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Ac Applicationform

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0% found this document useful (0 votes)
46 views4 pages

Ac Applicationform

Uploaded by

Martin Nadar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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RURAL INSTITUTE OF OPEN SCHOOLING

Under societies registration act XXI of 1860


GOVT.OF NCT OF DELHI.

APPLICATION FOR ACADEMIC/STUDY CENTER


ORGANIZATION PROFILE
1. Name of the Organization:
2. Year of Establishment:
(Please attach proof)

3. Type of Organization: Trust Society Educational Institution


(Tick most appropriate)

LLP Pvt. Ltd Bank / Insurance Co.


(Enclose the necessary
details and proofs)
Ltd R & D Organization PSU/Govt. Organization

Others
4. Full Postal Address:

District: State:

Country: Pin Code:


5. Official Communication:
Phone No:
(Country Code) (STD/Local Code)

Tele fax:
(Country Code) (STD/Local Code)

Mobile No.: +91


email:
Fill the following and enclose prop er Proof:
6. Premises Details: Owned Rented 7. Ready for Operations: Yes Not Yet
8. Total Carpet Area of Organization (Sq. Ft.):
9. Total Site Area of Organization (Sq. Ft.):
10. Internet Connectivity: Leased Line Broadband Dial-Up Speed
11. Details of Computers (Dedicated earmarked for Training and Research Purpose)
Type Processor RAM HDD Network (Y/N) Internet (Y/N)
Server Computer
Client Computer

12. Infrastructure Details: Generator LCD Player FAX Photo Copier


Sr. No. Other Infrastructure for Training Program Units Area (Sq. Ft.) Seating Capacity
1 Class Rooms
2 Library (Total Books: ____________)
3 Reading Room/ Conference Room / Audio Visual Room
4 Administrative Area
5 Trainer Room
6 Service Area - Toilets etc.
7 Other ______________________
13. Detail of Courses that you are interested to offer through RIOS:
Sr. No. Proposed Course Expected No. of Sr. No. Proposed Course Expected No. of
Admissions Admissions
1 7
2 8
3 9
4 10
5 11
6 12
(Use separate sheet, if necessary)
14. Teachers and other Staff Teaching Department Details:
Enclosed separate List of all Trainers and other Staff Members in following format:
Name | Father's Name | Date of Birth | Sex | Academic Qualification | Professional Qualification | Experience (Teaching & Non-
Teaching both) | Level of Association (Full Time/ Part Time/ Visiting Faculty) | Key Skills

DIRECTOR PROFILE
1. Name:
Latest Colour
Photograph in Passport
2. Designation: Size of the Proposed
Principal/Director
3. Sex: M F 4. Qualification:

5. Experience :

6. Photo ID Proof : Driving License Passport Voter ID PAN Card


(Kindly enclose the copy)

DECLARATION
We certify that the particulars furnished above or in the preceding pages are true to our best of our knowledge and express our
willingness for an inspection to assess the infrastructural facilities, qualified staff etc. We declare that the Organization will abide
by all the rules and directions of Rural Institute of Open Schooling (RIOS) given from time to time. In case of any information
furnished by us is found wrong or incomplete in any regard, we shall be the responsible for any decision taken by RIOS. I hereby
confirm that I will regularly visit/login website namely www.rios.ac.in and any information relevant will be received by me from
above-said website. Further, I will never claim any information officially or unofficially in hard copy and email. Therefore, only I
will be responsible for all types of consequences, if I don't visit/login the said website.

I have carefully read and understood all the guidelines, specifications and other information published by the RIOS on the
Website www.rios.ac.in In case of any disputes or for any unforeseen issue(s) or issues not covered in the guidelines,
specifications and other information published by the RIOS, the decision of the RIOS shall be final and binding on me and all
other concerned. I agree that the RIOS reserves the right to withdraw any location or any Discipline/Programme or its
nomenclature at any time without assigning any reason and to make modifications in any information published anywhere
whenever deemed necessary.

In the event of any disputes between the parties, which are not covered at the arbitration clause, the courts of Delhi shall have
exclusive jurisdiction.

Date:

Specimen Signature of the Proposed Principal/Director Seal & Signature of the Head of the Organization
FOR RC USE ONLY
Allotment Fee of Rs. 51,000/- (Non-Refundable and Non-Adjustable) in favour of "RURAL INSTITUTE OF OPEN SCHOOLING" payable
at "Delhi"

Demand Draft No. Date Bank Issuing Branch

Kindly allot me the following selected Progammes :

1) High School Examination 2) Intermediate Examination

PHOTOS TO BE PASTED:

Space for Affixing


‘WIDE RANGE PHOTOGRAPH SHOWING THE LOCALITY OF THE ORGANISATION’

UNDERTAKING
The above pasted photographs are belonging to our Organization. I also undertake that if I fail to pay renewal fee
for Regional Coordinator then RIOS have the right to transfer all our enrolled Students to any other Regional
Coordinator or treat them as Direct Students to complete their course.

I understand and agree that fees paid by me with the application form or on account of processing fee, for conduct
of inspection, for grant of approval of my application or any other fee or charges, as prescribed for Study Center
once paid, will be non-refundable. Withdrawal of my proposal or rejection by the RIOS at any stages for reason
whatsoever shall not entitle me to claim any amount or compensation from the RIOS.

Signature of the Proposed Principal/Director Seal & Signature of the Head

KINDLY SUBMIT ACADEMIC/STUDY CENTER FORM AT: Rural Institute of Open Schooling (RIOS)
Administrative Office: C-12, Ground Floor, Aruna Park, Near Vikas Marg, Laxmi Nagar, Delhi-92.
RURAL INSTITUTE OF OPEN SCHOOLING
UNDER SOCIETIES REGISTRATION ACT XXI OF 1860 (GOVT.OF NCT OF DELHI)

INFORMATION OF ORGANISATION
Name of the Organisation ………………………………………………………………………

Type of Organisation ………………………………………………………………………

Registered Address ………………………………………………………………………

Date of Registration ………………………………………………………………………

Registration Number ……………………………………………………………………….

Pan card No ……………………………………………………………………….

Proposed Office Address ………………………………………………………………………..

List of Office Bearers

President/Chairman ……………………………………………………………………….

Mobile No ……………………………………………………………………….

Authorised Person ………………………………………………………………………..

Phone No. with STD Code ……………………………………………………………………….

E-mail Address ……………………………………………………………………….

Fax ………………………………………………………………………..

DOCUMENTS TO BE ATTACHED

 Organization Registration Certificate Copy


 Organization PAN Copy
 Organization Head PAN Copy
 Organization Head Id Proof Copy
 Organization Building Ownership Proof/Rent Deed
 Organization Building Photograph.
 Organization Building Map
 List of Staff members

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