Government of Khyber Pakhtunkhwa

Elementary & Secondary Education

School Improvement Master Plan

Primary / Middle / High / H. Sec

1. School Name: ----------------2. School Level: ----------

3. Gender: BovsD GirlsO 4. EMIS Code: ____,/___,/____,/___,/__ 5.District: ________

6. Tehsil: ------ 7. Circle Name: -------- 8. Union Council: ------9. School Status: a. Functional D b. Non Functional D c. Merged D
10.Building Status: a. Government D b. Rented0 c. Damaged0 e. Shelterless D Two or more schools in one buildingD
a. EMIS 1 __}__}__}__}_

b. EMIS 2 __}__}__}__}_ C. EMIS 3 __}__}__}__}_

11. Total Teachers:

13. General Terrain of the Area:

12. DDO Code:

/__}

a. Hilly__ b. Plain__ c. Rocky__ d. Sandy__ If Other, please specify __________

14. School distance from metalled Road:

-------- Metres

15. Is there any incomplete/under construction scheme for which funds have been provided under any other
program (other than Conditional Grant). Yes:____ No:_____
If yes then facility names
Name of Programm:

1)_____2)_____3)_____4)_____ 5)_____
1) ____2) ____3) ____4) ____5) ____

16. PTC Bank Account Detail:

Bank Name: ------------------ Branch Name ----------

-------------Account Number---------------

Branch code

17. Conditional Grant Detail 2015 & 2016 (Since Jan, 2015)
th

Total Fund Received: ____________ Expenditure (Till 30 July 2016)_______

Facility Provided: 1)

2)

3)

4)

5)_____

1)____ 2)____ 3)____ 4)____ 5)____

Cost:

18. Total School Area: a. Total As per Record: ______ b. Total as per Actual______
Covered Area:---- Kanai -

---Marla

Open Area:---- Kanai -

---Marla

19. Total Enrolment: (excluding unadmitted)

Boys: -K/
1/2/
9/
10/--11/ -- 12/--- 3/--4/
-- 5/--6/
-- 7/--8/
--Girls: -K/
1/ 2/ -- 3/ 4/ -- 5/ 6/ -- 7/ 8/
11/
-9/ -- 10/ -- 12/-20. Facility (Class Rooms):
Facility

Total Existing
Numbers

Total
Functional

Total Damaged/
Requiring Demolition

Total Requiring
Repair

Total Repair
Cost (Rs.)

Class Rooms
21. Number of Additional Class Rooms required: ____ Unit Cost: ____Total Cost____
Space Availability For New Construction (Additional Rooms): Yes: ____ No:
Area Needs to be acquired ____ Kanai _____Marla

Comments: ----------------------------------

22. Facility (Group Latrine):

Facility

No. of
G.L Available

Total
Functional

Total Damaged/
Requiring Demolition

Total Requiring
Total
Repair
Repair Cost (Rs.)

Group Latrine
23. Number of Group Latrine required: ____ Unit Cost: ______Total Cost: _______
Space Availability For New Construction: Yes: ____ No:
Comments:

---------------------------------White: Director E&SED Pink: School Blue: IMU

24. Facility (Boundary Wall):

Facility

Complete

Partially
Complete

Damaged

Status of Boundary
Wall

Not
Available

Total Repair
Cost (Rs.)

Requiring
Repair

25. Type of Boundary Wall: Retaining Wall: ________ Normal Boundary Wall: _______
Length (Running Feet):

Height (Feet): __________

26. New Construction of Boundary Wall:

Construction Cost per Running Feet: ________Raising Cost Per Running Feet: _______
Comments:

------------------------------------

27. Facility (Water Supply):

Availability/
Yes or No

Facility

Type/Source

Functional

NonFunctional

Total Repair
Cost (Rs.)

Requiring
Repair

Water Supply
28. New Installation Total Cost: ----Feasibility For New Installation: Yes: _____ No:
Comments:

------------------------------------

29. Facility (Electricity):

Availability/
Yes or No

Facility

NonFunctional

Functional

Requiring
Repair

Total Repair
Cost (Rs.)

Electricity
30. New Electrical Installation: Total Cost ----Feasibility For New Installation: Yes: _____ No:
Comments: ____________________________________

31. Facility (Solar Panel):

Availability/
Yes or No

Facility

Functional

Non-Functional

Requiring
Repair

Repair Cost
(Rs.)

Solar Panels

32. Details of New Solar System Installation:

No of Fans ____ No of Bulb____ No. of Computers ______Cost of Installation ______

Comments: ------------------------------------

General Comments:

---------------------------------

Name of Head Teacher:

Name of PTC Chairman:

Name of Monitor:

Signature

Signature

Signature

Phone Number

Phone Number

Phone Number

Date:

Date:

Date:

White: Director E&SED Pink: School Blue: IMU