Join Paryavaran Mitra Programme
Enrolment Form
* School Information Name of the School :   Principal's Name :   Principal's Mobile Number : +91- Postal Address : State : Select State Andaman and Nicobar Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli Dadra Nagar Haveli Daman and Diu Daman Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu & Kashmir Jharkhand Karnataka Kerala Lakshadweep Lakshdweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab Rajasthan Sikkim TamilNadu Tripura Uttar Pradesh Uttarakhand West Bengal District : If other District then specify : City/ Town/ Village : Pincode :         Contact : Phone : +91- EmailID :   Website : EMIS Code (Educational Management Information System):   Year of Establishment : 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 Classes in the School : Jr. KG Sr. KG 1 2 3 4 5 6 7 8 9 10 11 12 -To- Jr. KG Sr. KG 1 2 3 4 5 6 7 8 9 10 11 12 Medium of Instruction : English Hindi Marathi Gujarati Kannada Malayalam Tamil Telugu Punjabi Urdu Bengali Oriya Assamese Garo Manipuri Bodo Konkani Type of School : GovernmentGovernment aidedPrivateOthers If other then specify :   Board of Examination : State Board ICSE CBSE Other     If other then specify :   Total Number of Students No. of Boys : No. of Girls : Total: Number of Teachers : School Facilities Own building YesNo If No then give details :  Boundary wall present YesNo Toilets present YesNo Safe drinking water source YesNo Playground YesNo Laboratory YesNo Number of Classrooms : Environmental activities in the school Does the school have any club? YesNo If Yes then give details :     What kind of activities are being carried out in the school for Environmental Education?  (Maximum 150 Characters.) Are activities on any of the following themes being taken-up in the school? Water and sanitation YesNo If Yes then give details :     Energy YesNo If Yes then give details :     Biodiversity & Greening YesNo If Yes then give details :     Culture and Heritage YesNo If Yes then give details :     Waste Management YesNo If Yes then give details :     What is/are the source/s of information for conducting the activities?  (Maximum 150 Characters.) Follow Up Teacher-in-charge : Is he/she a Teacher In Charge for Eco-club ? YesNo Language known to Teacher incharge : Mode of Communication : Mobile No : Email ID : Postal Address : Please state preference of communication with your school regarding Paryavaran Mitra : PhoneSMSEmailPost Paryavaran Saathi in the school :   To know more about Paryavaran Saathi Click Here Please enter text shown in Image:    Declaration Our school is honoured to be a part of the Paryavaran Mitra programme that aims to create 2 crore Paryavaran Mitra in 2 lakh schools. Our school pledges to facilitate carrying out Paryavaran Mitra action relating to Sustainability and Climate Change Education and help students to become Paryavaran Mitra who demonstrates environmental leadership qualities through positive change in behavior and action at individual, school, family and community levels. I agree If you need any help completing this form feel free to contact us at : Centre for Environment Education   Nehru Foundation for Development Thaltej Tekra Ahmedabad-380054 079-26858002 Email: paryavaranmitra@ceeindia.org