CHECK LIST TO BE FILLED AND SIGNED

BEFORE SUBMISSION OF APPLICATION FORM.

Please confirm attachments of following documents, duly flagged with the Registration form, before
its submission to the office of PEIRA.

Not
S# Nature of Document Attached
Attached
1. Society Registration Certificate under Act XX1-1860. F/A
2. Copy of constitution of Governing / Managing body F/B
3. List of members of Governing / Managing body F/C
4. Map (Blue print) of the school / college building F/D
5. School building fitness / soundness certificate F/E
6. Copy of lease agreement of the institution F/F
7. Copies of attested testimonials of teachers / head of F/G
institution, including librarian, PTI / DPE.
8. Bank surety for having funds equal to six months’ pay of F/H
staff in the Institution account
9. Bank statement regarding salary of teachers and Head of F/I
Institution
10. Detail of income Tax deduction at source F/J
11. List of student’s chairs, Library chairs, Laboratory stools F/K
and sports gadgets
12. List of subject wise science equipment alongwith its F/L
quantity against each.
13. Copy of service rules of teachers and non-teaching staff. F/M
14. Deed of ownership of the school building F/N
15. Copy of budget sanctioned for the school. F/O
16. Fixed deposit receipt. F/P
17. General time table. F/Q
18. Teacher’s time table. F/R
19. Prospectus. F/S
20. Certificate to the effect that the management will: F/T
i. extend full cooperation for conducting educational programs / activities/
workshops for teacher’s capacity building & students learning.
ii. ensure proper maintenance and regular audit of accounts by qualified
auditors.
iii. ensure that only Principal / Headmaster / Headmistress will conduct
correspondence with PEIRA.
iv. arrange clean drinking water facility for students & teachers.
Signature ________________
Name ________________

Date _____________ Designation ________________

15A