ADVERTISEMENT Maulana Azad Education Foundation an ...

20
ADVERTISEMENT Maulana Azad Education Foundation an autonomous body under Ministry of Minority Affairs, established to promote education among educationally backward minorities, is providing financial assistance to NGOs as grant-in-aid for school building/ hostel etc. and scholarship to meritorious girl students of minority communities. The details of schemes are available at website wA•ww.maef.nic.in . The quota of grant-in-aid as well as scholarship state wise for the year 2010-2011 as well as the application from for seeking grant-in-aid & scholarship are available at the website www.maef.nic.in. These can be downloaded/photocopied freely for use. Printed copies of the same can also be obtained from the Social Welfare Officer, Collectorate, Moti Daman. Application for scholarship should be sent directly to MAEF, New Delhi by the applicant girl students . Similarly, proposal for grant - in-aid should be sent directly to MAEF, New Delhi by the applicant NGO. The last date for receipt of scholarship form / proposal seeking grant -in-aid by NGOs in the Foundation's office is 30th September, 2010. Application forms in respect of scholarship received after last date will not be considered under any circumstances and will be rejected summarily. No.SW/332(5)/2010-2011^02^ 0 (Vijender Singh) Dated : 0 g /07 / 2010 Director ( Social Welfare )

Transcript of ADVERTISEMENT Maulana Azad Education Foundation an ...

ADVERTISEMENT

Maulana Azad Education Foundation an autonomous body under Ministry of

Minority Affairs, established to promote education among educationally backward

minorities, is providing financial assistance to NGOs as grant-in-aid for school building/

hostel etc. and scholarship to meritorious girl students of minority communities. The

details of schemes are available at website wA•ww.maef.nic.in .

The quota of grant-in-aid as well as scholarship state wise for the year 2010-2011

as well as the application from for seeking grant-in-aid & scholarship are available at the

website www.maef.nic.in. These can be downloaded/photocopied freely for use. Printed

copies of the same can also be obtained from the Social Welfare Officer, Collectorate,

Moti Daman.

Application for scholarship should be sent directly to MAEF, New Delhi by

the applicant girl students . Similarly, proposal for grant-in-aid should be sentdirectly to MAEF, New Delhi by the applicant NGO.

The last date for receipt of scholarship form / proposal seeking grant-in-aid by

NGOs in the Foundation's office is 30th September, 2010.

Application forms in respect of scholarship received after last date will not be

considered under any circumstances and will be rejected summarily.

No.SW/332(5)/2010-2011^02^ 0 (Vijender Singh)Dated : 0 g /07/2010 Director ( Social Welfare )

U`P

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MAULANA AZAD EDUCATION FOUNDATION

EDUCATIONAL SCHEMESAdministered through Non-Government Organisation

qmSocial Welfare Dept.q- ;,11 (Letter inward)

T,TiT,, N o...... `..` ) .............

\? 1.014'll

MAULANA AZAD EDUCATION FOUNDATION(W ljo r, TM s)

(MINISTRY OF MINORITY AFFAIRS , GOVT. OF INDIA)

tllallmq) ;qW ft , ft, I F CA - 110055Social Justice Service Centre, Chelmsford Road, New Delhi - 110055

Qff/Phone : 23583788 , 23583789 tqff/Fax : 011-23561945

47/Website': www.maef .nic.in

MrTGuidelines/Application form for Grant - in-Aid under Educational Schemes

qftr4q

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INTRODUCTION:

The Foundation was established on the occasion of Maulana Abul Kalam Azad's birthcentenary celebrations. His eventful life was packed with outstanding achievements in thediverse fields. He was towering figure on the Indian political scene and a scholar rated high inthe realms of Urdu Literature. To this, he added a trend-setting innings as a journalist. But hisgreatest claim to fame was his contribution as a thinker with a world vision and humanistoutlook. A dogged freedom fighter and an un-failing upholder of secular and democratic values.Maulana Azad deserves to be introduced afresh to the modern generation of Indians.

The Foundation is a voluntary, non-political, non-profit making social service organization,established to promote education amongst educationally backward sections of the Society. Itis funded by the Ministry of Minority Affairs, Govt. of India. The Hbn'ble Minister of MinorityAffairs is Ex-Officio President of the Foundation. It was registered under the SocietiesRegistration Act, 1860 on 6th July 1989.

The details about the programmes undertaken by the Foundation and the prescribedformats of application are given in the following pages.

f1 **il

EDUCATIONAL SCHEMES:-

+

assistance for construction/ expansion of Schools belonging toeducationally backward minorities,

(1)

+ ^ ^u aT ft Faftq^T ITA t f^rq f / Trix /f i ter,

Financial assistance for purchase of Science/Computer lab equipments/furniture

for institutions belonging to educationally backward minorities,

+ -4 Mg^ aT # Af'»rfcfr,

Financial assistance for construction / Expansion of Vocational Training Centre/ITI/Polytechnic belonging to educationally backward minorities,

+ WiT ;m # f - 4 u 4 t Tt TI4 *iTiff 9-4t * ft* f#iq f r r,

Financial assistance for construction of Hostel building in the institutions belongingto educationally backward minorities,

+ f3T#gt.qu/fi.^--s cf/fffrcT,

Financial assistance for construction/Expansion of D.Ed / B.Ed. College belongingto educationally backward minorities,

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OBJECTIVE OF THE SCHEME:-To provide basic educational infrastructure and facilities in the areas of concentration ofeducationally backward minorities which do not have adequate provision for elementary,secondary and Sr. Sec. Schools / Jr. Colleges / Professional & Vocational Training Institutes.

G

(2)

0. urr Jimts .-ELIGIBILITY CRITERIA FOR GRANT:- ,

+ 4 / i M T^z 3 Ff * cTa?-ic #V t1

Society/Trust should be registered under the Societies Registration Act/ Indian

Trust Act for the last three years,

+ oflrqtl/^F g ; qM c -q-q f f , mftT-Tr^rF u r t t Tr fir 1

Society/Trust must be having proper audit reports with Balance Sheet , Receipt-Payment & Income-Expenditure statements reflecting educational activities carried

out for the last three years,

+ /TFti ,b 37WgTU* r^ i &1 T 1 ^ rAEk FF^WftfTfir,WT4 Eft

Society/Trust should be in a position to receive involvement of knowledge -able persons

for furtherance of their programmes on voluntary basis,

+ a/TF tf r c TM f C ^gM f c Te of r

9fgWMW;rr qftq 3T ff TUT ;ffV/qftW tr'Ttf^ r1 9T qft7

Society/Trust should not be run for the profit of any individual or a body of individuals/family and it should not be controlled by any individuals or a body of individuals /

family.

+ 3r i f r/P r^g;i r i r r r//qi /f rm T xr^r x ,

The institutions for whose construction/expansion the assistance is required shouldbe in existence and recognized/affiliated to the concerned State/Central Board/Council/ University,

Society/Trust should not be functioning for furtherance of the interest of any political

party,

+ ;Mfllq^ / ft ^b F^qg t tg 3.irT 9f ,

Society/Trust should not in any manner incite communal disharmony,

+ (i ^r rg; tt WTr qiT # 31f qT WT

(50%'N3Tf i) WE 1187.4 c ^Fi/ c -4 *A ,

The majority (ie, more than 50%) of the beneficiary students , in the Institution forwhose construction expansion / strengthen assistance is sought , should bebelonging to educationally backward minorities /target group,

+ tf rif m w r 4q zg 3Tm i;f TRI^TF t'T6 gr# Tr 8t 1Tc iii Wcff 9T ,

For seeking assistance for construction of hostel building, it is necessary that theInstitution for which the hostel is required should be recognized at least up to 81hstandard,

+ qM Atlftj of ir t f^ T # r 1000-0 Trr r (4TUfi f 4) zir WrWff 7EF Vr ( M aA 4) f 4 5KT T # ER 30 Z cR *Yr qT T-T AT,

Society/Trust must be having at least 1000 sq. yard land (in urban areas) or atleast one acre land (in rural areas ) in its name or on lease for not less than 30years for the proposed project,

+ uTk i it f ^u r r r r10%fT fq c T ,

Society/Trust should be ready to invest at least 10% of the total cost of project as

NGO's share on the project.

+ , r W 3TiiT mf^tdm t RWMT -4 ERR TR qT r ;it ITT, fir q7Aft 1 r r rf-'f*firTMW, f frWt f of

The Society/Trust will not take loan on the building constructed with MAEFassistance /on the land on which the building has been constructed with theassistance of the Foundation . However , if it becomes necessary , then priorpermission of the Foundation for the same will be necessary.

Afifd A * f^R 1gT T :

Guidelines for submission of Proposal:-

+ W r T6ff c xrur r I , r u * 1 u F t f - l l t t Trt frFTff iWP 43Tr4 W'M'

The Society/Trust seeking assistance under the Scheme shall apply for purposesspecified on the prescribed proforma given at Annexure -II,

Backward areas, particularly areas that are educationally backward should receiveappropriate attention/priority,

+ C f9 *t it 4A TaT30.00MW 'Fqq tl 3T fi Tifi3T rCT T4 qEF ffi

r f# f rr m 4F rr a* 4^ f -c-q5 ,

Assistance to an individual unit should not exceed Rs.30.00 lakhs. and propsal foronly one porpose will be accepted at a time. For details and ceiling limit seeAnnexure -A,

+ 1 NctI ITT 40 07W Tf -rf imt t5^41M 0 A^IA cY 39M X7 W^4 zbl EFTq k-7 ft,

The grantee should undertake to name the entire beneficiary institution or a part

of it after Maulana Abul Kalam Azad,

i^r r f EFT aTW M;q ernThe Scheme may be revised as and when required and no claim will be entertained

from any Organization /Institution for consideration as a permanent beneficiary,

+ 3 t Tct 41 9t tr 30i 4 -Am;qr wft4f 4Nm:10.00 zFW #Tf6.00 0 c kT #7 f ufTTxf 1 ap# ARIA t iR ;it

ft T i t i P r f g 7 4^ TwT q f i r fry : R;Rp i 77 V 17•TtfFi i w4Tff

The applications may be sent to he Foundation by post or may be submittedpersonally in the Foundation off ice on all working days between 10.00 A.M to 6.00P.M. from May 1St to 30th Septemb er every year. The incomplete proposals will notbe accepted , and the same will be returned back pointing out the deficiency.Revised complete applications resubmitted will be treated as fresh applications,

+ 1 4 UWW " (iM - f ) %f -CItT AT fi IIEU

f,The Checklist available at Annexure -1 should be filled carefully and the pagenumbers of each document should be mentioned properly. No column should beleft blank . Each page must be sign d,

+ W ;MM 4 t (q A iff F') t' 'iii f tf rr>Only one proposal (for one purpos will be entertained at a time,

A;FiT qt7l,Each document/enclosure attach d to the application , must be certified/attestedby the 1St class gazzetted officer or Notary Public . Attestation by Society/Trustoffical will not be accepted.

+ wawf #, Ur 1 to

;qW

In case of application for Girls/Bo4ys Hostel building, a note justifying the need ofHostel building ' in the Institution shall be submitted separately . However whileconsidering the proposals for construction of Hostel buildings , preference will begiven to the Institutions , which are already running hostels

rtTO i #7 TT^ it pftm .-Procedure for Sanctioning Financial Assistance under the Scheme:

+ *MN w*A qT ZF't T, kii WT^ IF mm4 t ft fVT f5trrr,

On receipt of proposal , it will be scrutinized in the office of the Foundation, andthe shortcomings will be communicated to the Organization / Institution by registeredpost.

+ M 0 1 t f^fq r WqTff, f# r ffTT7 it 4 , Al t RTft ;qT fir * TV1 , N4 7^ 34 fh b6r-1 Zff r r tr, t 79M ;ft f tr rr,

The complete proposals shall be referred for inspection, which shall be carriedout through State Government officials, members of the Foundation or by any

other person to whom the Foundation may entrust this job,

-1^ 3k

ruqzff /T*Rrr1 fzrrire7tt1The inspection reports shall be placed before the Sub - Committee/ Governing Bodyof the Foundation for consideration and the decision shall be communicated tothe Organization / institution,

Annexure `A'

4ftF-ff q91 tTO ffgqT ,3^F '4ct :-CEILING LIMITS FOR SANCTION OF GRANT-IN-AID UNDER VARIOUS CATEGORIES

S. No. Category ( ^, r)

Ceiling limits (Rs)

1. * c 54fi TT Wl TdT 1NT t $3# 84f ffq5 3i1i 05,00,000f T ^T9T

If School is recognized up to 5th standard & to be upgraded up 05,00,000to 8th standard

2. * f 84f 1Tu5F w-gmpm t3i U 3Tq^ 10,00,000f lT FITS

If School is recognized up to 8th standard & to be upgraded up 10,00,000to 10th standard

3. *i c 84f i TT UT dT ATV W 3T ' 3t' 104 cTiEf 'Wth 15,00,000f4TT j19T * T T e c7UV -4 #zK T-54 x7117500

If School is recognized up to 8th standard and to be upgraded 15,00;000up to 10th standard and students belonging to target groupare 500 approx.

4. * W 1041 b1T Tlf ' icil APcf * AT 3# 1241/ V 15,00,000

f iiiHtIf the school is running up to 10th standard and to be upgraded 15,00,000up to 12th standard/Jr. College/Intermediate level

5. (1041 iir UT i AM) ^ iiku 02, 00,000

Purchase of lab equipments (physics/chemistry/biology) in 02,00,000High Schools (schools up to 10th standard),

6. 1241 5 TT W M;q t TT' T M;4-R1101 Jglb(q ( / 03,00,000

Purchase of Lab equipments in Schools recognized up to 03,00,00012th standard ( physics/chemistry /biology/computers)

7. 1041/1241 i iT ffff5 M--4T ATt-cT is W t4 f 01,00,000

Purchase of furniture & fixtures for schools recognized up to 01,00,00010th/12th standard (both)

(7)

#ffq-q5 `Z15'Annexure `A'

i it T6ff ff 6TJiTF #7 #ft'r:-CEILING LIMITS FOR SANCTION OF GRANT- IN-AID UNDER VARIOUS CATEGORIES

'sT.#. aZ T,54-cif

S. No. Category `)Ceiling limits (Rs)

8. 3;q c 4 f * q 4 IT zfffm 4-0 02,50,000

Purchase of computers for schools which are teaching 02,50,000computers as a subject

9. fRTN'1i) 100 c `1c T 3 $ zft cTt T crf %Kff 30,00,000

ur) 50 ftffa zlT 1T f EFT 15,00,000

'T) 30 ftRitl 4K 3T41i!^ ' TT l c 10,00,000For construction of Hostel buildingsa) 100 bedded dormitory type hostel building 30,00,000b) 50 bedded dormitory type hostel building 15,00,000c) 30 bedded dormitory type hostel building 10,00,000

10. i) s' . U. *f 4q f r/f w 15,00,000

ii) . U. *Aq %W T f*T/f rr 30,00,000i) For construction/expansion of D.Ed. College building 15,00,000ii) For construction/expansion of B.Ed. College building 30,00,000

11. i) A%4m qzR Pmh it f^T 10,00,000

ii) iz'ti q^^ it f' rR 3 T^,' [/^r2 t f 05,00,000i) For construction of Vocational Training Centre (VTC) building 10,00,000ii) For purchase of equipments/tools/machines for VTC 05,00,000

12. I) ffAzA fiTr0 T /3Tf fth f^iq 15,00,000

ii) dqAA F 6TOGTr^/GTO^ t f 33w-l / 0 15,00,000

WN-4 iti) For construction of Technical Institute/ITI/ITC building 15,00,000ii) For purchase of equipments/machines/tools for Technical 15,00,000

Institute/ITI/ITC

CX11 c Cb - I

Annexure - I

9r FK i c 4 l( r it iiCnii)

CHECK LIST OF DOCUMENTS REQUIRED TO BE ATTCHED WITH THE APPLICATION(To be filled by the Applicant)

TA f..S.No. Documents Pa ge No.

1 sTZT 3Tr 3ITE q r ipTf"d icbi I # VI dq5

Duly filled application form, i.e. Annexure - Ito VI

2 q of 797 T ;T c ii d

Certified copy of Registration Certificate

3 'fc q5[ 34qqr K;F t s i vgft cl of d ^

Certified copy of Memorandum of Association & Rules-Regulations or Trust Deed

4 1cTi-iii q'i3T W t-kt tlhlb-i ii{tE "tM9IIfiAfc

Certified copy of the present list of members of the NGO as per Annexure -III

5 Rfu# i 4q fC T ^T-FTTt #f137 it ic1g Eft 4W / M Oi -ff

Annual Report/Brief History of the activities of the NGO for last three years

6 fd c F qlqf t f ' T-F(EFlt Tiga^i c c 179 51ftc / OF lT4

3iFTT r j f d 3 f q i A^ilf^lc1 AfCertified copy of Audit Report with Balance Sheet, Receipt/Payment & Income/Expenditure statements of the NGO for the last three years

7 < c /0 /4i m7 ti t 3i3Tif<f/w^it T/ T Amm qq qfi vgrfafci Act

Certified copy of permission/recognition/affiliation certificate of the School/College/Institute

8 k-TTf t vim 4 9r/ Eft Tqzff s 3i4d q C s s/

3q t / f 3 ;MT ail 3iT T zrr c ( 30 qt # Tq )Certified copy of land/building title deed, i.e.' registered Sale Deed/Gift-Deed/Exchange-Deed or Allotment Order or Lease-Deed (for not less than 30 years)in the name of NGO

9 f ifIIr A m d r r ftEh^ zi muf^Tff qfc (qft tw fir

Certified copy of the revenue record of land proposed for construction(if the proposal is for civil construction)

10 qzftr q9' *T # f if°r fc Atdlf di i jzc-,fc Tfqf°r qT Fftff #f

^ft T ITT ft (zft Rfftff fir r of lrg t)Search Report or Title Certificate with brief history of land proposed forconstruction from an Advocate (if the proposal is for civil construction)

11 9ft $i A*T qa iPT^ic Tft # .7q" q it i^rq C ^

f TR uMmqT (;qft f f T ZffAt #)Certified copy of the Certificate for change in use of land, i.e. from Agriculturalto Non-Agricultural from SDM, (if the proposal is for civil construction)

12 f f ui ti f'ir C 34wTf^is r -^ '4F-Tftff ATif°f qT Q 3tr t 4W -917

URt II1TJ1TW I

Non-encumbrance Certificate pertaining to land proposed for construction^i fio x Sub-Registrar

Cont..2

(9)

Cont..2

TA wilk-i .#.S.No Documents Page No.

13 A f Tf°T fkq #7 ftq Tiq Afiftfd Af is (-qft 4 c

f if°rgTAtet)Certified copy of approved site-plan for the proposed construction, (if theproposal is for civil construction)

14 t 9Tr - /'iT Tr f _ 9 I 7 sKUI RIO fir it f 1rri f lR ( f f Or g ;Rffq W)Detailed Estimate item wise for the proposed construction prepared byChartered Architect/Licensed Engineer, (if the proposal is for civil construction)

1 5 r i / g f i f fr Rftu qM #Tr t;T

Ovgg T 1 N^KR ( : i 1 zw'l Ei wt^ 4Wgfdpt)Quotations from at least three standard firms for the equipments/ computers/furniture to be purchased with comparative statement (if the proposal is forpurchase of equipments)

16 c ;sTf 1^4 gfdqsH Ric Sf ^ it W AM ( 31 31J/

clf' 4i / Eft fir M14 t)Details of Trades being run & proposed trades with syllabus (if the proposal

is for ITI/PolytechnicNTC

17 -V #i 31 fR -l/t'-ER FAT iList of students class-wise/trade-wise as per Annexure -V

18 ftW#t Q9 gftW of t Ofiz qt wii i 9f 1/qf 9M N ZrCertified copy of the last Board examination result-sheets/Details of results

19 -IV t 37 fZ i g iT31 / 3 AkdlI 1c1 i ir31 / it friq

Tr-w -eft t m f 3r 'TFees, structure class-wise/trade-wise for existing classes/trades & proposedclasses/trades as per Annexure -IV

20 ^-VI 3 1 f %wit $ir

Teacher's details as per Annexure -VI

21 q ifr 4i f ^ gf t ch g1- 1^ ti Q@mmi

Three post card site photographs, from different angles of the existing

School/ College/Institute building

1) r Et 3Tm i i s Age s 31f q^;j 31p MW Liar t ;Tr 'Sff^ f

UE5 3 1 ii 30 i ff V 9* it qt t c ga gZ I Tr ;nTf *T 9T 31i

ggft4ft fiir wir l

2) -qft AT-fc M / / /31T t31f it f q*'RUTT agtz / /Lb R / 7Pft9t Ek

4i i' W it V it s FR f 9, 10, 11, 12, 13 AT 14 ^ fkq TR qfd Z ,5rMTFi r VF6t

Note: 1 ) Please send duly filled prescribed proforma along with all essential documents. If the applicationis found incomplete & the deficiencies are not removed before last date , i.e. by 301h September,the file will be closed and no further correspondence will be entertained,

If the proposal is for purchase of lab equipments /compgters/furniture /tools & machinery for

School/College/VTC/ITI then documents mentioned at S. No.9,10, 11,12, 13 & 14 in the Checklist

will not be required.

- I IAnnexure -II

MAULANA AZAD EDUCATION FOUNDATION(^ Tr4 T,)

(Ministry of Minority A fairs, Govt. of India)

#f , c '31R T Vii' w ,f, ct-110055

Social Justice Service Centre, Opp. New Delhi Rail Reservation Centrre,Chelmsford Road, New Delhi - 110 055

WW R :01Rt -'30f 0cDATE FOR SUBMISSION OF APPLICATION: 1 S MAY TO 30 to SEPTEMBER

( i3 rt 4(V/) )APPLICATION FOR FINANCIAL ASSISTANCE FOR :(please tick (V,,,) the purpose in the appropriate box)

• ZTi f Pjr4/1t u

Construction/Expansion of School building

91. t/t.r w f TAtTu

Construction/Expansion of D.Ed/B.Ed. College building* q51f r

Construction of Girls Hostel building

Construction of Boys Hostel buildingz f f / A Rfl ff WfIW

Purchase of Science/Computer lab equipments/furniture for schoolamq;91 00M / 3Tr /q c c & f r

Construction/Expansion of Vocational Training Centre/ITI/Polytechnic

/3T1/^TT * f 39^i/-T;9/ mo'/W4-EIT Eft ;51-NPurchase of equipments /machinery/tools/furniture for VTC/ITIPolytechnic

-----------------------------------1) Fq-q

EhT;TRAT TT9 T

Name & full address of the Society/Trust withpin-code/phone/fax number

2) ftrff TM/4T/ EM r ^Tfo UU q5r9N cfT f fi7 76MM T

Name & address of the Institution for whichassistance is required with pin-code/phone/fax number

(11)

3) cr (9N, q T, tfcTr cTTf I {r Tc

Contact person (with name , designation, address

and phone number)

4) 3 1 Fe4ft (i1/)Status of application (Society/Trust)

5) f 4THNearest Railway Station with distance in K.M.

6) 31 5 Eft tul Vii, c 3

I ^ri'ffEF-I 11, i 3

MI-ift i )NGO's registration number, date & place of registration(attach certified copies of registration certificate,Memorandum of Association & Rules Regulations/TrustDeed & list of members , as per Annexure -III)

7) # 4 t P I qv- P/PVR

3 ''i 3T;:T (3T T Its AST 0)Brief background/educational activities & other

8) () 31 f T 1 1 c1T (Tat 3

(a) Financial assistance required

(both in words & figures)

(4) fT tT(b) Purpose of financial assistance

9) , mtwfO . if 'T 3T

^Tmqqf #f fiTft rf T lrHow much amount NGO would be investingfrom its own resources on the proposed project

10) 1,PTIZTf T,eI TWT9# I Tf i

trT& jpTf )Financial assistance if any received from Govt.,

Local Body , other organization ( indicate the amountreceived with purpose on each account duringlast three years)

11) c 9T 3TT;5TT %W c N/ Tw qftq i^

3 f ii X iiurq;4 Eft R ft Wr-T Eft

Financial assistance , if any received from MaulanaAzad Education Foundation/Central Wakf Councilearlier, if yes, enclose copy of Utilization Certificate

12) k-TT #jKff t Wi ur^ 4 f Tf (fq

NO, Tf^UyFdM 731 T/ i f 4°I Eft AFTfhTa TTf c'1t Tick

Funds in the Bank A/c of NGO (attach certifiedcopies of Audit Reports with Balance S'l'eets,Receipt/Payment & Income/Expenditurf statements

of the NGO

13) 4W TTi r WWho are the intended beneficiaries

14) iT#3l ; #PJA i"ff

Number of minority institutions in the a ea

15) TT ^ UKF 31q Tqff ap4T f t gZF

Whether the Institution is running in its own or

rented building (attach three post card size photo

of existing building

16) #MF EFT eft ( {c-iT MT SIT Iii icif ),

MT/mot 5MM IT-4 Eft Alit la 5ift, QAftuf 9 Af'rr v 3T

tTT^-Vl 3rrzf-aft #ffr, )Level of Institution (by Recognized orUnrecognized)attach certified copy of recognition/affiliation certificate, copy of Board result-sheets,details of students as per Annexure -! ) & details

of teachers as per Annexure -VI

17) F &RT it -UT t iT-W/ts'-1 tT

(mac-IVtaTF )

Class-wise/Trade-wise fees charged b y the

Institution ( attach details as per Anne ure -IV)

18) 3^UT TT 4t

Detail of accommodation available

19) 3 c Vf TT (a=f >T / 4 3c( 7 m 1t'3T^cb 7ZP )

Area of land available ( mention in sq.

(attach papers as per checklist)

It)

yards/acres

(13)

M'JT cfi20) c r ^ c^ TcT4f

3 Tc 3 c^

Proper justification for construction of HostelBoys/girls building ( use separate sheet)

O-ffff s' At

( ^ /qTMft9-b i P )Details of existing trades

( if proposal is for VTC/ITI/Polytechnic)

22)at4k

(4ft xtciri' Fm W)Details of new trades( if proposal is for VTC/ITI/Polytechnic)

I hereby declare that the information given in this application are true & correct to the best

of my knowledge & belief.

4 r # ^ffmAT

Signature with full name &

Seal of the authorized person of the NGO

c / Dated: : .............................................

irk' / Place: : ...............................................

^q ^T

General Instructions:

• E{r Trt *W ER / Please fill in all columns,

• ¶rr uT URff r Tftff i T$ i 3rtiF n mi

Please attach documents as per checklist carefully with proper numbering on each page,

•rqT 4 W a * Uffrff r ,r,if the required documents are in regional language, then certified English /Hindi versionof the same shall also be attached,

• Each page of application document attached must be signed/stamped by the President/secretary of the Society/Trust.

R( i - 1 I I

Annexure -Th

LIST OF MEMBERS

S. No.ff,TQ r;fm

Name of MemberV!P

S/o / D/o^ r -40 TU

Full Address with Telephone NumberWITR Tai

Designation

#^FqT - IVG^>Annexure -IV

ITT ( -R/ -R)FEE STRUCTURE '(Class wise/ Trade wise)

^FAS. No.

rClass / Trade

Mftff tFees charged monthly

a4 ItmFees charged yearly If any conces-sion are given

VAnnexure -V

t 9Tq ^ qT^I` tDETAILS OF STUDENTS REQUIRED TO BE ATTACHED WITH ANNUAL REPORT

*-,EF 44 / ACADEMIC YEAR .................................

s' ^• cifStudents Belonging to Minorities

IStudents Belonging to Other

Communities *fS.No. Class

MuslimsaT;q

Others Totalwq

BoysUGirls

-'TTotal

GrandTotal

>TBoys

UTqT^Girl

>Boys Girl

A 1;q1t t #rqf zi

Seal & signature of the Principalof Institution

Seal & Signature of the President/Secretary/Manager of the Society/Trust

(17)

i

4) - V1

Annexure -VI

t At / DETAILS OF TEACHERS

S. No.fT^

Name of the TeacherT

QualificationW4 3T

Work Experience Trained/Untrained

(18)