobile No. ________________________ 12. Particulars of Savings Bank Account a) Account Number (Applicant only) b) Name of the Bank & Address (City and State) 13. Name and Address of the School of Class XI ______________________________________________________ __________________District ________________ State ___________ 14. School Code of Class XI _________ 15. Tuition fee charged by the school mentioned above Class X____________ Per Month Class XI____________ Per Month (Even if you have not studied in the present school) (Affiliated with CBSE / any other Board) (TICK √ mandatory field) 16. Enclosure attached 1. Photocopy of mark sheet Yes/ No 2. Original Affidavit duly sworn in before the First Class Judicial Magistrate/ SDM/ Executive Magistrate, as per prescribed format from the Parents Yes/ No (Photocopy of Affidavit will not be accepted) 17. Signature of Applicant _______________________ Date ________________________ 18. Recent Color Photograph of the Applicant duly attested by the Principal of School TO BE FILLED IN BY THE PRINCIPAL OF THE SCHOOL FROM WHERE THE STUDENT IS PURSUING HER CLASS XI The facts stated above are hereby certified to be true and correct. The School is affiliated with the CBSE, Class _____________upto year 20 to 20 vide AFFILIATION NO. ________________ Signature of Principal Name Telephone & Mobile No. Seal NOTE: Incomplete application will be treated as cancelled.
  2. 2. INSTRUCTIONS FOR FILLING FORM (F – 1) Eligibility Criteria The applicant should fulfill all the criteria given below for consideration and award of scholarship:- (i) should be an Indian national. and (ii) should be the girl child and only child of her parents. and (iii) should be a student of CBSE in Class X (i.e. passed class X from a CBSE affiliated school) and having 6.2 or more CGPA in Class X Examinations 2011 conducted by the Board and pursuing Class XI & XII from CBSE affiliated Schools (As per statement of subject-wise performance issued by the Board). and (iv) the tuition fees for Class X should not be more than Rs. 1,500/- per month during the Academic year. In the next 02 years the total enhancement of tuition fee shall not be more than 10% of the tuition fee. Value of scholarship Rs. 500/- per month Duration 02 years only (for Class XI & XII) Signature All the application must be signed by the applicant. Unsigned applications or signed by the parents will be rejected. Attestation All the applications must be certified along with signature/ stamp of the Principal of the present school where the student is studying. In case applications are not attested the same will be rejected. Documents to be sent with the APPLICATION  An attested copy of Mark sheet of Class X 2011 issued by CBSE.  An affidavit from the parent that the candidate is the only child of her parents on a non-judicial stamp paper of Rs. 10/- duly sworn in before First class Judicial Magistrate/ SDM/Executive Magistrate should be submitted along with the application. Photocopy of affidavit will not be accepted.
  3. 3. Where to send Duly filled up Application Form The duly filled in proforma be sent in an envelope superscribing “APPLICATION FOR MERIT SCHOLARSHIP FOR SGC X 2011 (F-1)” should be sent to the “SECTION OFFICER (SCHOLARSHIP) CBSE, SHIKSHA KENDRA, 2, COMMUNITY CENTRE, PREET VIHAR, DELHI–110 092”. Change of address must be intimated immediately. NOTE:  Scholarship will be sent to the correspondence address of applicant mentioned in application form. List of eligible applicant who is being sent scholarship will be displayed / updated on website regularly. Jurisdiction of Courts/ Tribunals a) A Scholarship once cancelled shall not be renewed under any circumstances. b) The decision of the Board shall be final and binding in all such matters. c) Any resultant dispute arising out of this scholarship scheme shall be subject to the sole jurisdiction of the court situated in Delhi/ New Delhi only.
  4. 4. FORMAT OF AFFIDAVIT TO BE ATTACHED WITH THE APPLICATION (ON NON-JUDICIAL STAMP PAPER OF RS.10/- SWORN BEFORE FIRST CLASS JUDICIAL MAGISTRATE/SDM/EXECUTIVE MAGISTRATE FROM THE PARENTS) I ___________________ s/o / d/o _____________ r/o __________________ do hereby solemnly affirm and declare as under:- 1) That ____________is my only one daughter and her date of birth is _________. 2) That I am the father/mother and Ms. ________________ is my only daughter. 3) That I have no other child except my above named daughter. DEPONENT VERIFICATION VERIFIED AT ON THIS ______________ DAY OF ____________ AND THE CONTENT OF THIS AFFIDAVIT ARE TRUE AND CORRECT AND NOTHING MATERIAL HAS BEEN CONCEALED. DEPONENT (Strike off whichever is not applicable)