Organisations Application Details

01 Name of the Organisation
02 Type of Organisation
03 Registered Address
Address Line 1
Address Line 2
District Block
Municipality/ Panchayat Village/ Town
PIN Code
04 Correspondence Address Same as Registered Address
Address Line 1
Address Line 2
District Block
Municipality/ Panchayat Village/ Town
PIN Code
05 Mobile No.
06 Alternate Mobile No.
07 Email ID
08 Brief Description of the Organisation
09 Vision & Mission Document of the Organisation
10 Organisational Structure
11 Year of Establishment
12 Date of Registration/ Establishment/ Incorporation
13 Type of Registration Document
14 PAN No.
15 TAN
16 GSTIN
17 UDYAM Registration No.
18 MoA/ Deed of Trust/ Partnership Deed/ Bye Law of the Organisation (Full Document)
19 Details of the Head of the Organisation / Highest Authority of the Organisation
20 Bank Account Details
Name of the account holder Account Number IFSC Code Branch Name
21 Upload Bank Account Details
22 Audit & Accounts Documents Income Tax Return (Last 3 Years)
Audited Balance Sheet & P/L – Last 3 Years
For SHGs- Scan of the Statement of the Savings/ Flexi Account of Last 6 Months
23 Accreditation [Max 5 Nos.]
24 Recognition/ Empanelment/ Affiliation/ Collaboration [Max 5 Nos.]
25 TRAINER DETAILS Download
26 AVAILABLE INFRASTRUCTURE DETAILS Download
27 Work Order / Completion Certificate of Training Programmes conducted under Govt. Organisations/ reputed Non-Govt. Organisations in last 3 years
28 Awards / Accolades (If any)
29 Photos of Training Programmes/ Awards Received
30 Transaction Details
Transaction No.
Date of Transaction
Amount of Transaction
From Bank
31 Any other Related Information
32 SELECT DISTRICTS AND TRADES APPLYING FOR EMPANELMENT
 
33 Date Place Signature Download
Declaration (Organisation)
We hereby declare that –
1. The information furnished above are true to best of our knowledge.
2. We would strictly abide by the Terms & Conditions stated in the “Expression of Interest” and deliver the services as required with optimum sincerity.
3. We have not been barred/ banned/ restricted from any such services from any Govt. or Non-Govt. Organisations in the past.
4. We have a clean legal background and no Criminal Case has been filed against me in the Court of Law as per our knowledge.
5. We are able to serve as a Training Provider for both short and long duration Programmes of the selected trades in the Urban and Rural Areas of the selected District/s of West Bengal along with all types of Machineries, Equipments and Training Material support as and when required.
6. We are capable of providing Marketing and Network building Support temporarily for the Target groups of Trainees.