EMIS – SCHOOL INFORMATION FORM FILLING

SCHOOL DETAILS – PART I

 PRELIMINARY DETAILS
U-DISE Code _______________________
School Name ______________________________________________
 LOCATION DETAILS
District _______________________ Block _______________________
Urban/Rural * _______________________
Local Body *
URBAN – Town Panchayat / Municipality/ Cantonment / Extended Chennai Corporation
RURAL – Village Panchayat
Village/Town/Municipality * _________________________________________________
Village/Ward * _________________________________________________
Assembly Constituency * _________________________________________________
Parliamentary Constituency * _________________________________________________
Educational District * _________________________________________________
Address Line 1 * ______________________________________________________________
Address Line 2 * ______________________________________________________________
Pincode * ____________________________

 COMMUNICATION DETAILS
(Either one is mandatory Correspondent / Head Master Mobile or Email)
Office STD Code _____________________ Office Landline __________________________
Office Mobile _____________________ Correspondent STD Code ________________
Correspondent LandLine ______________________
Correspondent / Head Master Mobile _________________________________________________
Mobile _______________________ Email __________________________________________
Website ________________________________________________________________________

 ESTABLISHMENT DETAILS
Year of establishment of School * _______________________
Year of Upgradation / Recognition * ______________________
Year of last renewal of School _______________ Certificate Number _________________
Whether School for Children With Special Needs (CWSN) * YES / NO If yes valid upto ______
Whether Shift School* YES / NO
Whether Residential School * (Tick applicable field)
YES - Ashram(Govt) / Non-Ashram(Govt) / Private / KGBV / ModelSchool / Ekalavya ModelSchool / Tribal
NO
1 EMIS – School Information Form Filling Sanjay Muthusamy | 9445544993
Is the School situated in Hill/Forest/Others Area? * (Tick applicable field)
a)In Forest / Hill Area b)Near Forest / Hill Area c)Near the Highways
d)Near the Coastal Area e)Not applicable

SCHOOL DETAILS – PART II

School Category * - Primary / Middle / High / Hr.Sec / Nursery & Primary / Spl School / Play School
Lowest Class * - Pre- KG / LKG / I / VI / IX / XI / Not Applicable
Highest Class * - VI / VIII / X / XII / Not Applicable
School Type * - Boys / Girls / Co-Education
School Managed By Minority Group * Yes (valid upto ________) / No
Medium of Instruction * - Tamil / English / Telugu / Kannada / Malayalam
Languages Taught * - Tamil / English / Telugu / Kannada / Malayalam
Does the School offer any Pre-Vocational course at Secondary Stage? *
Yes – Electronics / Automobile / Agriculture / Apparel / Beauty & Wellness / Multi Skill Foundation
Course No
Whether School is approachable by All-Weather Roads? *
Yes (approachable on any climatic conditions) No (Non approachable due to climatic conditions)
Whether Anganwadi is attached to the School? *
Yes - Total no of workers __________ Total no of students ___________
No
SCHOOL DETAILS – PART III

 SCHOOL DAYS AND HOURS DETAILS

Category * Primary / Upper Primary / Secondary / Higher Secondary
Number of Instructional days * ________________
Working Hours for Children (per day) ________________ (HH:MM)
Working Hours for Teachers (per day) ________________ (HH:MM)
Whether Continuous Comprehensive Evaluation (CCE) implemented? * YES / NO
When does the Academic Session start? Please indicate the month: * ________________ (June)

 SCHOOL SPECIAL TRAINING CENTER DETAILS

Whether any child enrolled in the School is attending Special Training? * YES / NO
(IF YES) No. of children provided Special Training in the Current Academic Year Boys ____ Girls ____
Special Training is conducted by? School Teachers / SPL Teachers / Both / NGO
Special Training is conducted in School Premises / Other than School Premises / Both
Type of Training being conducted Residential / Non Residential / Both
Does the school provide Psychological counselling to the students? * YES / NO
Club Details (Extra Curricular Activities) * Scout & Guide / JRC / NSS / NCC / Red Ribbon / Eco club

2 EMIS – School Information Form Filling Sanjay Muthusamy | 9445544993

 SCHOOL DETAILS – PART IV

 SCHOOL TEXTBOOKS DETAILS

Availability of free Textbooks, Teaching Learning Equipment (TLE) and Play material (in Current
academic Year) Primary, Upper Primary, Secondary
Whether complete set of free Textbooks received for the current year? * Yes / No / NA
Whether TLE available for each Grade? * Yes / No / NA
Whether Play materials, Games & Sports equipment are available for each Grade? *Yes / No / NA

 SCHOOL INSPECTION DETAILS

School Inspection during the Year, Inspection done by *
Officer Purpose Date of Inspection
CEO Audit / Academic / Non Academic ________________
DEO Audit / Academic / Non Academic ________________
BEO Audit / Academic / Non Academic ________________
ADPC Audit / Academic / Non Academic ________________
EDC Audit / Academic / Non Academic ________________

 SCHOOL MANAGEMENT COMMITTEE (SMC) / SCHOOL MANAGEMENT AND

DEVELOPMENT COMMITTEE (SMDC) DETAILS
Whether School Management Committee (SMC) is constituted? * YES / NO
(IF Yes) Total number of members in SMC Male _____ Female _____
Members of parents/guardians Male _____ Female _____
Representatives/nominees from local authority/local Government/urban local body
Male _____ Female _____
Members from weaker section and disadvantage group? Male _____ Female _____
Number of SMC meetings held during the Previous academic year _________
When was SMC constituted? _________
Whether SMC has prepared the School Development Plan? YES / NO
Whether Separate Bank Account for SMC is being maintained? YES / NO
Bank District: _______________________ Bank Name: __________________________
Bank Branch _______________________ IFS Code: __________________________
Account holder's Name: ________________ Account Number:________________________
SMC Chairperson Name _________________________________
SMC Chairperson Mobile Number _______________________________

Whether School Management and Development Committee has been constituted? * YES / NO
(IF Yes)
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Details of Members / Representatives Male _______ Female ________
Total Members Male _______ Female ________
Representatives from Parents / Guardians / PTA Male _______ Female ________
Representatives / Nominees from Local Government / Urban Local Body Male _____ Female _______
Members from Educationally Backward Minority Community Male _______ Female ________
Members from any Women's Group Female ________
Members from SC / ST Community Male _______ Female ________
Nominees from the District Educational Office (DEO) Male _______ Female ________
Members from Audit and Accounts Department (AAD) Male _______ Female ________
Subject experts (each one from Science, Humanities and Arts / Crafts / Culture) nominated by District
Programme Co-ordinator (RMSA) Male _______ Female ________
Teachers (one each from Social Science, Science and Mathematics) of the School
Male ___ Female _____
Vice-Principal / Asst. Headmaster, as a member Male _______ Female ________
Principal / Headmaster, as Chairperson Male _______ Female ________
Chairperson (If Principal / Headmaster is not the Chairperson) Male _______ Female ________

Year in which the SMDC was constituted? __________

Number of SMDC meetings held during the last academic year _______________
Whether SMDC has prepared School Improvement Plan? YES / NO
Whether separate Bank Account for SMDC is being maintained? YES / NO
Bank District: _______________________ Bank Name: __________________________
Bank Branch _______________________ IFS Code: __________________________
Account holder's Name: ________________ Account Number:_______________________
SMDC Contribution (in Rs.)________________ SMDC Chairperson Name ____________________
SMDC Chairperson Mobile Number ______________________________

Whether the School Building Committee (SBC) has been constituted? *YES / NO Year _______
Whether the School has constituted its Academic Committee (AC)? * YES / NO Year _______
Whether the School has constituted its Parent-Teacher Association (PTA)? * YES / NO
(If Yes)
PTA Established Year __________________
Number of PTA meetings held during the last academic year: __________________
PTA Registration No. __________________
Academic Year for Last PTA Subscription Paid __________________
PTA Chairperson Name __________________
PTA Chairperson Mobile Number __________________

4 EMIS – School Information Form Filling Sanjay Muthusamy | 9445544993

 SCHOOL DETAILS – PART V

 SCHOOL LAND DETAILS

Total land availability (Including Building area and Playground) (Two fields to be entered) YES / NO
__________ Sq.Ft. & __________ Acre
Whether the School has a Playground facility? * YES / NO (If Yes Two fields to be entered)
Area of the Playground (in sq.ft) * __________ Sq.Ft. & __________ Acre
Whether land is available for expansion of School facilities? * YES / NO (If Yes __________ Sq.ft)
Land Ownership * Rented / Leased / Owned / Rental Free

 SCHOOL BUILDING AND BOUNDARY WALL DETAILS

Type of Boundary Wall *
Pucca / Pucca but broken / Barbed wire fences / Hedges / Under Construction / No boundary wall
Perimeter of boundary (in meters) * _________________
Length of the boundary wall constructed (in meters) * _________________
Total no of Buildings / Blocks * _________________ No’s

 CLASSROOM DETAILS
Classrooms under construction * _________________No’s
Do all the classrooms have desk / table for students? * YES / NO
Out of the available classrooms, details by stage / level *
Pre-Primary Primary Upper Primary Secondary Higher Secondary.
Rooms ________ Rooms ________ Rooms ________ Rooms ________ Rooms ________
Whether there is a ramp for differently abled children to access classrooms? * YES / NO
(If Yes ) Whether hand-rails for ramp available? * YES / NO

 OTHER ROOM DETAILS

Staff quarters (including Residential Quarters for Head Master/Principal and Others) * YES / NO
(If Yes) How many rooms * ________________
Whether the School has Library facility/Book Bank/ Reading Corner? *
Library (Number of books) * _________________
Book Bank (Number of books) * _________________
Reading Corner (Number of books) * _________________
Newspapers & Magazines (Number of books) * _________________

 SCHOOL TOILETS FOR STAFF DETAILS

Details of Toilets and Urinals for Staff :
Total number of Toilets available * Gents ______ Ladies ________
Total number of Urinals available * Gents ______ Ladies ________
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  SCHOOL TOILETS FOR STUDENTS DETAILS
Details of Toilets and Urinals for Students :
Details of Toilets and Urinals for Students : Boys only Girls only
Not Not
In Reason for Non- In Reason for Non-
In In
Use functional Use functional
Use Use
Total number of Toilets available (Definition
Water Supply / Water Supply /
of functional toilet: water available in the
Drianage Problem Drianage Problem /
toilet, minimal odour, unbroken seat,
/ Toilet Damaged / Toilet Damaged /
regularly cleaned with working drainage
NA NA
system, accessible to users, closable door) *
Water Supply / Water Supply /
Drianage Problem Drianage Problem /
Number of CWSN friendly functional toilets *
/ Toilet Damaged / Toilet Damaged /
NA NA
Water Supply / Water Supply /
Total number of Urinals available * Drianage Problem Drianage Problem /
/ Toilet Damaged / Toilet Damaged /
NA NA
How many of the above Toilets have running
water facility for flushing and cleaning? *

How many urinals have water facility? *

Is a Sanitary Worker engaged to clean the Toilets? * YES / NO

Is there Land available for construction of additional Toilets if required? * YES / NO
_______ Sq.ft
Whether the School has been provided with Napkin Vending Machine? * YES / NO
Available _________No’s / Functional __________ No’s
Whether the School has been provided with Incinerator? * YES / NO
Manual (Choolas) : Available _________ No’s / Functional __________ No’s
Automatic (Electrical) : Available _________ No’s / Functional __________ No’s

 SCHOOL DRINIKING WATER AND HAND WASH FACILITY DETAILS

Handwash Station :

Total no of Handwash Tap in use * Boys ______ Girls _______

Whether drinking water available in School premises? * YES / NO

(If Yes ) Source of drinking water – Hand Pumps / Well / Tap water / RO Purifier / Others

Whether the School is provided with Overhead tank ? * YES / NO

Whether water purifier is available in the School? * YES / NO

Does the School have provision for Rain Water Harvesting? * YES / NO

6 EMIS – School Information Form Filling Sanjay Muthusamy | 9445544993

 SCHOOL DETAILS – PART VI

 DETAILS OF EQUIPMENTS (FOR TEACHING AND LEARNING PURPOSE)

List of Devices Supplied by Purpose Available Functional

Connecting Classrooms
DVD Player
PC - Desktop Computer
PC - Laptop
PC - Tablet
Photocopier (Xerox)
Printer - Dotmatrix
Printer - Inkjet
Printer - Laserjet
Projector
Projector Screen
Smart Board
Television
UPS
Virtual Classroom
Smart Classroom
Supplied by: * Directorate of School Education / SSA / RMSA / Local Body / MLA Fund / MP Fund /
Donors / School Management Committee / Centrally Sponsored / School Trust (or) Society / PSU under
CSR / RD / NABARD / NGO / Alumni / Public
Purpose * Teaching / Academic / Administrative

Does the School have a Computer Aided Learning Lab (CAL)? * YES / NO
Does the School have Internet Facility? * YES / NO
If Yes - Internet Facility Provided by - Directorate of School Education / SSA / RMSA / Local Body / MLA
Fund / MP Fund / Donors / School Management Committee / Centrally Sponsored / School Trust (or)
Society / PSU under CSR / RD / NABARD / NGO / Alumni / Public
Service Provider Name : _________________
Data Speed : __________________________
Range : Kbps / KBps / Mbps / MBps
Does the School have a Electricity? * YES / NO / Not Functional

 DETAILS OF MEDICAL CHECK-UP

Whether medical checkup for Students was conducted in the Last Academic Year? * YES / NO
If Yes - Date : ______________, _____________, ____________ (dd/mm/yyyy)
Whether De-worming tablets were given to Children? * Compelte(2doses) / Partial (1dose) / Not
Given
Whether Iron and Folic acid tablets given to children as per guidelines of WCD? * YES / NO
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  PHYSICAL FACILITIES AND EQUIPMENT IN SCHOOLS WITH SECONDARY / HIGHER
SECONDARY SECTIONS
School Laboratory Facilities (For Higher Secondary Sections only)
Laboratory * Biology / Chemistry / Computer / Geography / Home Sciences / Language / Mathematics /
Physics / Psychology
Separate Room Available * YES / NO
Present Condition * Fully equipped / Partially equipped / NA
Integrated Science Laboratory for Secondary Sections available? * YES / NO
School Equipment Details
List of Equipments: * Supplied by: * Quantity: *
Audio / Visual / Public Address System __________________ _________
Biometric Devices __________________ _________
Fire Extinguisher __________________ _________
Kit – Mathematics __________________ _________
Kit – Science __________________ _________

 SCHOOL INVENTORY DETAILS

List of Things * Supplied by: *
Air Conditioner _______________ Available : _______ No’s / Functional : _______ No’s
Almirah _______________ Available : _______ No’s / Functional : _______ No’s
Bench _______________ Available : _______ No’s / Functional : _______ No’s
Blackboard _______________ Available : _______ No’s / Functional : _______ No’s
Bureau _______________ Available : _______ No’s / Functional : _______ No’s
Cabinet _______________ Available : _______ No’s / Functional : _______ No’s
Ceiling Fan _______________ Available : _______ No’s / Functional : _______ No’s
Diesel Generator _______________ Available : _______ No’s / Functional : _______ No’s
First Aid Kit _______________ Available : _______ No’s / Functional : _______ No’s
Chair _______________ Available : _______ No’s / Functional : _______ No’s
Desk _______________ Available : _______ No’s / Functional : _______ No’s
Desk with bench _______________ Available : _______ No’s / Functional : _______ No’s
Fridge _______________ Available : _______ No’s / Functional : _______ No’s
Table _______________ Available : _______ No’s / Functional : _______ No’s
Tube light _______________ Available : _______ No’s / Functional : _______ No’s
Water Purifier _______________ Available : _______ No’s / Functional : _______ No’s

Supplied by: * Internet Facility Provided by - Directorate of School Education / SSA / RMSA / Local Body / MLA
Fund / MP Fund / Donors / School Management Committee / Centrally Sponsored / School Trust (or) Society /
PSU under CSR / RD / NABARD / NGO / Alumni / Public

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