Electronic Government to Citizen Service Delivery System

Personal Information

CID*:

Name*:

Gender*:

Father's Name*:

Mother's Name*:

Mobile Number*:

Email Id*:

Contact Address

Guardian Contact Number*:

Address*:

Scholarship Type

Note : You can choose more than one from the option given below.If eligible.

Scholarship Applied For*:

	Undergraduate Scholarship
	King's Scholarship

Mark Details

Have you passed class XII from Bhutan?*:

Yes No

Have you taken class XII examinations under BCSEA?*:

Yes No

Index Number*:

CID as in BCSEA*:

Name as in BCSEA*:

School Name*:

Stream*:

Passed Month and Year*:

(YYYY)*

Serial Number	Subject Name	Other Subject Name	Marks Obtained	Full Marks
1

Attach Mark Sheet

Class X Mark Sheet*:

Common

Text Verification:*