Parwaan Preschool: A School Readiness Programme

Early Child Development Entrepreneurship

Registration Form

Personal Detail of Candidate:

Name:______S/D/W/H/o: (Please circle and write name)______

Age (in completed years) ______Date of Birth: ______(DD/MM/YY)

Gender: Male Female Marital Status: Married Unmarried

CNIC No: (Mandatory) ______Contact No: ______

Email ID: ______

Postal Address:

Home Address / Village/Town / UC Name / Tehsil & District

1-Estimated Demographic Profile of Area: (with in 1 km for urban 2 km for rural radius)

No. of Households / No. of Children
(3-5 years)
No. of Government pre- primary schools for 3-5 years children / No.of Private pre-primary school for 3-5 years children
No. of Govt Primary School / No.of Private Primary School

School tuition fee for pre-primary in your area (PKR): Minimum------, Maximum------

2-Academic Qualification: (Please provide photocopies of academic record and CNIC)

1. Matriculate 2. Intermediate 3. Graduate

4. Master 5. Other (Specify):______

3-Employment/Working Status and Income:

Are you currently employed/working? Yes No

If other please provide detail

______

______

Personal Income? Monthly PKR ______

4-Household Income

What is the total monthly income of your household? PKR:______

5-Training Attended Regarding Early Childhood Development (ECD)/Early Childhood Education(ECE) during last three years (If any if yes please provide certificate):

Venue / Year(s) Attended / Course Title / Organization
From / To
---/------/------/ ---/------/------
---/------/------/ ---/------/------

6-Experience of Running ECD Centre or teaching experience (If any):

Name of Org / Years of Experience / Position/Grades
From / To
ECD (pre-primary) / ----/------/------/ ----/------/------
Teaching experience in years / ----/------/------/ ----/------/------

7- Do you have appropriate space available for ECD center establishment Yes No

12 feet by 15 feet minimum?

8- Can you provide functioning, clean and separate a toilet facility to ECD children? Yes No

9- Do you have outdoor space available for children to play? (Varanda etc) Yes No

10- If not can you provide appropriate space for ECD center establishment? Yes No

11-Does the space has the capacity to accommodate 25 to 30 children? Yes No

12- Are you willing to invest your money in your ECD centre Yes No establishment?

If yes how much______PKR

14-Language Proficiency:

Skills / Urdu / English
Read / Average Good Very Good / Average Good Very Good
Write / Average Good Very Good / Average Good Very Good
Speak / Average Good Very Good / Average Good Very Good
Understand / Average Good Very Good
/ Average Good Very Good

15-Willingness about Training Participation:

Are you willing to attend the entire training program for 6 weeks regarding ECD?

Yes No

Are you willing to contribute training fee PKR 2000/- for training market value

PKR 80,000/-? Yes No

Are you willing to contribute in ECD kit 10,000/- for your ECD Kit market value 80,000/- in 2 monthly installments? Yes No

16-Candidate Personal Consent:

I hereby solemnly declare that the detail provided by me is correct and I am agreed to establish ECD center.

Name of Candidate:______Signature:______

Family Consent:

Name:______Signature: ______Relationship:______

CNIC: ______

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