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FORMAT OF CERTIFICATE TO BE ISSUED BY THE DISTRICT EDUCATlON OFFICER INRESPECT OF SCHOOLS ALRE~Y AFFILIATED WITH THE BOARD AND SEEKING

EXTENSIONfUPGRADATION OF AFFILIATION WITH THE CENTRAL BOARD OFSECONDARY EDUCATION

(In accordance with School Safety Policy, 2016 issued by the NDMA, Manual on Safety and Security of ChildreninSchools developed by NCPCR and the National Building Code)

PART-AThis part is to be filled-up by'the school and to be produced before the District Education Officer along with all

rti d t d rtif t . .. Isuppo mg ocumen s an ce I rea es m ongmaGENERAL INFORMATION

1. Affiliation Number Allotted by CBSE to the School 2132814 Annexure -I2. Name of the School as per affiliation letter ofCBSE DELHI PUBLIC SCHOOL

HATHRAS,., Address of the School 08 K.M. MILESTONE ON S.H.-33,,).

Hathras-Mathura Highway,Hathras (U.P.) -204213

4. Standard\level/c1ass upto which the school is Class Nursery to Class Xrunning

5. Is the name and address of school in CBSE Yesaffiliation letter and State NOC/recognition/ U-DISE same exactly the same.

6. U-DISE code allotted to the school 09130407407 Annexure -II,7. Name and address of the Trust/Society/Company Shri K.K. Jain Educational Trust

(under section-S) running the school as on date AligarhAnnexure -III

8. Is the Trust/Society/ Company duly registered with Yesthe competent registering authority and theregistration is valid as on date?

9. Purpose of present application Upgradation to Senior SecondaryLevel

10. Location of School Outside the Municipal limits of anytown/city

11. Has the school obtained Recognition Certificate Yesfrom the State Government from Class 1 to 8

12 N umber of Recognition Certificate from Class 1 to 15792-938 and date of issue 31.3.2016 Annexure -IV (A& B)

INFORMATION REGARDING ~AND DETAILS AND OWNERSHIP

13 Is the school situated on a single contiguous plot of Yesland bounded on all sides by a Pucca BoundaryWall?

14 Are both the school and the Play Ground situated in Yesa single compound bounded by a single continuousBoundary wall on all sides?

15 Total Area (in square meters) in respect of 12 and 38060.00 sq. mt. Annexure -V13 above which the school is situated

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16 The land is .in the possession of the school Shri K.K. Jain Educational Trust,Trust/Society/Company legally valid by way of Alizarh

17 Name of the Owner/Lessee ofthe Land in respect of Shri K.K. Jain Educational Trust,point 14 above .Aligarh

18 In case the land is in the possession of the NOsociety/school by way of lease as per StateGovernment norms, the period of the lease

19 Is any public road, canal or thorough-fare, HT line NOetc. passing through the land in respect of point 14above.

INFORMATION REGARDING ESSENTIAL SAFETY REQUIREMENTS

20 Has the school been inspected by the Government Yes. Annexure -VIengineer and the school building been foundstructurally safe for running a school?

20 (a) If yes the date of last inspection 04.02.201621 Has the school been inspected by the officer of Yes Annexure -VII

Government Fire Department and the schoolbuilding been declared safe for school from thepoint of view of fire safety?

21 (a) If yes date of last inspection ·25.06.201622 Has the school compound been checked by the Yes Annexure -VIII

public health department and the health sanitaryconditions been found to be satisfactory and thewater has been found safe in drinking?

22 (a) If yes the date of last inspection 23.03.2018INFORMATION REGARDING THE STAFF

23 Does the school have well defined service rules and Yesconditions for its employees as per prevalent normsof appropriate Government?

24 Is the school paying salary to the teachers and other Yesemployees as per the norms of the appropriateGovernment?

25 Is the salary to the teachers and other employees of Yesthe school being paid through the bank by mode ofelectronic clearing?(Payment by cheque or cash to the individuals is notallowed)

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PART-B

This part is to be filled-up by the District Education Officer after verifying all supporting documents andcertificates in original and visiting the school

FileNo ....................................................................................................................Date of Issuance ... ?.fl .: 1. ~:. ~Q Ih. .........................................................................................

J This is to certify that the information above, provided by the school has been verified on the basis ofall supporting documents and certificates and visiting the school and the information has been found

correct.2 Is the school recommended for extension/upgradation of affiliation? I 9.-C!?

~~*ignature(Name aridStamp ofIssuing DEO)

DISTRICT EDUCA nON OFFICERIEQIV ALENT OFFICER FROM EDUCA nON ~INISTRA TION AT, DISTRICT LEVELNAME OF DISTRICT

Counter Signature

(Name, Designation and Stamp)DISTRICT COLLECTORIDEPUTY COMMISSIONER

(or his authorized representative*), NAME OF DISTRICT

(*Not below the rank of a Group -A Gazetted Officer)

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;vYv.J!..~(~H ature of Principal) (Signature ofD.E.O.)1<"

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