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JAI SHREE RADHEY EDUCATION & CHARITABLE TRUST
B-4/211, Near Step by Step Pre. School, Chitrakoot, Jaipur {Rajasthan} India
Important Note:
1. Kindly ensure that your institution fulfills all the requirements as stated in the norms for becoming Information Centre as
programs selected. 2. Kindly provide all the details/documents as stated in the application form & norms for becoming
Information Centre. 3. Kindly put your full signature & seal of your organization on each page of the application form &
documents enclosed. 4. Kindly fill in true points in the application form.
[APPENDIX A] Institutional Details…
1. Name of the Institution
_______________________________________________________________________________
2. Type of Institution
Trust
3. Location of the Institute
_______________________________________________________________________________
Society
Proprietor
Partnership
Firm
Company
College [UG/PG]
4. Year /Reg. No. of Establishment _______________________________________________________________________________
5. Full postal address/Pin code
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
District:__________________________________ State: _________________________________
Pin Code: ______________________________ STD Code: _______________________________
6. PAN No. of The Organization.
_______________________________________
[Enclosed / Not Enclosed] _____________
7. Audited Balance Sheet 2Yrs.
_______________________________________
[Enclosed / Not Enclosed] _____________
8. Floor Plan/Inst. Layout
_______________________________________
[Enclosed / Not Enclosed] _____________
9. Document Relating to Address Proof of Institute [lease/rent/sale/Owner]
[Enclosed / Not Enclosed] _____________
10. Photographs of the Institute [Lab/class/reception/office/front/library etc.]
[Enclosed / Not Enclosed] _____________
[APPENDIX B] Management/Head of the Inst. Details…
1. Head of Mngt./Co-ordinator
_______________________________________________________________________________
2. Designation
_______________________________________________________________________________
3. Postal Address
_______________________________________________________________________________
_______________________________________________________________________________
4. Communications Connectivity
Tel. No.: ______________________ /______________________ Fax: ______________________
Mobile:+91-______________________ / ______________________ /______________________
Email: _________________________________ Website_________________________________
|email: [email protected] | [email protected] |website:www.jsrectrust.org |
| Connectivity: +91-0141-2441937 | +91-80587-94220 |
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5. Educational Qualification
_____________________________ Profession / Experience______________________________
6. ID/PAN/Qualification/Age/Address proof etc. of the Head of the Management
[Enclosed / Not Enclosed] _____________
[APPENDIX C] Infrastructural Facilities Details…(Kindly select the appropriate option. Enclose the details also)
1. The building of Institution is
Leased
SN
Type of Facility
1
Class Room
2
Computer Lab
3
Library
4
Theory Room
5
Conference Room
6
Auditorium
7
Staff Room
2. Internet Connectivity
Broadband
Rented
Owned
No. of Rooms
Dialed up
Area [in sq. ft.]
Seating Capacity
Speed
3. Details of the Computers…
Type
Server Comp.
Client Comp.
Processor
RAM
Hard Disk
Network [Y/N]
Internet [Y/N]
[Kindly attach a list as per the above stated format for details of the computer]
4. Library {Detail}
S. No.
1
Reference Books
2
Text/Subject Books
3
Periodicals Subscribed
4
Journals Subscribed
5
News Papers Subscribed
6
Course CD’s
7
Course Audio/Video Cassettes
8
Other Category Books
5. Equipment Available
S. No.
1
Generator/UPS/Inverter
2
LCD Projector
3
OHP
4
Fax
5
Photocopier
6
Other Equipment {if any}
6. Faculty Details
SN
Name of the Faculty
Category
Total No.
Equipment
Total No.
Designation
Qualification
Experience (in Yrs.)
Subject
Kindly enclose the detailed Bio Data and self attested copies of educational certificates of the faculties. The JSREC Trust may insist
on meeting any /all faculty member & or inspection of their appointment/contract/engagement orders.
|email: [email protected] | [email protected] |website:www.jsrectrust.org |
| Connectivity: +91-0141-2441937 | +91-80587-94220 |
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7. Institution is Recognized by
_______________________________________
[Enclosed / Not Enclosed] _____________
Information Centre Affiliation Amount Details…
1.
Amount Remitted Rs. __________/- [_______________________________________] in favor of JSREC TRUST, Payable at
Jaipur {Rajasthan}
Demand Draft No.
Date
Bank/Branch Name
DECLARATION
I declare that the information supplied in this registration is correct and complete. I also declare that I understood the terms and
conditions stated here and from the website.
Date: ____ ______ ___________
{DD}
{MM}
{YYYY}
Name:
________________________________
Designation
________________________________
________________________________
Signature {with Seal}
|email: [email protected] | [email protected] |website:www.jsrectrust.org |
| Connectivity: +91-0141-2441937 | +91-80587-94220 |
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DECLARATION
1. I / We certify that all the information given above and in the preceding pages signed by me / us is / are complete and
correct.
2. I / We declare that the institute will abide by all the rules and directions of JSREC TRUST given time to time.
3. I / We declare that I / We am / are authorized to sign on behalf of my organization and that my directors and
shareholders / members (where relevant) are in total agreement of my / our application.
4. In case of any information furnished by me / us is found wrong or incomplete, I / We declare that the institute may be
derecognized and is also open to any action as per law.
5. I / We undertake not to do any advertisement of our own in print / electronic media without the prior written permission
of JSREC TRUST.
6. I / We hereby undertake that if it is ever found that the Institution is not able to run as per the norms, rules and
procedures laid down by JSREC TRUST, the JSREC TRUST shall be free to withdraw the study centre recognition.
7. I / We shall verify all the original documents of the students and certify that the students registered at my / our study
centre for any programs are eligible in all respect as per the eligibility norms of all courses. I / We shall produce the
original documents of the students as and when required by JSREC TRUST.
8. I / We understand that JSREC TRUST reserve the right to terminate the study centre registration if it is found that I /
We have knowingly made a false declaration in the form.
9. I / We understand that the approval of my / our institution as Study Centre shall be done as per the norms of the
JSREC TRUST.
10. I / We understand that JSREC TRUST reserve the right to reject the application without assigning any reason.
Place: _____________________
Date: _____________________
(Head of the Institution Signature, Name, Designation and Seal)
_____________________________________________________________________________________
Note: The declaration mentioned on this page has to be submitted on at least stamp paper of RS 10/-
|email: [email protected] | [email protected] |website:www.jsrectrust.org |
| Connectivity: +91-0141-2441937 | +91-80587-94220 |