Award Application Form - The Associated Chambers of Commerce

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GENERAL INFORMATION
The ASSOCHAM Summit-cum-Awards on SKILLING INDIA – The Way Forward comprises
two stages selection process consisting of questionnaire assessment, and finally jury selection.
I. First Phase: Questionnaire Assessment
Questionnaire assessment includes an assessment of how the organization has integrated the
skill development process and its strategy and management of operations.
II.
Second Phase: Jury Selection
Panel of jury consisting of eminent persons will review each entry and finally decide the
winners.
CATEGORIES FOR AWARDS
During ASSOCHAM Summit-cum-Awards on Skilling India, awards in Gold and Silver category to
the meritorious organization will be made in the following categories:
Sr.
No
Name of the Awards
Code
Number
01-16
1
Best Vocational Training Provider (VTP) - Training
2
Best Institute - Innovation
02-16
3
Best Institute - Open & Distance Learning in Vocational and Skills Development
03-16
4
Best Institute - Women Skill Development
04-16
5
Best Institute - Placement
05-16
Best Large Scale Private Organization – Training Programme
06-16
6
7
8
( Having more than Rs. 100 Cr annual Turnover)
Best Medium Scale Private Organization – Training Programme
07-16
(Having more than Rs. 25 Cr. but less than Rs. 100 Cr. annual turnover)
Best Small Scale Private Organization – Training Programme
08-16
(Having less than Rs. 25 Cr. annual turnover)
9
Best Higher Vocational/Professional Institute for Skill Development
09-16
10
Best PSU -Public Sector Training Programme
10-16
11
12
13
14
Best NGO- Skill Development
11-16
Best ITI- Skill Development through PPP Model
12-16
Best Sector Skill Council
13-16
Best State in Skill Development
14-16
15
Best Bank/Financial Institution who Support/Finance Skill Development
15-16
16
Best International Organization in Skill Development
16-16
17*
Best Entrepreneur in MSME For Outstanding Performance After Vocational
Training.
17-16
* For Category number 17 bearing Code no. 17-16, please filled Annexure No. I & II(A) only.
Eligibility Criteria:
The awards process is open to all Indian and Overseas Organizations/Institutes (Public and Private Sectors),
NGOs, Skill Training Providers, Funding Agencies, Assessors, Vocational Training Providers (VTPs),
Facilitators associated with vocational/technical/employability and entrepreneurial skill etc.
Submission of Application Form
 The details can be filled out directly on the soft copy of the prescribed format. Answer
should be legible and attachments should be clearly indexed and indicated.
 Hard copy of the application form with enclosures etc should be sent to ASSOCHAM-SDC.
The entire set of information should also be provided in a CD.
 The application form completed in all respect in a closed envelop must reach us latest by
20th February, 2016 at the following address:
ASSOCHAM -SDC
ASSOCHAM Corporate Office, 5, Sardar Patel Marg,
Chanakyapuri, New Delhi – 110021
Phone: 011- 46550555 (Hunting Line)
Fax: 011-46536481/82
E-mail Id:assocham@nic.in
Participation fee for awards:
o Rs. 10,000/- is award processing fee for each category
o Cheque should be prepared in favor of ASSOCHAM-SDC, payable at New Delhi.
o Kindly note that an entity can apply for multiple categories, separate application form
along with requisite fee is to be submitted for each category.
Mode of Payment
Detail of Payment - DD/Cheque No./Online payment reference no. and Date
By DD / At Par Cheque
in favour of ASSOCHAMSDC payable at New Delhi
Bank Account Details for online payment:
Name of Account Holder and Address
Bank Name
Bank Current Account Number
The Associated Chambers of Commerce
and Industry of India
5, Sardar Patel Marg, Chanakyapuri
New Delhi - 110 021 India
State Bank of Hyderabad
52050210412
Bank Address
36, Elite House, Zamrudpur, Kailash Colony,
New Delhi- 110 048 India
Branch code ( If any)
20588
MICR Code
110004007
Indian Financial System Code- (IFSC Code)
SBHY0020588
National Electronic Fund Transfer Code(NEFT Code) (if any)
SBHY0020588
Annexure - I
AWARD APPLICATION FORM
1. Please indicate code and category of the award:
Name of the Award Category: …………………………………………Code No: ……..
Contact Information: (preferably head of the organization or his authorized representative)
Name of the Organization
:……………………………………………………..
Contact Person Details
Name
: ..……………………………………………………
Designation
: ……………………………………………………..
Postal Address
: …………………………………………………….
………………………………………………………
PIN Code: ……………….. State: ………………..
Mobile & Landline Number: …………………………………………………….
Fax Number
: …………………………………………………….
E-mail ID
: …………………………………………………….
Declaration
I / We certify that all information provided in this form is accurate and true to the best of my/our
knowledge. I / We am / are willing to provide any supporting documentation / evidence that may be
required to verify the information provided herein and I / We agree to abide by the decision of
ASSOCHAM in all matters relating to the Award.
Authorized Signatory:
Name & Designation:
Company Seal:
Date:
Place:
Annexure - II
FUNCTIONAL DETAILS
The objective of these details is to judge the applicants for the said award ceremony. It will guide
the jury in assessing how effectively they have provided the skill development activities.
Note:* Please don’t leave any column blank. Mention N.A. in the Column which is not applicable.
* Financial period counts from April to March.
* Please put your initials of each pages.
Part – A
Sr.
No
1
2
Particulars
Details
No. of trainees trained
in the industry/on job
training to trainees
> 90
80 to 90
70 to 79
60 to 69
50 to 59
No. of instructors
trained in the industry
> 12
10 to 12
7 to 9
4 to 6
1 to 3
Financial contribution
by the industry partner
> Rs. 1.0
cr.
Rs.0.75
cr to 1 cr
Rs.0.50cr
to Rs.0.75
cr
Rs.0.25 cr
to
Rs.0.50cr
< Rs.0.25cr.
No. of trainees placed
in the industry of the
industry partner
> 90
80 to 90
70 to 79
60 to 69
50 to 59
Expenditure incurred
towards up-gradation
of facilities/
infrastructure
> Rs. 2.00
cr.
Rs.1.50
cr to
Rs.2.00
cr.
Rs. 1.0cr
to Rs.1.50
cr
Rs.0.50 cr
to Rs.1.0
cr
< Rs.0.50cr.
> Rs. 1.25
cr.
Rs.1.00
cr to
Rs.1.25
cr.
Rs.0.75 cr
to Rs.1.00
cr
Rs.0.50 cr
to Rs.0.75
cr
< Rs.0.50cr.
3
4
5
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
6
Revenue generation by
IMC (Income from
activities and Bank
interest to be given
separately)
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
Percentage of students
pass out as compared
to enrolled
7
100%
90 to
99%
80 to 89%
70 to 79%
60 to 69%
> 95%
91 to
95%
86 to 90%
81 to 85%
75 to 80%
100%
99 to
96%
91 to 95%
86 to 90%
81 to 85%
15 and
above
12 to 14
9 to 11
6 to 8
3 to 5
15 and
above
12 to 14
9 to 11
6 to 8
3 to 5
> 12
10 to 12
7 to 9
4 to 6
1 to 3
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
Percentage of pass out
students placed in the
industry
8
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
Theory sessions
conducted
9
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
10
How many campus
interviews conducted
in the last 3 years
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
11
How many
industries/firms
participated in the
campus interview
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
12
No. of instructors sent
for training in industry
and other training
institutes
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
No. of industrial visits
arranged for trainees
13
10 and
above
visits
8 to 9
visits
6 to 7
visits
4 to 5
visits
2 to 3 visits
More than
100%
80 to
100%
60 to
80%
40 to 60%
20 to 40%
100%
95 to
99%
92 to 94%
85 to 89%
Less than
84%
Zero
dropout
Upto
2.5%
Upto 5%
Upto 7.5%
Upto 10%
100%
90 to
99%
80 to 89%
70 to 79%
60 to 69%
>100%
75 to
100%
50 to 74%
25 to 49%
<25%
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
Percentage increase in
intake capacity
14
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
15
Percentage of
enrolment as
compared to number
of seats
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
Percentage dropout as
compared to enrolment
16
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
17
Percentage of students
pass out as compared
to enrolled
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
18
Percentage increase in
placement of passed
out students against
previous year
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
Sr.
No.
Details
19
Budget allocated for Skill
development
20
Budget utilized for Skill
Development
21
Total Number of youth skilled
22
No. of States/UT covered for
skill development training
programme.
23
Total No. of candidates
assessed and certified
F.Y. 2012-13
F.Y. 2013-14
F.Y. 2014-15
Contribution/Activities other than enlisted above. (Please specify with its impact assessment, if any)
Part-B
Parameter
Sr. No.
1
Whether placement cell established
2
RozgarMela/Employment Camp organized
3
4
Efforts made to encourage self employment
Any skill competition conducted
12
Whether regular meetings with the instructors to
ensure quality training
Conduct of regular mock tests/class/periodic tests to
obtain better results
Whether regular maintenance programme in place for
the various machineries
Steps to increase the computer literacy rate amongst
the staff
Steps to increase computer literacy rate amongst the
trainees
Steps taken to increase female candidates’
admissions in the ITI
Availability of basic amenities like drinking water,
toilet etc
Availability of internet facility
13
Uniform for trainee
14
Soft skill training to trainee
15
16
17
18
19
ISO certification obtained
Web portal for ITI
Encouragement of extracurricular activities
Availability of first-aid facility
Setting of library facilities/development of library
20
21
Availability of modern teaching aids
Availability of power backup facility
5
6
7
8
9
10
11
* Any other information relevant and not reflected in the form:
Comments with Brief details, if any
* You may like to give a brief write-up of your success story for mentioning it at the time
of award ceremony. It may also be published and distributed to all the participants.
Name of the Organization:
Address:
Annexure – II (A) for Sr. No 17. Code No. – 17-16
NOMINATION FORM for the category
“Best Entrepreneur in MSME For Outstanding Performance After Vocational Training”
ELIGIBILITY:
Self-employed individuals trained under vocational training programme and possessing experience
of minimum three years of running his/her owns income generation activities are eligible.
--------------------------------------------------------------------------------------------------------------------A. PERSONAL PROFILE:
1. NAME
______________________________________________________
2. ADDRESS (Permanent)
______________________________________________________
______________________________________________________
Phone: (O) ______________ (R) _______________STD Code: ________
Mobile: ___________________ E-mail:____________________________
3. DATE OF BIRTH:
4. GENDER: Male
_ _ (D)/_ _ (M)/_ _ _ _(Y)
Female
5. EDUCATIONAL QUALIFICATION: (Only the last qualification acquired)
Sr. No.
Name of School/College
Exam.
Passed
Year
6. FAMILY BACKGROUND (at the time of setting up of your income generation activity):
[Please tick mark appropriately]





Service:
Self-Employed:
Un-employed:
Business:
Any Other:
Yes/No
Yes/No
Yes/No
Yes/No
Pl. Specify:
7. VOCATIONAL TRAINING PROGRAMME(S) ATTENDED :
Sr.
No.
Title of the
Programme
Duration
Month & year
of completion
Specialization
(If any)
Name &Address of the
organization that
conducted the
programme
- Please attach separate sheet, if required.
- Please enclose the copy of programme completion certificate.
B. PROFESSIONAL DETAILS:
1. Name &Address of the establishment : _____________________________________________
2. Year of establishment
: _________________________________________________
3. Type of activity (Please tick) :
Manufacturing
Servicing
Trading
4. Details about activity/ies:
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------5. No. of employees at the time of setting up:
6. No. of employees at present:
7. Initial investment:
8. Sources of investment:
Sr. No.
Source
1
Bank
2
Friends & Relatives
3
Family
4
Own Funds
Amount (Rs)
9. Investment at present:
10. Average annual income at the end of first year:
11. Average annual income at present :
12. Processes/special machines/technologies introduced and/or self-development related
programmes attended, to enhance business prospects (Give details, if any):
13. Any special achievements :
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
C. OTHER DETAILS TO BE FURNISHED:
A brief write up (not exceeding 700 words) stating why you should be considered for the Award.
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
D.
PLEASE GIVE TWO REFERENCES WHO KNOW ABOUT YOUR WORK
(Other than employees & relatives)
1.
Name: _____________________________
Address: _____________________________
Tele: (O) ______________________ (R) __________________ (M) _______________
E-mail: __________________________________
2.
Name:
_____________________________
Address: _____________________________
Tele: (O)______________________ (R) __________________ (M) ________________
E-mail: __________________________________
E.
DECLARATION:
I _________________________________________ declare that the information provided
is correct to the best of my knowledge and belief.
Signature
Name
Place:
Date:
SKILL DEVELOPMENT CENTRE
THE ASSOCIATED CHAMBERS OF COMMERCE & INDUSTRY OF INDIA
Corporate Office: 5, Sardar Patel Marg, Chanakyapuri, New Delhi -110021 Phone: 011- 46550555 (Hunting
Line) Fax: 011-46536481/82 Website: www: assocham.org
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