GOVERNMENT OF INDIA

MINISTRY OF MINORITY AFFAIRS

NAI UDAAN SCHEME - APPLICATION FORM

( Financial Support for Mains Exam to Students who cleared Prelims Exam Conducted By UPSC, SSC, State Public Service Commission, etc. )

General Instructions

Student Details

Full Name (as per SSC/HSLC/HS Certificate) *

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Father / Mother's Name *

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Date of Birth (as per SSC/HSLC/HS Certificate) *

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Marital Status *

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Married

Unmarried

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Spouse Name (If Married)

Gender *

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Community *

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Category *

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Address Line 1 *

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Address Line 2

Address Line 3

PIN Code *

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Country *

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State *

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District

E-Mail *

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Mobile Number *

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Aadhaar Number / Virtual Id *

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Family Annual Income (Rs.) *

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Bank Details

IFSC Code *

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Bank Name *

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Bank Address *

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Bank Code *

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Account No. * Ensure accuracy of the Account No. to avoid payment problems

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Name as in Bank Passbook *

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Service Examination Details

Exam Name *

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Application No. *

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Roll No. *

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Prelims Exam Result Date *

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Mains Exam Tentative Date *

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Remarks (if Any)

Declaration

I hereby declare that, I have carefully gone through the eligibility criteria under the Scheme and the information given above is correct to the best of my knowledge. It is further undertaken that the documents submitted by me are genuine. If the information found to be incorrect and/or the document(s) [ to be uploaded in the next stage after submitting this Form ] found to be bogus or fake; my application would be summarily rejected without prior notice and I will also be liable to be prosecuted as per the relevant sections of law. Further, I understand that, applicant who is found guilty of furnishing wrong information will be barred from applying for the scheme in future.

I Agree *

Nai Udaan Scheme Division, Minsitry of Minority Affairs, 11th Floor, Pt. Deendayal Antyodaya Bhavan, CGO Complex, Lodhi Road, NEW DELHI – 110003. Tel-011-24302552 Helpline: 1800-11-20011 (Toll Free) Email: naiudaan-moma@nic.in