This document outlines the format of an application form which includes sections for: 1) Applicant information such as name, father's name, date of birth, place of birth, community, examination details, roll number, and identity proof 2) Family income details and income certificate 3) Educational qualifications including examination name, board/university, year of passing, total marks, and marks scored 4) Bank account details for direct benefit transfer including account number, bank name, address, MICR code, IFSC code, and cancelled cheque copy. 5) Contact details including permanent address, temporary address, email, phone numbers and preferred correspondence address.