| Study Center Name * : |  | ![]()  *
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     | Center Head / Director Name * : |  | 
               
     
     | Complete Address of Proposed Sight * : |  | 
    
     
     | Block * : |  | City * : |  | 
     
   
    
     | State * : |  | Dist : | Pin No * : | 
     
     
     | Email Address * : |  | Ph/Mobile No * : |  | 
     
     
     
     | Year of Eastblishment (Study Center) : |  |  |  | 
     
     
     | * Fill up the Required Study Centers in the Column Below - 
(Which department are yoiu run at your center : Computer/Vocational/Technical/Correspondence/Paramedical/Govt. Coaching/Othes) | 
     
     
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     | Total Space Available in the Study center ( In Sq. Feet) | 
         
           
     | How many PC Avaliable : |  | Internet Facility : |  | 
     
     
          
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     | Center Information (* Correctly Mentioned) | 
     
     
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                 | Center Head Room | Theory Room | Practical Room | Library Room | Reception | Staff Room |  
                 |  |  |  |  |  |  |  | 
     
      
     | Are you presently ( Franchisee/Franchiser/NGO/Trust/Society/ Pvt. Firm/ Parthnership Firm/Ltd) Fill Up | 
     
     
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     | Eastemated Cost of Total Setup : |  | No of Faculty : |  | 
     
     
     | Declaration : All The impormation given above are true to the best of my knowledge & nothing is concealed therein.  I have read & understood the rules & regulations mde by V.I.H.E & accept the same. | 
     
     
            
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