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Online Project Application


Form - Application for Old Age Home

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:: Provide Your Amount ::

Amount *

Sponsor Present ? * Yes No




[ After Click On Primary Submit Check your Email ID for Final Submission ]

NGO DETAILS

NGO/CBO/Startup/ Other Organizations Name as recorded in (NITI Aayog Portal): *
NGO/CBO/Startup / Other Organizations Unique Id as recorded in (NITI Aayog Portal): *
Address of Registered office of the Organization: *
City / Town / Village: *
District: *
State: *
Mobile No.: *
Telephone:
Email *
Fax:
Statute under which the organization is registered: *
Project Id: *

Enter your Beneficiary Data

Component - Senior Citizens

Acknowledgment No *
Financial year for which grants-in-aid is applied:* *
Name of the organization *
Nature of the Project:
Type of the Project * Ongoing
The organization has been receiving financial assistance continuously for last three years * Yes No
No Utilization is pending in terms of para of 212(1) GFR: * No UC Pending

EAT Module and CCTV Status information

Whether EAT Module is implemented * Yes No
Whether CCTV Installed * Yes No
URL for website *
SI. No. /IP Address for CCTV *
User ID/ User Name *
Password *
Whether live feed of CCTV linked with website * Yes No

Project Location

State *
District *
Address *
Alternate Address *
Landmark *
City / Town / Village:* *
Location Type *
PIN Code *
Latitude of Project Location *
Longitude of Project Location *
Date of commencement of the Project *
Year of Commencement of Grants-In-Aid from G.O.I. for the Project:
Whether the Project is recognized by the State Government * Yes No
Date of Registration *
Complete address of location(s) location wherever programmed project/scheme is being implemented
(STD Code)Tel. No: (Like:01206512472)
(STD Code)Fax No:
Email *
Nearest Railway Station / Bus Stand *
Whether building is * Owned Rented On Lease Donated
If no, Provide details of usage

Rent Agreement

Details of bank accounts in which grants-in-aid released, during last three financial years, were deposited

The amount of support sought from the Ministry for recurring grants-in-aid

Availability of the following at centre

Details of Medical checkup and treatment of the Aged

Nutrition Support(in case of SrCH including for elderly women/ RCH & Home for Dementia)

Productive Activities

Other Activities(other than productive activities)

Are there any linkages with any other organization/institution if so,please specify the name of the organistion for each service

Yours faithfully

NGO Beneficiaries Details

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Contact Info

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+91 8918726833

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