Scholarship Application Form - Access Welfare Trust

Educational Scholarship Application Form

Last Date for Applying: 31st August 2025

Personal Details

Family Details

Educational Details

Scholarship Details

Document Upload

Personal Details

1. Name *

2. Gender *

3. Date of Birth * Age: Age will be calculated automatically when you enter your date of birth

4. Place of Birth *

5. Marital Status *

6. Religion *

7. Reservation Category *

8. Nationality *

9. Present Address * Please enter your complete address including house number, street, city (minimum 10 characters)

0/500 characters

PIN Code *

State *

Country *

Permanent address is same as present address

10. Permanent Address * Please enter your complete permanent address including house number, street, city (minimum 10 characters)

0/500 characters

PIN Code *

State *

Country *

11. Contact Phone No. * No limit on number of digits. Include country code if international.

12. WhatsApp No. * No limit on number of digits. Include country code if international.

13. Email ID *

Family Details

14. Family Details Fill in details for at least Father and Mother. Other family members are optional.

Relationship	Name	Age	Occupation	Annual Income	Details of Employment
Father
Mother
Spouse
Sibling 1
Sibling 2
Sibling 3
Sibling 4

15. Family Total Annual Income * Please attach Income Certificate in document upload section

16. Is applicant a person with disability? *

17. Type of Disability * Required when disability is selected as "Yes"

Type *	% of Disability *	Describe Disability *

18. Disability Certificate * Required when disability is selected as "Yes"

i. Name & designation of Issuing Authority *

ii. Certificate Number *

iii. Date of Issue *

Disability Certificate *

Upload your official disability certificate (PDF/JPG/PNG, max 10MB)

Educational Details

19. Educational Details (Please attach all Marks Certificate)

Educational details	Name & Address of Institution	Govt / Private	Board / University	Marks / Grade Obtained	Year of Passing
X (SSLC)/10th
XII (HSC)/+2
UG Degree
Vocational
Diploma
Others

Upload Marksheets/Certificates

Upload marksheets for each educational level you have completed (PDF, JPG, PNG only)

📚 10th/SSLC Marksheet

Upload your 10th standard marksheet

📚 12th/HSC Marksheet

Upload your 12th standard marksheet

📚 UG Degree Marksheet

Upload your undergraduate marksheet

📚 Vocational Certificate

Upload vocational course certificate

📚 Diploma Certificate

Upload diploma course certificate

📚 Other Certificates

Upload any other educational certificates

Note: Upload marksheets only for the educational levels you have completed. You can skip levels that don't apply to you.

Scholarship Details

Programme for which scholarship is applied

20. Course (Currently studying) *

21. Course Duration *

22. Which Year of the Course *

23. Roll No. *

24. Name of Institution *

25. Type of Institution *

26. Address of the Institution * Please enter the complete institution address including building number, campus area, city, state, and PIN code (minimum 10 characters)

0/500 characters

27. Phone Number of Institution * No limit on number of digits as requested. Include country code if international.

Email ID of Institution *

Website of Institution *

28. Term/Semester for which Fees to be paid *

29. Amount of Fees to be paid *

i) Tuition Fees *

ii) Other Fees *

Fee Circular Upload *

Institute Official Fee Circular

Upload the official fee circular or fee notification from your institution

Required: PDF, JPG, or PNG format only (max 10MB)

30. Scholarship Amount requested *

Amount in Figures *

Amount in Words *

31. Details of any scholarship received *

a) Did you receive AWT scholarship in the Academic Year 2024-25? *

Yes No

b) Other scholarships details *

32. Details of other scholarships applied for *

0/500 characters

References, Documents & Declaration

33. Provide contacts of two references (At least one reference from educational institution) * First reference is required. Second reference is optional.

Name of Referring Person *	Phone # *	Email ID *	Position *

Optional	Optional	Optional	Optional

34. Details of Extracurricular/Sports accomplishments *

0/500 characters

35. Any other information or requests *

0/500 characters

36. Write a short note about your goals in life & why you need this scholarship. *

0/1000 characters

Bank Details *

Please provide your bank account details for scholarship disbursement. All fields are required.

37. Account Holder Name as per passbook *

38. Account Number *

39. Bank Name *

40. Bank Branch Name *

41. IFSC Code *

Self Declaration *

I assure that I am not a beneficiary of any other scholrship either from Government or from any Trusts. I hereby declare that the above entries are true to the best of my knowledge and belief, and furnishing of false information by me will result in disqualification of my application.

* I agree to the above declaration and confirm that all information provided is true and accurate.

Place *

Date

1. Passport Size Photograph

Recent passport size photograph (JPG/PNG)

2. Digital Signature

Your digital signature (JPG/PNG)

Required Documents *

All the following documents must be enclosed with application. If any document is unavailable at the time of applying, kindly inform the probable date of submission.

1. Photo ID *

Aadhaar (PDF/JPG/PNG, max 10MB)

2. Institute ID Card *

Student ID from your institution (PDF/JPG/PNG, max 10MB)

3. Address Proof *

Utility bill/Bank statement (PDF/JPG/PNG, max 10MB)

4. Aadhaar Card *

Aadhaar card copy (PDF/JPG/PNG, max 10MB)

5. Birth Certificate *

Official birth certificate (PDF/JPG/PNG, max 10MB)

6. Community Certificate *

Caste/Category certificate (PDF/JPG/PNG, max 10MB)

7. Course Fee Details *

Tuition/Term/Semester fee receipts (PDF/JPG/PNG, max 10MB)

8. Income Certificate *

Family income certificate (PDF/JPG/PNG, max 10MB)

9. Attendance Certificate *

From institution (PDF/JPG/PNG, max 10MB)

10. Fee Receipts 2025-26 *

Academic year receipts (PDF/JPG/PNG, max 10MB)

11. Bank Passbook *

Bank passbook first page or bank statement (PDF/JPG/PNG, max 10MB)

* I agree to the terms and conditions and confirm that all information provided is accurate.

Access Welfare Trust

Login Required

Application Already Submitted

Educational Scholarship Application Form

Personal Details

Please fix the following errors:

Family Details

Please fix the following errors:

Disability Certificate *

Educational Details

Upload Marksheets/Certificates

📚 10th/SSLC Marksheet

📚 12th/HSC Marksheet

📚 UG Degree Marksheet

📚 Vocational Certificate

📚 Diploma Certificate

📚 Other Certificates

Scholarship Details

Please fix the following errors:

Institute Official Fee Circular

Previous Year Marksheet Required *

Previous Year Marksheet (2024-25) *

References, Documents & Declaration

Please fix the following errors:

Bank Details *

Self Declaration *

1. Passport Size Photograph

2. Digital Signature

Required Documents *

1. Photo ID *

2. Institute ID Card *

3. Address Proof *

4. Aadhaar Card *

5. Birth Certificate *

6. Community Certificate *

7. Course Fee Details *

8. Income Certificate *

9. Attendance Certificate *

10. Fee Receipts 2025-26 *

11. Bank Passbook *