FORM OF APPUCA TION FOR LICENCE 1. ¥ull name of the applicant or Association (if registered, a copy of the registration certificate and particulars of all memb~ of association shall be given ) 2. Religion 3 Residence (town or village) (Note) : In case of association, particulars regarding item 2 and 3 be mentioned in respect of each members. 4 Name of the in~tit:lltion. 5. Aims and objects of the institution. 6. Details about the fInancial condition 01' the institution. (funds, property and sow-ccs of income). 7. Arrangt;mtmls matk: ur pruposc:u lu b<: made fnr bnarding and 1ndging. A1RO details of the building, whether owned by the institution or rented. 8. Arrangements in respect of general health of inmates and facilities for their medical treatment and arrange- mentsproposed to be made for the education at~d vocational at~d n~oral training designed to make them fit for rchabilitation in lifc as normal citizens. 9 Full address of the proposed institution including the name of the city or town iUlU lh~ lucalily. lO.If any such application has been made previously, please state its result together with its date, month and year. .2.. 11.Ifthe institution exists at present, the date of its commencement, annual reports of its working if prepared or its working to date. 12. Number and particu1ar!! of inmate!! at the time of opening the institution. 13.Mnximum of accommodation for children and women. 14.Any other particulars. L'Wc _hcrcby solemnly afftrnl that the above and aIUlexed particulars are true according to my/our best Knowledge and belief. Signatw-e(s) with d41te and pl.1ce and Name in block letters.