Application for Affiliation

To

The Secretary,

Central Board of Higher Secondary Education Delhi, Admin Office : Laxmi Nagar, Delhi

Sub. Regarding Affiliation

Sir,

We want affiliation / information center for our institute / school. We understood and read carefully all rules and regulations, terms and conditions and we accept them. The details

of our institute / school / college / academy as under:-

1. Name of the institute / school ……………………………………………………………………….......................

2. Regd. No. if registered: ………………………………………………………………………………....................

(Copy attached)

3.FullAddress:……………………………………………………………………………………...............…………

…………………………………………………………………………………………………............………………

Dist…………………………………………………………..State……………………………...............……………

Phone…………………………………………Mobile………..………………………Pin……….................……..…

E-mail………………………………………………………………website………………………................……….

Nearest Bus Stand.

Nearest Railway Station.

Nearest Airport.

4. Detail of members if society / trust / firms:

I

II

III

IV

V

VI

VII

VIII

IX

X

5. Detail of the Authorized person of institute / school/ college / academy  who will work with the Board on the behalf of the institute/school/College:

Name: ………………………………………………………………………………………………………...............

Father name: …………………………………………………………………………………………….....................

Mother name: ………………………………………………………………………………………………

Date of birth…………………………………………………………………………………………………

Full.address: ………………………………………………………………………………………………..

…………………………………………………………………………………………………………………

………………………………………mobile………………………………………email…………………

(Copy attached any identity as a proof of address)

6. Detail of Building:

I. Total Class Room…………………………………………………………………………

II. Water arrangement………………………………………………………………………..

III. Toilet facility…………………………………………………….………………………….

IV. Play ground………………………………………………………………………………….

V. Computer facility……………………………………………………………………………

VI. Internet facility………………………………………………………………………………

7. Detail of Staff:

I. Hindi Teacher…………………………………………………………………………………….

II. English Teacher……………………………………………………….……………………….

III. Math Teacher…………………………………………………………………………………….

IV. Science Teacher………………………………………………………………………………….

V. Social Science……………………………………………..………………………………………

VI. Computer Teacher....................………………………………………………………………….

VII………………………………………………………………………………………………………..

VIII……………………………………………………………………………………………………….

IX…………………………………………………………………………………………………………

X…………………………………………………………………………………………………………..

8. Bank Detail of the institute:

I. Name of the Bank……………………………………………………………………………………

II. Branch …..……………………………………………………………………………………………

III. IFSC code: ……………………………………………………………………………………………

IV. Account No ………………………………………………………………………………………….

V. Name of Signatory Person ……………………………………………………………………….

9. Is your institute/school/colleges affiliated with any other educational Board / University

give detail? If yes copy attached.

…………………………………………………………………………………………………………..

…………………………………………………………………………………………………………..

………………………………………………………………………………………………………….

9. Other Details:

……………………………………………………………….................………………

……………………………………………………………………….................………

………………………………………………………………………………................

………………………………………………………………………………................

I here by declare that the above information is true.

Dated.

Signature ……..........………….

Place: Name……………............…….…

Designation……..........……….

Stamp.