APPLICATION FOR CRECHE UNITS CONTINUATION 1. (A) Name of Organisation : (B) Full Address : 2. (A) Registration No. : (B) Valid upto : 3. Date of application : 4. No. of continuation Creche Units applied for & period (list attached Annexure-A) : 5.Grant amount applied for : i. Recurring : ii. Non- recurring : 6. It is certified that the Bank Account of the Organisation is operated upon jointly by: i. Name : Designation : ii. Name : Designation : The Demand Draft may please be drawn on State bank of India. 7. behalf of the Institution/ Organisation, undertake by the terms and conditions of the sanction stipulated by the Director of Social Welfare, Chennai 5. SIGNATURE NAME DESIGNATION SEAL Notes: Application for New / Additional Unit to Be submitted in the prescribed application form separately. FORM - A (See Rule 13 (b)) FROM OF APPLICATION FOR CERTIFICATE OF PS CONDITION 1) Full Name of the applicant : 2) Religion : 3) Residence (Town or Village) : (In case of application particulars regarding items 2 & 3 mentioned in respect of each numbers) 4) Name of Institution : 5) Aims and Objectives : 6) Details about the financial condition : of the Institution funds,property and source of income 7) Arrangements made or proposed to : to be made for boarding and lodging and also details of the building whether owned by the institution or rented 8) Arrangements in respect of general : health of inmates and facilities for their medical treatment and arrangements proposed to be made for the educational, vocational and normal training 9) Full Address of the institution : 10) Has any such application made previously : if so, its results together with its date, month and year. 11) If the institution exists at present the date : of its commencement.
