Institute Location :

Study Centre Applied For
City / Town / Village  

Institute Information :

Name of the Institute Year of Establishment Status of The Institution
P.O. P.S. Pin
Postal Address of the Institute    
Institute Contact No.
Phone1 Phone2 Email Address

Information About Centre Head :

Name of the Centre Head Designing / Position Hold of the Centre State
District P.O. P.S.
Postal Address of the Centre Head Pin  
Mobile Email Address of the Centre Head Date of Birth of the Centre Head
Nationality Religion Sex
Marital Status Educational Qualification of the Centre Head Professional Experience of the Centre Head

Available Infrastructure Facility of the Centre :

Office Room
Theory Room
Practical Room
Staff Room
Waiting Room
Any Other

Faculty Information of the Centre :

(As on date of proposal)
Name Qualification Teaching Experience Status Full time / Part time

Details of Available Facilities of the Centre :

No. of Computer No. of Reference Books Licensed Software
No. of Journal No. of CD's No. of Projector / LED
Internet Facility with Speed Inverter / Generator Facility Drinking Water Facility

Upload Documents :

Colour Passport Size Photograph of The Head of The Institute
Voter Card of The Institute Head (Both Side in One Page)
Pan Card of The Institute Head
Trade License / Registration Certificate of The Institute
Colour Photograph of Theory Room
Colour Photograph of Practical Room
Colour Photograph of Office Room
Colour Photograph of Front Side of The Institute
I hereby certify that the context stated above are correct and true to my knowledge and belief and hereby confirm that our Organization / Society / Trust is free from any legal / official disputes whatsover.I accept that any facts stated above. I found incorrect will automatically result in cancellation for nominations associate.However I will have no right whatsover to fight / challenge legally against the judgment in any court of law. All disputes are subject to Ranaghat Jurisdiction only.