STEP Institutional Application form
(Seal and signature of Chief Executive required on each page)

BACKGROUND DATA:

1. Name :
2. Address :
3. Telephone No. :
4. Date of Registration :
5. (i) Registeration No. :
   (ii) Latest renewal Receipt with attestation :
6. Registred under (Act) :
   If Trust Act latest I.T. clearance
   Certificate with attestation.
7. Foreign Contribution Regulation Act approval
   Number (if any) :
8. Building – Rented/Owned/Other :
9. Type of structure :
10. Approx area (Sq.ft.) :

MANAGEMENT DATA:

1. Managing Trustee/President/Chief Executive :
   (Name in Capitals)
2. Secretary (Namein capital) :
3. Treasurer (Namein Capitals) :
4. No.of Staff for Administration : Permanent Temporary
   a). Part time :
   b) Full time :
5. No. of Field Staff available :
   (Not included above)
   a). Part time :
   b) Full time :
   c) Total Staff (a + b) :

RESOURCE PERSONS/TRAINERS :

1. Trainers/Resource persons available (if any)

ACTIVITY DATA:

1. No. of years of effective operation :
   after registration
2. Area of operation (Districts/Blocks/Villages : State................ District.................
   in Tamil Nadu & Other States)
3. (Additional Sheet may be attahced if needed) :State..District. Blocks Village (No.).
4. Activities, Projects completed :
5. Activies, Projects ongoing :
6. Area(s) of specialisation :

SOURCES OF FUNDING:

Funding (Past)

Funding (Current)

DETAILS FOR CONDUCTING THE PROPOSED TRAINING PROGRAMME:

1. Name of the training :
2. Duration (working days) :
3. Resource persons avilable :
4. Space availability :
5. Equipments available :
6. Additional Infrastructure available :

DETAILS OF TRAINING UNDER TAKEN DURING THE PAST THREE YEARS:

WILLINGNESS:

1. Is the NGO willing to be listed
   With the Tamil nadu Women’s
   Development Corporation for
   The implementation of the
   Vocational Training Programme:
   (Please Tick option) :

             Yes      No.

If yes, whether committing to
Provide placement/assistance for
Self-employment to the candidate on
Completion of training :
(Pleae Tick option)

                                                            Yes      No.

Declaration

Certified that the above particulars are correct and give a complete and correct picture about the organisation,..........................................................

(Name)

Signed :

Name(in capitals) :

Authorised Signatory :

Seal :

Location of the Office:

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