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Grant in Aid to Voluntary Organisations working in the field of Intrgrated Programme for Older Persons

APPLICATION CUM MONITORING FORM FOR GRANT-IN-AID TO VOLUNTARY ORGANISATIONS WORKING IN THE FIELD OF INTEGRATED PROGRAMME FOR OLDER PERSONS

(for Ist instalment and new cases)

PART - A

1. Financial year for which grant-in-aid is applied: ________________
2. Name of the Organisation: ________________
3. (a) Nature of the Project*: ________________
(b) Date of commencement of the Project: _____ / _____ / _____
(c) Year of Commencement of Grant-in-aid from G.O.I for the Project: ________________
(d) Whether the Project is recognised by the state government: Yes / No
4. Date of Registration of the organization: _____ / _____ / _____
5. Address of Registered Office: ________________

(STD Code) Tel. No:
(STD Code) Fax No:
Email:
6. (a) Complete Address of location / location where programme / project / scheme is being implemented: ________________

(STD Code) Tel. No:
(STD Code) Fax No:
Email:
(b) Nearest Railway Station/Bus stand: ________________
7. Whether building is: OWNED / RENTED / ON LEASE / DONATED
(Please indicate √ against appropriate box)

* Please indicate: 1. Old Age Home, 2. Day care centre, 3. Mobile medical unit, 4. Non-institutional services.

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