1. Name of Institution*:
2. Postal Address:
City/Place:			Block/Tehsil* :
District*:		Pin Code*:		State:	Select State Delhi Uttar Pradesh Uttarakhand West Bengal Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Andaman & Nicobar Islands Dadra & Nagar Haveli Daman & Diu
3. Phone No. with STD Code/ Mobile No.*:			Email:
4. Name of the Principal*:			5. Qualifications of the Principal:
Administrative Experience (in Years)*:			Teaching Experience (in Years):

1. Name and address of Trust/Society/Etc *:
2. Is the Trust/Society/Etc Registered?	Yes No	3. If Yes, under which Act? *:
4. Year of Registration: (Certified copy of the Certificate of Registration and Memorandum of the Society is to be enclosed. Enclosure-I)		Registration No.*:
5. Whether the Trust/Society/Etc/Management is of non-proprietary character: (List of members with their addresses stating how the menbers are related to each other to enclosed. Enclosure-II)	Yes No

6. Name and official address of the Manager/President/Chairman of the Centre:

Name :				Designation:
Address :				Phone No. with STD Code:

1. Is the Institution/ college located in a rented building or own building?	Yes No
a). Area of school/campus*	(in Acres)	(in sq. Mtrs.)
b). Built up area (in sq. Mtrs.) *

2. Infrastructure Details:

a). Rooms, Libraries and Laboratories

S.No.	Item	No. of Rooms	Size in sq. ft. (l*b)	Area in sq. ft.
1.	Classrooms (min. 300 sq. ft. each)
2.	Composite Science Lab
3.	Physics Lab
4.	Chemistry Lab
5.	Biology Lab
6.	Maths Lab
7.	Computer Lab
8.	Library
9.	Other Roos/Hall
10.	Special Needs Workshop

3. Teaching Staff (List of staff indicating qualifications, subjects(s) taught & experience etc. to be enclosed. Enclosure-VII):

S.No.	Staff	No. of Permanent Teachers	No. of part time Teachers	Total
1.	TGTs (Trained Graduate Teachers)
2.	PGTs (Post Graduate Teachers/Lecturers)
3.	Librarian
4.	Vice Pricipal/Head Master/ Head Mistress

4. Administrative support staff:

S.No.	Staff	Permanent	Not Permanent	Total
1.	Clerks
2.	Lab Attendants
3.	Accountants
4.	Peons

Other Facilities:

a.	Facility of Toilets	Available for Boys Available for Girls Not availabe
b.	Facility of Drinking Water	Available Not availabe

5. Library Facilities:

Total No. of Books		No. of Dailies (Newspapers)		No. of Magazines

6. Other Facilities available in the school:

Sports & Games	Dance Room	Gymnasium	Music Room	Hostel	Health and Medical Check up