Application Form For Ccis/ngo Seeking Grant In Aid

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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

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