ASHA Centre Acceptance Form 2023

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SOG NE HHBLOD b¥ro Tos, ed (9) National Institute of Open Schooling {An Autonome Hon under Mtb: (Shiksha Mantralayay Regional Direc Govt. of Indiay The Largest Open Schooling System in the World :18Q 9001:2008 Certified F-33104 NOS/RCB/ASHA/EXAM/C FIX/2023])3,9 Date: 28.06.2023 7 By Speedpost/ Email All Principals of DTC and HWFTC Karnataka Region Sub: Examination Centre Acceptance form for ASHA Theory Examination on Sunday, the 09.07.2023-reg Madam/Sir, Greetings from NIOS Regional Centre, Bengalurul!!! At the outset, we would like to convey our sincere thanks for your continued support. NIOS is scheduled to conduct theory examinations for ASHA Workers on Sunday, the 09.07.2023. In this regard we request you to kindly accept to conduct theory examinations for ASHA workers on Sunday, the 09th July 2023 between 02.30pm-4.00pm. The Exact No of ASHAs writing the exam would be intimated later. It has been decided that encrypted soft copy of Question cum Answerbooklet would be shared in Exam portal which have to be Printed, Photocopied and supplied to the ASHA Workers on the day of Examination. The enclosed proforma for Centre Acceptance form herewith be duly filled, signed and returned to this office with a copy by email (edp17asha@gmail.com) and Hard copy latest by 01.07.2023, positively by speedpost to the below mentioned address: To, Regional Director, National Institute of Open Schooling, Regional Office, Bengaluru 3*4 Floor, PUE Bhawan, 18**Cross Sampige Road, Malleswaram-560012 Looking forward to your continued support, and thank you in advance, With warm regards, Yours faithfully a wali > ert National instifuta of Qnen sah en ee ital Malleshwaram, Bengaluru - 560 052 Encl:a/a SRL OOrUSe Rom, a.chs.e WER, INRe we{OH eogegpe clerslack-So001? evfra, carding, PUL ara, 10 ey, TARA, ATT “S600 Regional C Floor, PUE Building, 18" Cross, Malleshwaran, Bengaluru-S60012 Ph.080-23404225/22, Email>rebengal jusnc.in, Websites: www ALAVINO. (ifschool is LAV of NIOS) (ise) 8] aes a) Latest Passport size oS photograph of . i Centre Supdt. with The Regional Director eee seal of the school/institutions Sub: Acceptance to act as Superintendent of Examination Centre for National Institute of Open Schooling (NIOS) ASHAs Examination to be held on 09 July 2023, 2:30pm to 4:00pm (Sunday). Sir, Thereby accept to offer my School/Institution as an Examination Centre to NIOS and to act as Centre ‘Superintendent for ASHAs Examination on 09" July 2023, 2:30pm to 4:00pm (Sunday). Thereby undertake that | will conduct the examination strictly as per Guidelines to be supplied to me by NIOS. | certify that no near relative of mine is appearing for these examinations. 1. Complete address of the School (in BLOCK LETTERS) Yours faithfully, Signature with Name of Principal (In Block Letters) [PIN CODE: 2. Name, Designation and Residential address of the Centre Superintendent Signature of Centre Superintendent, if Principal is not acting as Centre Superintendent 1 [PIN CODE: Tele O): Tel (R) Signature Attested by the Principal (With STD Code) Fax: Mobile Seal of the Institute/School E-Mail: Please Provide Bank details for transfer of fund towards Centre Advance: ‘Ale Holder Name | Bank & Branch Name Bank Ale Number I IFSC Code of Bank ‘i: In ase of AL as amex centre, Centre Advance fond wi be transfer to™The Caardinavo™ ofthe AUAVTaT NtOS only. Kindly attach the front page of Bank Passhook for ready reference. Page 1 of 2 Notes: ar Principal of the school should act as Centre Superintendent, Deputy Superintendent may be appointed by the Centre Superintendent, if the total number of candidates allocated is 250 or more. Only in ‘exceptional circumstances the Vice-Principal or the Senior-most PGT/TGT of the school may be nominated as the Centre Superintendent - Please give all the telephone numbers of Institution (as well as the mobile number of Principal). Please provide PP number for contact, if there is no telephone at the office/residence of the Cent. Suptd. and a convenient Fax No. in which urgent message may be faxed to you. Please ensure that an undertaking from only “Nationalized Bank” is taken for the custody of QP. Extension counters are not to be used for storage of Question Papers. If undertaking is given by any officer, other than Bank Manager, it should be countersigned by the Manager. Please ensure that the banks agree to all the conditions particularly for making standby arrangement for delivery of Question Papers in the event of Bank Holiday or some eventuality, and also to the service charges payable by NIOS. Syndicate Bank & Indian Bank are bankers of NIOS. Pl. use the services of such Bank as far as possible. Other information and Physical facilities available in the School/Institution (a) The Name of the Boards/University with which School/Institution is _ affiliated: (b) Affiliation No. & its year of validity” (©) Affiliation Status: Temporary/Permanent: (@) Affiliation is up to Secondary only ii) Senior Secondary (with Science) }) Senior Secondary (Without Science) iv) Degree 4. Name of Labs (Please Tick) 4) Secondary: Science/Home Science/Math./Computer (With teachers and other facilities ii) _ Senior Secondary: Physics/Chemistry/Biology/ Available) Geography/Home Science/Computer 5. The number of rooms and their size available for examinatior 6. Does the school/collage have CCTV in the room/hall to be used for the conduct of examination Available/Not Available 7. Does the School/collage have a hall (to be used for the examination? YES/NO Size of the hall: sq.m. 8. Does the Schools have boundary wall? YES/NO. 9. Inthe case of availability of Computer Lab please indicate the number of computers: 10. The maximum number of the candidates which can be accommodated for the examinations ina day. 11, Please furnish the following information with regard to Post Office from where sensitive material is to be

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