efgykvksa ij vR;kpkjks dh jksdFkke ds fy;s f'k{kkRed dk;Zdze (Education work for Prevention of Atrocities on Women) Application Form Assistance to Voluntary Organisations for Education Work for Prevention of Atrocities on Women 1. Name and address of the Organisation 2. Nature of the Organisation 3. Date of establishment 4. Brief of history and a brief account of activities of the organisations since inception 5. Whether registered by any State Govt. If so, by which of the State Government 6. Whether recognised under Indian Societies Registration Act, (XXI) of 1860 7. List of papers/statement to be attached (i) Prospectus of the organisation or brief description of its objects and activities; (ii) Constitution of the Board of Management and the particular of each member; (iii) Constitution of the Organisation, (iv) A copy of the Annual report for the previous year; (v) A copy each of the receipt and disbursement statement and balance sheet for the previous one year certified by a Chartered Accountant or a Government Auditor; (vi) Detailed budget estimates for the year for which grant is required giving item-wise expenditure; (vii) A statement indicating the sources from which the counter-part expenditure is (viii) yet to be met; and (ix) Information relating to the grant received or request thereof made, if any to other bodies e.g. University, Central/State Government. Central Social Welfare Board or Local Bodies/Quasi Government Institutions for the purpose. The decision of these bodies on such request should be communicated to the Department. List of additional papers, if any; (x) Has the organisation applied for or received assistance from the State/Central Social Welfare Board for Awareness Generation Camps/Public Co-operation Camps? If so, give details; (xi) Additional information, if any Signature of the Secretary /President of the Organisation(with stamp)