Proforma for seeking information from Private Coaching Center
All the Coaching Incharge are directed to Fill Correct Information.
Name of Coaching Institute
Address of Coaching Institute
Name of the  Locality
City/ Town /Village
Pincode (Enter digit only)
Mobile No.(Enter digit only)
Assembly Constituency
District
Coaching Provided For
Area of Coaching center in (Square meter)(Enter digit only)
Total No. of Rooms (Enter digit only)
Sitting Arragment for Student per Room (Enter digit only)
Name of Society/Trust /Organisation/Company/firm running the Private coaching
Society/Trust /Organisation/Company/firm Detail thereof
Name of Individual running the Private Coaching
Year of Establishment
Coaching Details
Coaching Provided For Floor No. Capacity in each discipline Student in Each discipline Fee for Coaching classes Per Month
Teaching Staff Deatils
No. of Teaching Staff
Name of Teaching Staff Gender Faculty Complete Qualifiaction
Non Teaching Staff Deatils
No. of Non Teaching Staff
Name of Non. Teaching Staff Gender Nature of Work Qualification
Whether character and antecedents of all staffs verified by the Police Authority
Nature of Land on Which is running
Whether Fire certificate obtained from competent authority
Whether structure stability Certificate obtain from competent authority
No. of Toilet for Boys (Enter digit only)
No. of Toilet for Girls (Enter digit only)
Whether Building is Barrier free for specially able child
Other Facility provided by the coaching center
Any Other Information
Visual Code
Type The Code Shown