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‘Kendriya Vidyalaya No.3,Band, Mathura
(Railway Colony Baad, Mathura-281005)
Website: www krmattuabaad eden
E-MalLkvbaadmathura@pmaicom,
kemathurabaad@kwvsed ore
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‘ere (#eiR1)/Baad (Mathura) “BYVOOOTS
CENTRAL BOARD OF SECONDARY EDUCATION
REGIONAL OFFICE ~ ALLAHABAD.
36-B, M.G.Marg, Civil Lines, Allahabad-211001(U.P.)
‘School Name with Complete Address ..b4.E.D3.
Bs.
(To be filed carefully)
PROFORMA FOR FIXATION OF EXAMINATION CENTRE, CUSTODIAN AND APPOINTMENT OF
ENTRE SUPERINTENDENT FOR ALL INDIA SECONDARY & SENIOR SCHOOL CERTIFICATE
EXAMINATIONS-2019
ALL-COLUMNS MUST BE FILLED BY THE SCHOOL AUTHORITIES COMPULSORILY.
1. Name of the Schoo! with complete Postal Address: EIN. DRIYVA... VIDYALAYA
(To be filled in capital letter)
District
‘School Telephone No, with STD Code
‘Telephone No, of Principal's Residence
Principal's Nobile No.
Examination Coordinator's Name & Mobile No. +1.
Fax No.
E-mail ID of the school
2. No. of candidates the school is sponsoring for 2019
(@) AISSE (x)
(b) AISSCE (x1)
Total No, of Candidate for Exams (X+XiI)
3. Name of the Exam Centres where the Student of the Schoot Appeared for:
(a) 2016 Exam SDRS..WRM.. MATER A.....
(b) 2017 Exem 2RPS....URM... MATHURA.
(c) 2018 Exem 2
44, Name of the school(s) other than given in column on pre page for allotment of Exam,Centra In order of
preference (Not to be let blank) :
1. (@) Name & address of the school with cod JEY.ALALY.A.
* —(®) Exact Distance in Kms. from your schoo!
(To be filed carefully)
(©) Whether conveyance evailabie
IL (@) Name & address of the schoo! with code
(b) Exact Distance in Kms. from your school:
(Tobe filed carefuly)
(c) Whether conveyance available
I, (2) Name & address of the school with cod
(©) Exact Distance in Kms. from your schoo!
(To be filed careful)
(6) Whether conveyance available
5, Nam of the school(e) run by your management in the City (any)
1
6, Name of the suibject(s) for which
* Fates for cofiduct of Practical
Examinations is/are avalab
7. No. of Candidates that can be accommodated
for Board Examination, if your school is.
considered for foxation as an exam.Centre
(THIS INFORMATION IS MANDATORY AND TO BE FURNISHED IN PROPORTION TO THE
CANDIDATES SPONSORED FOR THE EXAMINATION.)
8. (2) Name of the Principat (In Capital letiere)
‘Whatsapp Number of the Principal
{b) Name & Address of the Chalimar/President
‘of the schoo! Managing Commities
(@)Telephone No/Mabile No. ofthe Chairman!
Manager of the School Managing Commities
Note : Its obligatory for the Principal to work as Centre Superintondant except solf contres fixed by
the Board of as por guidelines & Instructions of the Board and In no Circumstances any
teachar/person whose ward/near relative is appearing In the Examination of the Board shall bo
appointed for examination work.
8. Storage of question papers :
The Question Papers have to be stored In the nearby Nationalized Bank. An undertaking {in tho
Proforma on paged) to thia effect that the Bank Is ready to undertake the responsibility and will
ensure safe custody of question papers be obtained and sent to the Board. The following
Information may also be given.
(@) Please state if Syndicate Bank A SNRIGATE..BANIS. AURANGABAD
is available near the school
180, mention ful address of
the Branch with PIN CODE
