Application Form For Ccis/ngo Seeking Grant In Aid Page 9

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identity proof for the record?
Whether the child shifted or enrolled in the home
5.
with the approval of child welfare committee
Whether district administration is immediately
6.
informed on entry of any new inmates and staff
E. Utilization Certificate
1.
Amount of Grant Received Last year( If any)
2.
Attached Utilization Certificate
DETAILS OF CHILDREN RESDING IN CCIS
NAME OF INSTITUTION/CCI-----
Sr No
Name
Age
Sex
Educational
Orphan
Haryana Other
of the
(D.O.B)
status
Singal Parent
State
child
MR
phy
Challenged
HIV
1
2
3
4
5
6
7
8
1
01.07.06
M
Class IV
Singal parent
--
West
9 years
& MR
Bengal
7
months
19 days
 TOTAL NO. OF CHILDREN:
 TOTAL MALE
 TOTAL FEMALE
:
INSTRUCTIONS FOR TABLE II
1. List of children to be prepared starting from children in the age group 0-6, 7-10, 11-14,
15-18 and above i8 Years'.

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