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   Loan Application for Post Graduation, Higher Studies, Foreign Studies, IT or Other Career Oriented Studies»  
     
 

 Details of STUDENT/APPLICANT                         (All Fields are mandatory. Specify NA/No for no details available)

   
(1) Applicant's Name in Full:
Surname                       Name                               Father's Name
   
(2) Native Place: Community: Age:
Marital Status: Occupation: Income: Per Month
   
(3) Father's or Guardian's Name in Full:
Surname                       Name                               Father's Name
Residential Address:
Tel. No. (Res.): Occupation: Income: Per Month
Note: if more then one contact no. separate with coma (e.g. 02228814574, 6985474512)
Office Address:
Tel. No. (Off.): Fax. No. (Off.): E-Mail:
Note: if more then one contact no. separate with coma (e.g. 02228814574, 6985474512)
   

(4) Educational Details:

 
Examination
or Degree
School
or University
Year of Passing Marks Obtained Percentage Remarks
(Prizes/Medals/
Scholarship etc.)
S.S.C.
H.S.C.
F. Year
S. Year
T. Year
Others1
Others2
Others3

Marks obtained in the last exam with class:

   
(5) In last exam you have ATKT or Not?
   
(6) Special Qualifications & Distinctions:
   
(7) Proposed Course of study:
   
(8) Duration of Course: in Years
   
(9) Name & Address of College/Institution you interested to Join:
(9)(a) Have you been admitted or accepted by above mentioned college/institute for above mentioned course? 
   
(10) Are you attending any college or institute at present?
If YES, mention name & course

Note: if not attending any college or institute, specify NA else specify details
   
(11) Have you been sanctioned loan by any Kapol Organization? 
If YES, mention organization name, Loan File No., Duration since availed loan

Note: if no loan sanctioned, specify NA else specify details
   
(12) Amount required for proposed course is Rs.    Per Year
Other Expense Rs.
(
For books, instruments, examination fees, equipment, Boarding, lodging etc.)
Per Year
Total Expense for Year is Rs.
   

(13)(a) Provide details, If help promised from other funds/individual for proposed course of study:

Name of Funds
or Individuals
Amount Asked
for Rs.
Amount Promised
for Rs.
Reply Received

(13)(b) Amount that the applicant himself/his parents/his guardian/relatives will contribute to wards total expense: 80

   
(14) Total Fees Rs.
My Contribution (25%) Rs.
Balance (75%) required now is Rs.
   
(15) Date from which you required help? e.g. Specify date format as 10TH January 2011
   
(16) Financial Circumstances:
Father's/Guardian's Income Per Month with income tax certificate Rs. Per Month
Other members residing with family and other Income Per Month
(If any) with income tax certificate:
Rs. Per Month
Total members in family:
   
(17) Copies of Testimonials from education authorizes:
   
(18) Other qualification, experience,
other  details/information applicant may wish to mention regarding the application
   

(19) Reference of at least 2 person (Kapol) from whom reference can be made about the candidate:

    Particulars

Reference  Person 1

Reference Person 2

    Name:

    Address:
    Tel. No.:
   

(20) Surety living in Mumbai at least 2 person (Kapol) fro the purpose of repayment or returning the amount of loan with interest and insurance premium:

Particulars

Surety Person 1 Surety Person 2 Surety Person 3 (Applicant's Father)  
Name:  
Address Res., Off.:
99-100-101
 
Tel. No. Res., Off.:  
Birth Date:  
Occupation:  
Income Per Year:  
Since How long you know Applicant?  
Relation with Applicant, if any:  
PAN No.  
Whether you stand as a guarantor to any person?
(If Yes, details of amount of guarantee else No)
 
Are you a borrower?  
 

(21) Declaration: I hereby declare that entries in form are true. I have read the terms and conditions of agreement to be entered in to.

 

I want to apply to

 

   

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