This document is a school/institute questionnaire that collects information about a school or institute to administer central government scholarship schemes for SC students. It collects details like the school code, name, location, type of scholarship scheme, number of beneficiaries, names and contact information of key staff, enrollment numbers of SC students, number of scholarship applications, and documents collected. It also asks if the school has a hostel and collects feedback on any issues faced or suggestions related to the scholarship.

5. 1
School/Institute Questionnaire
School/Institute must be filled in advance and handover to the field representative
Sl. No. Details of School/Institute Response
1 School/Institute U-DISE/AISHE code
2 School/Institute Name
3 Rural/Urban
4 State
5 District
6 Type of Scholarship Scheme: Pre-matric-1; Post-matric-2
7
School Category: Up to 10 beneficiaries-1; (11-20)-2; (21-50)-
3; (51-100)-4; (>100)-5
8 Number of Beneficiaries
9 Institution Head Name
10 Mobile number of Institution Head
11 Name of the INO
12 Designation of the INO
Codes: Head/Principal of the institution – 1; Teacher – 2;
Administrative officer – 3;Scholarship in-charge-4; Other – 5
(Specify)
13 Mobile number of INO
14 Whose KYC information has been provided by your institution?
Codes: INO-1; Head/Principal of the institution – 2; Other
(Specify)
15 When the KYC of INO was last updated? (Year only )
16 Type of school/institute
Codes: Government-1; Government Aided-2; Private-3; Others-
4
17
Class/Course school level
(Codes: Class I=1; Class II=2 and so on up to Class XII=12)
Lowest
level:
Highest
Level:
18 Class/Course in institute (Multiple Selection whichever
applicable)
Graduation – 13
Post-Graduation – 14
ITI/Polytechnic - 15
Technical and vocational/professional courses of XI and XII
level - 16
Technical and vocational/professional courses at UG & PG level
– 17;
NA – 19
20
Does School have hostel facilities Yes:1, No-2
Enrolments in School/Institution in 2022-23
22 Total number of enrolled students in the school/institute
(classes/courses-IX and above)

6. 2
23 Out of the total students enrolled, how many are SC students?
(Number)
24 Total number of students who applied for the Central government Pre-
matric scholarship scheme for SC students in 2022-23
(As per the school record).
25 Total number of students who applied for the Central government
Post-matric scholarship scheme for SC students in 2022-23
(As per the school record).
Number of beneficiaries under the following four categories (Post-matric students)
26a Group 1: Degree and Post Graduate level professional courses
26b Group 2: Other Professional Courses leading to Degree, Diploma,
Certificate
26c Group 3: Graduate and Post Graduate courses not covered under
Group I & II
26d Group 4: All post-matriculation (Post Class X level) non-degree
courses
Number of application documents of beneficiaries who were studying in the school in 2022-23
30a Application form of Scholarship
30b Income certificate
30c Caste certificate
30d Domicile certificate
Any issues or problem faces by the INO
Any suggestion related to scholarship
Signature and Stamp of the Institution