Application of Atal Tinkering Lab (ATL)

1. Name of Applicant School

2. Complete Address of School :
3. State :
4. District :
5. Pin code :

SCHOOL CONTACT DETAILS :

6. Official Contact No. :

PRINCIPAL CONTACT DETAILS :

7. Name of Principal :
8. Mobile No. :
9. Email Address (capital letter)
10. Principal Aadhar No. :

VICE PRINCIPAL CONTACT DETAILS :

11. Name of Vice Principal :

12 Mobile No. :
13. Email Address (capital letter)
14. Vice Principal Aadhar No. :

NAME OF PROPOSED ATL IN-CHARGE (Science Teacher) :

15. Name of Proposed ATL In-charge :

16. Mobile No. :
17. Email Address (capital letter) :
18. Science Teacher Aadhar No. :
19. School UDISE Number :

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1.Years since Establishment
0-5 Years
(Pl. tick)
6-10 Years

11-15 Years

16 Years and above

2. Type of School :
Central Government / Central PSU
(Pl. tick)
State Government

Local Body (Municipality / Nagar Nigam)

Private Aided Private-Unaided

Tribal /Social Welfare Department

3. Board of Affiliation :
CBSE ICSE/ISC
(Pl. tick)
State Board IB Other

4. Which area is your school in? Rural Urban

5. Co-educational? Yes Boys only Girls only

6. Educational Grade Offered in School Upper Primary Secondary Higher Secondary

8. Total Student Enrolment of the School

9. Total Student Enrolment (6th to 10th)

10. Highest qualification of Principal : Below Graduation / Graduate / Post Graduate / M. Phil / PhD / Post
Doctorate (Pl. mention)

11. Stream of qualification of Principal Science (PCB) / Maths / Computer Science / Commerce / Other

12. Highest qualification of ATL in-charge Below Graduation / Graduate / Post Graduate / M. Phil / PhD / Post
Doctorate (Pl. mention)

13. Stream of Qualification of ATL in-charge Science (PCB) / Maths/ Computer Science / Commerce / Other

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 Plain State Hilly/Himalayan State Island State
14. Select State :
Hilly / Himalayan States include Jammu & Kashmir, Himanchal Pradesh, Uttarakhand, Sikkim, Nagaqland,
Arunachal Pradesh, Assam, Manipur, Tripura, Mizoram, Meghalaya ( Island States) include Andaman & Nicobar
Iislands and Lakshadeep

1. Performance of the School {Average attendance of staff for the past 3 years (as per Academic Year)} :

2016-17 2017-18 2018-19

Total No. of Science Teachers

Total No. of Maths Teachers

Total No. of Computer Science Teachers

Average attendance (%) of Science, Maths &

Computer Science Teachers (calculated against
Total working day)

2. Average attendance of Students for the past three years (as per Academic Year) :

2016-17 2017-18 2018-19

Total No. of Student from class 6th to 12th/10th

(Please mention the number of students from 6th to
10th if your school doesn’t have class 6th to 12th

Average attendance (%) of Students (Calculated

Against total working days)

3. Percentage of Students (Grade X) obtaining the following scores in board exams in the previous 3 years :

Score % 2016-17 2017-18 2018-19

Below 60%

Below 60-69.99%

Below 70-79.99%

Below 80-89.99%

Below 90-100%

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4. Percentage of Students (Grade XII) obtaining the following scores in board exams in the previous 3
years (Schools having classes till Xth are not required to answer this question :

Score % 2016-17 2017-18 2018-19

Below 60%

Below 60-69.99%

Below 70-79.99%

Below 80-89.99%

Below 90-100%

5 a) Number of Intra-School Science, Technology

& Innovation Related Activities /
Exhibitions/Fairs/ Competitions Organised by your
School in 2018-19 (as per academic year) :
b) Number of Inter School Science, Technology
& Innovation Related Activities/Exhibitions/Fairs/
Competitions Organised by your School at
District/State/National Level in 2018-19
(as per academic year) :
c) Total Number of Awards Won in Inter School
Science, Technology & Innovation Related Activities/
Exhibitions’/Fairs/Competitions at District/State/
National Level in 2018-19 (as per academic year) :
This should not include extra-curricular activities like
debates, drama, painting competitions.

6. Does your school participate in any of the Science exams? :

National Talent Search Examination (NTSE)

Junior Science Talent Search Examination (JSTS)

Kishore Vaigyanik Protsahan Yojna (KVPY)

National Science Olympiad (NSO)

Other State level

7. Number of other extra-curricular Scholarships/Awards won in 2018-19 (as per academic year) :

This should include extra-curricular activities like

Debates, Drama, Painting Competitions, Music,
Dance and Sports etc.)

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1. Dedicated built-up area available for setting up ATL (in Sq. feet) as per guidelines :

[All weather area (1500 sq. ft.). All weather area

(1000 sq. fit.) in hilly and island states, UTs.] Yes No

2. Availability of Infrastructure :

YES NO
Steady Electricity Connection

Computer Lab with internet

Science Lab

Playground

Library

Internet speed (2MBPS or above)

3. ATL recipient schools are required to open & share their ATL facility with the
community/nearby schools, would you agree with the same?

YES NO

4. Notable STEM Alumni engaged with School :

a) Total number of alumni engaged :

b) Details of associated alumni : (Please mention the details of upto 5 alumni)

Name of the Alumni Frequency of Current affiliation Current Current

Engagement of alumni Designation Organisation

Definition : A notable alumni is a person(s) who belongs to technology background or has 10 years of experience or
is an award winner, or has won recognition in the area of STEM, or has research publications, won medal at
National/International level.

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5. Linkages to mentors :

a) Total number of mentors school is associated with

b) Details of associated mentors : Please mention the details of upto 5 mentors

Name of the Mentor Frequency of Current Current Current Contact

Engagement affiliation of Designation Organisation Number
Mentor

Definition of Academic includes all higher educational institutions and research Organisations
Industry includes all big corporates, small companies, entrepreneurs, innovators, maker-spaces, NGO partners.
Definition of Mentor : Mentor is a person/Organisation/entity that engages with the school on-going basis in
conducting guest lectures, hands on sessions, supporting student projects, giving guidance and any other hand holding
support if required, on a pro-bono basis.
7. Why do you think your school should be selected for ATL ? (50 words)

8. What activities will you do in the ATL to make your school an innovation hub? (50 words)

9. Declaration on School Letterhead :

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 (Only on School Letter Head)

To
Mission Director,
Atal Innovation Mission (AIM)
NITI Aayog, Sansad Marg, New Delhi –110001

Subject: Declaration

Dear Sir,

Our school, ______________________________________[write name of school] hereby

declares that we have read and understood all the terms and conditions of the Atal Tinkering
Laboratories Scheme. The information submitted in the application form by our school is
complete and to the best of my knowledge and belief; there is nothing that has been
concealed or suppressed.

We also confirm that we have the requisite space of 1500 Sq. Ft in a Plain state to setup the
ATL in our school premises.

Thanking you.

With Regards,
[Signature of the Principal with the school stamp]

(Write Name of Principal)

Principal