Center Empanelment Registration Download Instructions

Organization Name (Institute / School / College / University) *

Organization Type *

Center Type *

Affiliated to *

Affiliation Number *

Organization Telephone *

Organization Mobile *

Organization Email *

Country *

State *

City *

Organization Website

Nearest Railway Station *

Distance from Station(in kms) *

Nearest Airport

Distance from Airport(in kms)

Name of Account Holder *As per bank records

PAN/TAN *

Bank Name *

Upload Cancelled Cheque *

Branch Name and Address *

Account Type *

IFSC *

Bank Account Number *

Confirm Bank Account Number *

Organization Head

Name *

Designation *

Mobile *

Alternate Mobile

Email *

Alternate Email

Picture (Latest Passport Size) *

Signature *

Superintendent / Centre Head

Name *

Designation *

Mobile *

Center Head Alternate Mobile Number

Email *

Center Head Alternate Email

Picture (Latest Passport Size) *

Signature *

Deputy Superintendent / IT Head / Network Administrator

Name *

Designation *

Mobile *

Deputy Alternate Mobile Number

Email *

Deputy Alternate Email

Picture (Latest Passport Size) *

Signature *

Organization Architecture

Campus Wall *
Campus Wall Height (meters) *
No of Entry Gate(s) *
CCTV at Entry Gate(s) *
Electricity BackUp *
Drinking Water *

Organization Staff

Female Staff *
Male Staff *
Female MTS *
Male MTS *
Female Guard *
Male Guard *

Organization Stationery

Photocopier *
Printer *
Internet Connectivity *
Total Number of Computers (Nodes) *

Number of registered students against course(s) offered by the Organization in current academic year.
Course	Title	Male Students	Female Students	Other Students	Total Students	Add Row(s)

The Organization capacity (floor-wise) to uphold the number of candidates in upcoming examination(s).
Floor	Class Room(s)	Seats Type(Capacity)				CCTV in		Washroom		PwD				Action
	Total Class Room(s)	Total Single Seats	Total Double Seats	Total Multi Seats	Total Number of Seats	Class-room(s)	Coorridor(s)	Male	Female	Provision	Total Seats(s)	Washroom(s)	Ramp(s)

Details of examinations previously conducted by the organization on (National / State Level).
Exam Title	Exam Type	Exam Area	Exam Year	Total Student	Action