01 |
Name of the Organisation * |
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02 |
Type of Organisation * |
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03 |
Registered Address * |
Upload Address Proof (For SHGs- Address Proof of the Group Leader (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
Address Line 1 * |
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Address Line 2 |
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District * |
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Block * |
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Municipality/ Panchayat * |
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Village/ Town * |
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PIN Code * |
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04 |
Correspondence Address * |
Same as Registered Address |
Address Line 1 |
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Address Line 2 |
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District * |
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Block * |
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Municipality/ Panchayat * |
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Village/ Town * |
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PIN Code * |
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05 |
Mobile No. * |
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06 |
Alternate Mobile No. |
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07 |
Email ID * |
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08 |
Brief Description of the Organisation * |
Within 300 Words |
09 |
Vision & Mission Document of the Organisation |
Upload Copy (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
10 |
Organisational Structure |
Upload Copy (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
11 |
Year of Establishment * |
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12 |
Date of Registration/ Establishment/ Incorporation * |
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13 |
Type of Registration Document * |
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14 |
PAN No. * |
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Upload Copy (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
15 |
TAN |
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Upload Copy (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
16 |
GSTIN |
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Upload Copy (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
17 |
UDYAM Registration No. |
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Upload Copy (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
18 |
MoA/ Deed of Trust/ Partnership Deed/ Bye Law of the Organisation (Full Document) * |
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Upload Copy (Only PDF max 200 KB) File size exceeds 200 KB. Please upload a smaller file. |
19 |
Details of the Head of the Organisation / Highest Authority of the Organisation * |
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20 |
Bank Account Details * |
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21 |
Upload Bank Account Details * |
Upload Scan of the Cheque of the Bank Account in the name of the organisation/ For SHGs – Scan of the 1st Page of the Passbook (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
22 |
Audit & Accounts Documents * |
Income Tax Return (Last 1 Year) [Mandatory for all except SHG] Applying as SHG
Upload Copy (Only PDF max 200 KB) File size exceeds 200 KB. Please upload a smaller file. |
Audited Balance Sheet & P/L – Last 1 Year [Mandatory for all except SHG] Upload Copy (Only PDF max 200 KB) File size exceeds 200 KB. Please upload a smaller file. |
For SHGs- Scan of the Statement of the Savings/ Flexi Account of Last 6 Months (Only PDF max 200 KB) File size exceeds 200 KB. Please upload a smaller file. |
23 |
Accreditation [Max 5 Nos.] |
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24 |
Recognition/ Empanelment/ Affiliation/ Collaboration [Max 5 Nos.] |
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25 |
TRAINER DETAILS- as per the Prescribed Format * |
Upload Copy (MS Excel max 50 KB) File size exceeds 50 KB. Please upload a smaller file. |
26 |
AVAILABLE INFRASTRUCTURE DETAILS – as per Prescribed Format * |
Upload Copy (MS Excel max 50 KB) File size exceeds 50 KB. Please upload a smaller file. |
27 |
Work Order / Completion Certificate of Training Programmes conducted under Govt. Organisations/ reputed Non-Govt. Organisations in last 3 years |
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28 |
Awards / Accolades (If any) |
Within 300 Words |
29 |
Photos of Training Programmes/ Awards Received |
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30 |
Transaction Details* |
Upload Copy (Only PDF max 80 KB) File size exceeds 80 KB. Please upload a smaller file. |
Transaction No.* |
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Date of Transaction* |
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Amount of Transaction* |
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From Bank* |
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31 |
Any other Related Information |
Within 200 Words
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32 |
SELECT DISTRICTS AND TRADES APPLYING FOR EMPANELMENT * |
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33 |
Date |
Place * |
Signature *
Upload Copy (Only JPG max 50 KB) File size exceeds 50 KB. Please upload a smaller file. |