Application form for CCIs/NGO Seeking Grant In Aid
A.
INSTITUTIONAL DETAILS/GENERAL INFORMATION
1. Name of the Institution:
_______________________________________________
2. Name of the Society
3. Details of CCI :
Name and Designation of CCI In- Charge
______________________________________________
Complete Address
_______________________________________________
Mobile/ landline No
______________________________________________
Email
_______________________________________________
PAN No
_____________________________________
Bank Account No
_____________________________________
Name and Branch of the Bank ________________________________________
IFSC Code
_______________________________________
Sanction capacity of the Home ______________________________
4. Registration Details ( Attached Registration Certificate ( If any)
Whether registered under Societies Act 1860/2012
Yes /No
Whether registered under JJ ACT 2015/2000
Yes /No
Registration No ------------------------ Dated --------------
5.
Total Number of children present ( Attached detail of each children as per format
at ( Annexure A)
Male
Female
Age breakup of children
Sanction capacity of the Home _________________
Sr No
Age
Number of Children
Total
Girls
Boys
1.
0-6 years
2.
7-14 years