National Institute of Open Schooling Application Form

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National Institute of Open Schooling Application Form Application to be filled in by the institution seeking grant of accreditation for various Accreditation Programmes of National Institute of Open Schooling (NIOS) & FVTRS. A. Details of the processing fees/dd. DD No. Date Name of the Bank Accreditation sought for OBE Vocational Academic 1. Name & address of the organization. PIN Code Telephone No. (O) STD Code Fax E-mail 2 Name & Designation of the Head of the institution Name : Designation : Address : Phone : Email 3 Type of organization (a) NGO (b) School (c) Workshop 4 Information about the society/trust running the school (a) Name and address of Trust/ Society (b) Is the Trust/ Society Registered? YES/NO (c) If yes, under which Act? (d) Year of Registration Registration No. (Certified copy of the Certificate of Registration and Memorandum of the Society is to be enclosed. Enclosure -I)

(e) Period up to which Registration of Trust/ Society is valid (f) Is there a Resolution of the management to run NIOS scheme in the institution. YES/NO (if yes, enclose the copy) 5. When was the institution established year upto. 6. What is the level of education is being imparted by the institution? 7. What target group the Institution plans to cater (Please tick ) less than 14 age group 14+ age group 8. Accreditation applied for which Level of Open Basic Education (OBE) Programme (Please tick ) A equivalent to Class III B equivalent to Class V C equivalent to Class VII VIII 9. District in which organization will work (a) Detail of Available infrastructure in Organization/Institution Infrastructure No. Infrastructure No. (i) No. of Class Room (vi) Workshop/Lab with furniture (ii) Hall (vii) Tools and equipment (iii) empty classrooms (viii) Science labs (iv) Library (ix) computer lab (v) Play Ground (area) (x) Home science lab 10. Details of Academic and Administrative/Support Staff Faculty/Teacher In Institutions Remarks i. Academic Teachers ii. Vocational Teachers iii. Clerk iv. Accountant v. Lab assistant vi. Any other Please attach separate list of each

11. Please state (Attach separate sheet) - Why the institution is seeking NIOS accreditation for Programme. - If accreditation is granted, what would be the impact/benefit in the operational area? 12. Other Facilities a) Facility of Toilets Boys Girls Not available b) Facility of Drinking Water yes No 13. Details of the Vocational Courses being conducted by the applicant Society in any other institution or in the same campus. Sl. No. Name of the Courses/Trade Duration of the course Entry level Qualification Year of starting the courses Intake capacity Name of the recognizing accrediting/affiliating/ Central/ State govt. agency/others 14. Name of the Vocational Courses of NIOS for which accreditation is being sought. Sl. No. Name of Course/ with NIOS course code no Proposed intake/no. of batches proposed 1. 2. 3. 4. 5. 15. Justification Note motivation factors indicating the reasons as to why you are keen to provide vocational education courses, proposed by you for the accreditation, for the people

in your area. Indicate your experience in the field, kind of services/activities the society is currently engaged in, so as to acquaint NIOS with your sense of commitment to this work. (Please submit this on a separate sheet.) 16. Tools & Equipments (course wise) for proposed courses (To be submitted separately for each course) Name of the Course. Sl. No. Name of the Tools/Equipments Specifications of the Tools/ Equipments Quantity in stock Date of purchase. (In case purchases have been made in different years, the years of first and last purchase) Note : Photo copy of testimonials of both academic and professional qualifications of faculty and other staff be enclosed with the application form. Building details: To be filled by all seeking accreditation a) Whether the Institution is located in a rented building or own building. Please attach a copy of the Title Deed/Lease Deed. b) Institute located in the area, whether commercial/residential/institutional/ others Commercial Residential Institutional Others specify (Please tick mark) c) Date of occupation of premises. d) Date of lease & date of expiry. e) Whether the Institution has the facilities to conduct public examinations. If so, please specify details regarding Halls, rooms etc.. 17. Details of availability of General Audio-visual/Teaching aids available in the institute.

18. Finances: a) Details of the sources of finance of the institution (i) Govt. Aid (ii) Donation (iii) Fees from students (iv) Others 19. Any other information Any other relevant information/particulars which the applicant wishes to highlight in connection with the Accreditation of Vocational courses of NIOS. List of Enclosures (To be attached by an applicant institution duly attested) Document No. Particulars Whether enclosed or not Please tick ( ) or ( X ) 1. Copy of the Certificate of Registration 2. Justification Note 3. Resolution of the Management for taking up NIOS Courses 4. A copy of the Title Deed or rent/lease Deed 5. List of Tools & Equipments/trade wise 6. List of teachers/supporting staff and their particulars/trade wise with copy of their testimonials for Academic & Professional Qualification 7. Demand Draft of the requisite amount in favour of Secretary, NIOS payable at NOIDA. 8. Other Documents as required

Certificate Certified that the institution (Name) applying for Accreditation of courses of NIOS is fully owned by (Name of the Society/ Trust) Certified that building housing the institution and other structure has been declared safe (including fire safety) by the competent local authority. Certified that the information/particulars furnished above are Correct and authentic to the best of our knowledge. Signature of the President/ Secretary of the FVTRS Rubber Seal of the Society Name & Address Date: Place: