Department of Environment, Government of NCT of Delhi Level-6, C-Wing, Delhi Secretariat, I.P. Estate, New Delhi - 110002 Phone-3392032, 3392034, 3392028, Telefax-3392034 Willingness for setting up of Eco-Club in schools/colleges. 1. Name of the School/College : 2. Name of the Principal : 3. Address/Phone/Fax/E.Mail : 4. Educational District and Zone : 5. Whether Member of Eco-Club of the Deptt. of Environment in last 3 years : 6. Name of the proposed Eco-Club in-charge teacher : 7. Whether Utilization/Annual Report submitted : 8. Account Number and Name of the Bank for electronic clearance of funds : Certified that our school is interested in setting up the eco-club in our school. Signature of the Principal with School seal.