APPLICATION FORM FOR ENTREPRENEURSHIP DEVELOPMENT
TRAINING PROGRAMME

AFFIX PASSPORT SIZE

PHOTO DULY ATTESTED.

1. Name of the candidate :
2. Address:
       a)Current Address :
       b)Permanent Address :
       c)Telephone No. :
3. Date of Birth & Age :
4. Mother’s Name,Occupation & Annual Income :
5. Husband’s Name,Occupation & Annual Income :
6. Father’s Name, Occupation & Annual Income :
7. Whether SC/ST/BC/BC/DNC:
   (Copy of Certificate should be enclosed)
8. Applicant’s Educational Qualification :
9. Previous work experience/Additional :
   Qualification/Skill Training/if any
10. Employment Status
    Whether employed / Self employed or Unemployed :
11. If employed:
       a)Name of the Institution where employed :
       b)Position :
       c)Duration :
12. If Self Employed:
    Nature of present Business :
    a) Period of Experience(Years/Months) :
13. Annual Income :
14. Nature of the business you want to
    start (If uncertain please so indicate) :
15. Expected Project Cost, if estimated :
16. How much can you invest in your
    Project? Eg. Can you invest 25% or more Project Cost? :
17. Why do you want joint this Course :
18. Has any of your family member as Name
    of Relation-obtained bank loan? If so is her/she
    is repaying regularly? :
       1
       2
       3
19. Name the Bank and Branch : Bank Branch
       1.
       2.
       3.
20. Does he/she haven overdues? :
        1.Yes/No
        2.Yes/No
        3.Yes/No
21. Please tick the relevant category below;
    if applicable State Govt’s 10% special
    subsidy towards margin money of the
    project cost is eligible to the following categories:
          A. Single/Unmarried
          B. Widow
          C. Destitute
          D. Divorcee
22. Whether the applicant has any movable or immovable
    assets/savings? Specify the value and its source :
23. Any other matter you would like to be
    considered, please specify.

SIGNATURE OF THE CANDIDATE.

Date:

Place:

DECLARATION

I hereby agree to attend the theory/practical class regularly failling which the total cost towards my training will be repaid by me /my parents/guardian to the Tamil Nadu Corporationfor Development of Women Limited , Chennai.

Place:

Date:

Signature of Applicant

I……………………………(Full name in capitals) hereby agree to the above in respect of my daughter/wife/sister/any other( please specify relationship) who will undergo the Women Entrepreneurship Training…………………………………

Place:

Date:

Signature of Parent/Guardian

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