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Bank of Baroda

HEAD OFFICE : MANDVI, BARODA Please paste


a recent
photograph of
student

APPLICATION FORM FOR


Please paste
a recent
photograph of
student
EDUCATIONAL LOAN

EDUCATIONAL LOAN APPLICATION FORM

The Branch Manager,


Bank of Baroda,
______________ Branch,
____________________.

Dear Sir,

I/ my ward have / has secured admission to ________________ course conducted by


_________________School/ University / College/ Institute located at ______________.
For my / his / her education we request you to provide us financial assistance of
Rs_____________(Rs._________________________________________________) the
details of which are as given in this request application.

We undertake to repay the loan in ____________monthly installments beginning


____________months starting after -1- year after the course period or -6- months after
the borrower (student) getting the job.

Please complete all sections in BLOCK LETTERS and tick √ boxes wherever
applicable

(A) PARTICULARS OF THE STUDENT:

Name:_________________________________________________________________

Date of Birth:_________(DD) _______(MM)__________ (YYYY) Age:

Address:_______________________________________________________________
(Overseas address if student going for overseas studies)_________________________
PIN : _______________________
Telephone:____________ Fax:____________________ Mobile No. _______________
Nationality: ___________ Marital Status:_____________ Caste/Religion_____________
Life Insurance Policy details (if any):____________________________

EDUCATIONAL DETAILS : Please enclose mark lists of the examination passed

Examination Institution/University Year Number of Percentage Class Specialisation


from which passed Passing Attempts of marks Obtained if any
SSC
HSC
Degree
Post
Graduate*
Any Other *

• To be specified in the column "Specialisation"


PARTICULARS OF SCHOLARSHIPS / PRIZES WON FOR ACADEMIC DISTINCTION:

Examination Specify the academic distinction Name of the Amount of Duration of


for which the scholarship prize Scholarship Scholarship Scholarship
was awarded Prize Rs.
From To

Any other information (Extra curricular activities and distinction awards received

if any):___________________________________________________________

PARTICULARS OF THE COURSE FOR WHICH THE LOAN IS REQUIRED

Name of the course:___________________________________________________________

University Institution:__________________________________________________________

Course/Institution is affiliated
To/recognized by
Duration of the course:________________________________________________________

Part time / Full time :__________________________________________________________


Correspondence / Distance Education

Expected per month income after completion of the course Rs:_________________________

In case of studies abroad state the details of R.B.I. approval (if necessary). Details of Foreign
Exchange required, Copies of Passport, Visa and other details to be submitted.

PURPOSE OF THE LOAN: (Rs. in '000)


Require Fee Payable Examination Cost of Books/ Caution Other Edu. Lodging Travel Total
ment for to College/ /Library/ Equipments/ deposits/ Exp. /Boarding Exp/ Expen
School/ Laboratory/ instruments building (e.g. Study passage ses
Institution fees /Uniforms fund/ tours, money
refundable projects,
deposit thesis etc.)
1st Year
2nd Year
3rd Year
4th Year
5th Year

Source of finance : Details of Scholarship / Loans / Own Funds


Loan amount Own Sources Scholarship Total
1st
2nd
3rd
4th
5th

(B) GUARDIAN'S / PARENT'S/GUARANTOR'S PARTICULARS: (If guardian & guarantor are


different separte sheet showing these particulars for each to be obtained)

Name :________________________________________________________________

Relationship with Student:_________________________________________________

Date of Birth:_____________ (DD)_______(MM)_______(YYYY) Age :

PAN/GIR No.:_______________. Driving License No:_______________

Passport No(If any) _________________________________


Residential Address (For Correspondence - with proof of residence)
______________________________________________PIN_____________________
Telephone : _______________ Fax:________________ Mobile No. _______________
Permanent Address:_____________________________________________________
______________________________________________PIN:____________________
Telephone : _______________ Fax:________________E-Mail. __________________

Whether residing in Own/Rented Accommodat Since When residing :

Interest during study period will be serviced - Yes / No

Working Since:_____Retirement Age:________


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