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State of Madhya Pradesh - Section
Section 21 in Right of children to Free and compulsory Education Rules, 2011
21. Power to issue directions.
- The State Government shall have powers to issue directions to redress any issue or difficulty that comes up in the process of implementation of the rules.From 1[see rule 11 (1)]Self Declaration Cum-Application for Grant of Recognition of School------ (name of place) Date---------To,The District Education OfficerDistrict---------------------Madhya PradeshSir,I forward herewith a self declaration regarding compliance with the norms and standards prescribed in the Schedule to the Right of Children to Free and Compulsory Education Act, 2009 and application in the prescribed profroma for the grant of recognition to --------------------------------------- [Name of the school].Yours faithfully,Enclosure:Chairman of ManagingCommittee/Manager/principalName of the school -------------------| A. School Details | ||
| 1 | Name of School | |
| 2 | Academic Session | |
| 3 | District | |
| 4 | Postal Address | |
| 5 | Name of Village & Ward No. | …………….Ward no…...…… |
| 6 | If urban area Name of city & Ward No. | …………….Ward no…...…… |
| 7 | Block | |
| 8 | Pin Code: | |
| 9 | Phone No. with STD Code | |
| 10 | Fax No. | |
| 11 | E-mail address, if any | |
| 12 | Police Station | |
| 13 | Longitude | |
| 14 | Latitude |
| B. General Information | ||
| 1 | Date of First Opening of School (DD/MM/YY) | |
| 2 | Is it the school run by Trust/Society/Organisation | Yes/No |
| 3 | If yes –a- Name of the Society /Trust/Organisationb- Registration No. of Trust/Society/Organisation ( Pleaseenclose copy of the document of registration) | |
| 4 | If No – | |
| a-Name of the Owner | ||
| b- Address | ||
| 5 | Name and official address of the Manager/President/Chairman ofthe School | |
| Name | ||
| Designation | ||
| Address | ||
| Phone | (O).................................(R)...................... | |
| Mobile No. | ||
| E-mail address |
| C. Nature and area of School | ||
| 1 | Medium of Instruction | |
| 2 | Specify entry class | |
| 3 | Minimum age of admission in entry class | |
| 4 | Specify exit class | |
| 5 | If aided by Government/local authority,a- the name of the Government/localauthorityb- Amount received as aid for lastyearc- percentage of aid against expenditure | |
| 6 | Is school recognized- Yes or No | |
| 7 | If yes,Name of the authorityRecognition numberDISE code | |
| 8 | Does the school have its own building or is it running in arented building | |
| 9 | Total area of the school | |
| 10 | Built-up area of the school(enclose photograph of thebuilding) | |
| 11 | Area of play ground | |
| 12 | Whether school is under obligation to provide free educationto specified number of children on account of having received anyland , building , equipment or other facilities , either free ofcost or at a concessional rate from the State Government ,Central Government and local authority? | |
| 13 | If yes , enclose copy of the document |
| D. Status of Enrolment & Fee | ||||
| Class | No. of Section | No. of Students | Annual fee | |
| 1 | Pre-primary-Nursery | |||
| 2 | Pre-primary-KG-I | |||
| 3 | Pre-primary-KG-II | |||
| 4 | I | |||
| 5 | II | |||
| 6 | III | |||
| 7 | IV | |||
| 8 | V | |||
| 9 | VI | |||
| 10 | VII | |||
| 11 | VIII |
| E. Infrastructure Details | |||
| Room | Numbers | Average Size | |
| 1 | Classroom | ||
| 2 | Office room – cum –Store Room – cum –Headmaster Room | ||
| 3 | Kitchen – cum - Store |
| F. Other Facilities | ||
| 1 | Whether all facilities have barrier free access | |
| 2 | Teaching Learning Material (attach list) | |
| 3 | Sports and Play equipments (attach list) | |
| 4 | Facility of books in LibraryBooks (No. of books)Periodical /Newspapers | |
| 5 | Type and number of drinking water facility | |
| 6 | Sanitary Conditions | |
| (i) Type of toilets | ||
| (ii) Number of toilets separately for boys | ||
| (iii) Number of toilets separately for Girls | ||
| 7 | Is Fire security system available |
| G. Particulars of Teaching Staff | |||
| 1. Teaching in primary/ middle school exclusively (details ofeach teacher separately) | |||
| Teacher Name (1) | Father/Spouse Name (2) | Date of Birth (3) | |
| Academic Qualification with subjects (4) | Professional Qualifications (5) | Teaching Experience (6) | |
| Class / Classes Assigned(7) | Appointment Date (8) | Trained or Untrained (9) | |
| 2. Teaching in Both Elementary and Secondary (details of eachteacher separately) | |||
| Teacher Name (1) | Father/Spouse Name (2) | Date of Birth (3) | |
| Academic Qualification with subjects (4) | Professional Qualifications (5) | Teaching Experience (6) | |
| Class / Classes Assigned(7) | Appointment Date (8) | Trained or Untrained (9) | |
| 3. Head Teacher | |||
| Teacher Name (1) | Father/Spouse Name (2) | Date of Birth (3) | |
| Academic Qualification with subjects (4) | Professional Qualifications (5) | Teaching Experience (6) | |
| Class / Classes Assigned (7) | Appointment Date (8) | Trained or Untrained (9) | |
| H. Curriculum and Syllabus | ||
| 1 | Details of curriculum &syllabus followed in each class (upto VIII)1. State Govt.2. CBSE3. Others | |
| System of pupil assessment | ||
| Whether pupils of the school are required to take any Boardexam upto class 8? |
| I- Limit of Neighbourhood for purpose of section 12 (1) (c)of the Act |
| No. | Dated: |