GOVERNMENT OF INDIA
Ministry of Youth Affairs & Sports
Application
PART A: Details of the Applicant
1. Name of Applicant :
S U R A J R A I N A
2. Aadhar No.
5 5 1 0 5 8 0 1 2 7 3 9
3. Bank Account Number (With Bank Name) ( Write Account Number which is
linked with your Aadhar Number, start with the left most box and fill only
required number of boxes, leave rest blank):
2 6 0 9 0 1 0 0 0 1 9 2 3 8
Note: Aadhar number linked bank account is a prerequisite condition for consideration for this programme.
Proof of Aadhar linked account from the concerned bank to be attached with the application form.
4. Name of Guardian :
R A J E S H R A I N A
5. Date of Birth :
Date 1 6 Month 0 1 Year 2 0 0 1
6. Domicile/Place of birth:
7. Gender :
Male Tick Female / Others /
8. Residential Address with PIN CODE:
3rd F L O O R 28 S H R E S H T H A
V I H A R D E L H I 1 1 0 0 9
2
9. Contact Details :
Telephone N I L
No.
Mobile No. 8 9 2 0 8 4 2 5 2 4
E-mail
Address
10. Details of Educational Qualifications (to be verified at the time of final selection):
Name of the Name of Board/ Year Percentage Subjects
course/Degree University of Marks
BA LLB Government Law 2024 79 Civil / Criminal /
college , Mumbai Corporate Law
LLM IBL NALSAR - IICA 2026 Still Insolvency and
Pursuing Bankruptcy Laws
11. Details of Passport (copy to be enclosed) :
Passport Office File No. DL1076172189622
Passport No. U7794337
Date and Place of Issue Delhi
Date of Expiry 22/03/2032
In case passport was
applied for and not issued,
please give File No. & Date
12. Category (SC/ST/OBC/General) : Kashmiri Migrant / ( General )
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13. Physically Handicapped : Yes/No - No
(If so, details thereof)
14. Details of previous Foreign Visits :
Place visited Details of visit Sponsored by Year of
Visit
Thailand Liesure Family 2022
Denmark Represented India in Amity Institutes 2017
the European
Parliament alongside
delegates from 30
other European
nations.
15. Hobbies : Watching Sports ; Training Mixed Martial Arts (MMA); Reading
about Philosophy; Exploring Pop culture and film making
16. Details of Medical History, if any: None
17. If any case pending against you in any court of law at the time of filling up
this form. If Yes, give full particulars of the case /arrest/fine/conviction/
sentence etc. and /or the name of the case pending in the court at the time of
filling up this form.
NONE
18. Languages (Indian/Foreign) known:
S.No. Read Write Speak
1 English English English
2 French French French
3 Portuguese Portuguese Portuguese
4 Chinese Chinese Chinese
5 Kashmiri Kashmiri Kashmiri
19. Whether worked with any youth related organization like NCC, NSS, NYKS,
other (please specify and enclose relevant documents thereof) ANY
DISTINGUISHED WORK DONE, if so, please state, clearly. (Max 150 words)
Actively engaged with NSS Mumbai in ground-level initiatives aimed at
understanding community dynamics, addressing local needs, and fostering
problem-solving through collective action.
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Focused on developing social and civic responsibility, leadership skills, and
community participation while promoting national integration, social harmony,
and preparedness for emergencies. Worked on practical solutions to
community challenges, emphasizing collaboration, group living, and shared
responsibilities.
20. Describe any achievement in the field of academics or any other field, which
is relevant for considering your application. (Max 150 words)
1. Have represented INDIA in more than 10 International dialogue competitions &
conventions.
2. CO - Founder of Socio - Political think tank known as GEO STARTA
3. Been a part of more than 40 Model united Nations as Executive Board Member ,
Secretariat , Organising Committee and Delegate.
4. Scored 97% In my 12th CBSE Board Exam.
Signature of the applicant -
Date of Application - 22-11- 2024
Caption
Part-B : (To be filled by recommending official / organization)
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Certification of the character of the nominee and recommendation along with a
brief description about the exceptional qualities and future utility of the nominee
(Approx 100 words):
(Signature)
Name :___________________
Designation :__________________
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