1. Name & Address of the School with Contact No. of School:
2. Name of the Scheme and Year: Reimburshment of Tution Fees, 2014-15
Sl.
Name of
Student
Sex
DOB
Father's
Name
Residential
Address with
Pincode
School Name
Phone No./
Mobile No.
Class
Income as per
certificate (SDM)
Catgy.
Account
No.
MICR No.
1
2
3
4
5
6
7
8
9
10
Contd.
Certificate by the School
1. Certified that the above particulars are verified from the office record of the School.
2. Certified that the school is Recognized/Affiliated vide No._________________________.
3. Certified that the above student is not a repeater in the same class and his attendance in the previous year was more than 80% wherever applicable.
4. Certified that the above is not covered under 20% quota meant for poor families as per latest prescribed regulations set by the Directorate of Education, Govt. of NCT of Delhi in
this regard.
Date:
Signature with seal of the Principal/Head of the School