DoECC

Bhoomithrasena Registration

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Details of the Institution

Name of the Institution*

Type of Institution*

Category of Institution*

Subcategory of Institution*

Institution Code

Affiliated to*

Email ID*

Landline Number

Address line 1*

Address line 2*

Pincode*

District*

Village

Local Body Type*

Local Body*

Name of institution head*

Mobile no of institution head*

Mark the institution location in map *

(Pan and Zoom in the map to identify the institution location and double click at the desired location to mark it)

Details of the Faculty in charge

Name*

Department/Subject*

Designation*

New Designation*

Mobile Number*

WhatsApp Number

Email ID*

Brief biodata of the faculty

Is there a Co-faculty in charge for the club?*

Details of the CO-Faculty in charge

Name*

Designation*

Department/Subject*

Mobile Number*

WhatsApp Number

Email ID*

Brief biodata of the faculty

Details of existing clubs in the institution engaged in environmental conservation

Nature club

Forestry Club

Others

Existing environmental issues in the region

Proposed no of students in the club*

Bank details of the Institution

Beneficiary Name

A/C No

Bank Name

IFSC Code

Plan Scheme Treasury Savings Bank (PSTSB) Account details

Name of treasury *

PSTSB A/C No *

BMC

Bhoomithrasena Registration

Details of the Institution

Mark the institution location in map *

Details of the Faculty in charge

Details of the CO-Faculty in charge

Details of existing clubs in the institution engaged in environmental conservation

Existing environmental issues in the region

Bank details of the Institution

Plan Scheme Treasury Savings Bank (PSTSB) Account details

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