| A. School Details |
| 1. |
Name of School |
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| 2. |
Academic Session |
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| 3. |
District |
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| 4. |
Postal Address |
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| 5. |
Village/City |
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| 6. |
Taluka |
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| 7. |
Pin Code: |
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| 8. |
Phone No. with STD Code |
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| 9. |
Fax No. |
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| 10. |
E-mail address if any |
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| 11. |
Nearest Police Station |
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| B. General Information |
| 1. |
Year of Foundation |
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| 2. |
Date of First Opening of School |
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| 3. |
Name of Trust/Society/Managing Committee |
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| 4. |
Whether Trust/Society/Managing Committee isregistered
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| 5. |
Period upto which Registration ofTrust/Society/Managing Committee is valid
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| 6. |
Whether there is a proof of non-proprietarycharacter of the Trust/Society/Managing Committee supported bythe list of members with their address on an affidavit in copy
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| 7. |
Name official address of the Manager/President/C/Chairman of the School
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Name |
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Designation |
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Address |
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Phone |
(O)….......................................(R) …........................................
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| 8. |
Total Income & Expenditure during last 3years surplus/deficit
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Year |
Income |
Expenditure |
Surplus/deficit |
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| C. Nature and area of School |
| 1. |
Medium of Instruction |
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| 2. |
Type of School (Specify entry & exitclasses)
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| 3. |
If aided, the name of agency and percentage ofaid
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| 4. |
If School Recognized |
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| 5. |
If so, by whichauthority• Recognition number
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| 6. |
Does the school has its own building or is itrunning in a rented building.
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| 7. |
Whether the school buildings or other structuresor the grounds are used during the day or night for commercial orresidential purposes (except for the purpose of residence of anyemployee of the school) or for political or non-educationalactivity of any kind whatsoever?
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| 8. |
Total area of the school |
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| 9. |
Built in area of the school |
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| D. Enrollment Status |
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Class |
No. of Section |
No. of Students |
| 1 |
Pre-primary |
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| 2 |
I-V |
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| 3 |
VI -VIII |
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E. Infrastructure Details & SanitaryConditions
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Room |
Numbers |
Average Size |
| 1 |
Classrooms |
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| 2 |
Office room - cum - Store Room - cum -Headmaster Room
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| 3 |
Kitchen - Cum - Store |
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| F. Other Facilities |
| 1. |
Whether all facilities have barrier free access |
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| 2. |
Teaching Learning Material (attach list) |
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| 3. |
Sports & Play equipments (attach list) |
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| 4. |
Facility books inLibrary• Books (No. of books)• Periodical/Newspapers
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| 5. |
Type and number of drinking water facility |
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| 6. |
Sanitary Conditions |
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(i) Type of W.C. & Urinals |
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(ii) Number of Urinals/Lavatories Separately forBoys
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(iii) Number of Urinals/Lavatories Separatelyfor Girls
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| G. Particulars of Teaching Staffs |
| 1. |
Teaching in Primary/Upper Primary exclusively(details of each teacher separately)
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Teacher Name |
Father/Spouse Name |
Date of Birth |
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(1) |
(2) |
(3) |
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Academic Qualification |
Professional Qualifications |
Teaching Experience |
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(4) |
(5) |
(6) |
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Class Assigned |
Appointment Date |
Trained or Untrained |
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(7) |
(8) |
(9) |
| 2. |
Teaching in Both Elementary and Secondary(details of each teacher separately)
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Teacher Name |
Father/Spouse Name |
Date of Birth |
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(1) |
(2) |
(3) |
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Academic Qualification |
Professional Qualifications |
Teaching Experience |
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(4) |
(5) |
(6) |
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Class Assigned |
Appointment Date |
Trained or Untrained |
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(7) |
(8) |
(9) |
| 3. |
Head Teachers |
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Teacher Name |
Father/Spouse Name |
Date of Birth |
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(1) |
(2) |
(3) |
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Academic Qualification |
Professional Qualifications |
Teaching Experience |
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(4) |
(5) |
(6) |
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Class Assigned |
Appointment Date |
Trained or Untrained |
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(7) |
(8) |
(9) |
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| H. Curriculum and Syllabus |
| 1. |
Details of Curriculum & syllabus followed ineach class (upto VTII)
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| 2. |
System of Pupil Assessment. |
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| 3. |
Whether pupils of the school are required totake any Board exam upto class 8?
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