Department of Economic Analysis & Research, NABARD

Transcription

1 Department of Economic Analysis & Research, NABARD R & D Fund : Application Form for seeking Grant Assistance for organising Conference/ Seminar/ Workshop/Symposium etc. ( (Please submit two sets of Application form & other documents (hard copy) and also mail the scanned copy of application form and other documents to the Regional Office/Head Office of NABARD at least 45 days in advance of the event) 1 Name of the Organizing Agency (i) Type/Status of Organisation (University/College/ NGO/MFI/PRI/ Society/etc. (ii) Date of Establishment (iii) Registered/ Unregistered (iv) If registered then under which Act (validity of registration in case of NGOs/MFI/ PRIs, etc.) (v) Agency's Past Experience in holding seminars/ conferences (no of seminar & its details) during last 5 years (vi) If any other agency/ Professional Association (i.e. Co-organizer) is also involved in organizing this Seminar, give the Name and Details of Agency and the nature of association 2 (i) Name, Designation & Address of the of the convener / coordinator (ii) Contact details of Institute/ seminar Coordinator Phone No Landline (with STD code) Mobile No:

2 Fax No: address: 3 Date of the Seminar 4 Title of the Seminar/Conference 5 Objective of the Seminar/Conference 6 Major topics to be discussed during the Seminar ( Pl attach a separate sheet, if required) 7 Relevance of the Seminar (i) Relevance of organizing the Seminar on the proposed theme in the present day context ( Pl attach a separate sheet, if required) (ii) Relevance of the theme/ topics to NABARD and its area of operation ( Pl attach a separate sheet, if required) 8 Status of the Seminar (Regional/ National/International) 9 Total No. of participants (i) No. of participants from Same state

3 (ii) No. of participants from other states (iii) No. of participants from Foreign countries (iv) Name of countries from where foreign participants are expected: 10 Name, designation, vocation, expertise in respect of experts presenting the Lead Paper, Memorial lectures etc. 11 Session-wise/ Speaker-wise day to day schedule (Pl attach authenticated copy) 12 Address of Venue of the Seminar with contact details 13 Infrastructure with the agency (i) Conference Hall owned / hired (ii) Approximate capacity of Seminar Hall (iii) No of guests to be accommodated: (a) In Owned hostel/ Guest house (b) In hired- hotel/ hostel 14 Name of co-sponsors and amount of grant expected from each of them 15 Category-wise delegate fee / registration fee per head 16 Own involvement of the agency & its source 17 Proposed Budget for the Seminar: a Budget: Item-wise estimated expenditures (i) Lunch / Dinner expenses for participants (ii) TA / DA/ Honorarium to invited speakers (iii) Accommodation expenses for participants (iv) Postage, Stationery, Xerox, etc.

4 (v) Publication of Pre-Conference/ information brochure material/ Souvenir/ etc. (vi) Publication of Conference / Seminar abstract / Proceedings/ Action points/ recommendations (vii) Other Expenditure (specify) b Total Expenditure Estimate (17 - a) Budget: Item-wise estimated Income (i) Registration fees from delegates (ii) Contribution by the Co-Sponsors (agency-wise details) (iii) Income from advertisement (iv) Agency s own contribution Total Expected Income (17 - b) 18 Gap in Budget (Expenditure Income) 19 Assistance sought from NABARD 20 No of times agency has already availed grant assistance from NABARD during (a) Current financial year (give title of seminars) (b) during last five years 21 Printing of Proceedings/ Journal (i) No of copies to be printed (ii) Expected no of pages per book 22 Any other information, the agency would like to furnish to NABARD 23 List of Attachments (i) Two copies of Announcement Letter/ information Brochure (ii) Day to Day Schedule of the Seminar (indicating session topic, time slot, name of speaker & designation) on Institute s letter head duly authenticated by the competent authority (iii) Budget of the seminar (Sl. No- 17)

5 24 Bank details of the Agency (i) Name of the account holder to whom the payment is to be made (as appearing in the bank account) (ii) Name of the Bank (iii) Name, Address & Contact details of the Branch (iv) Account Number (v) RTGS /NEFT/IFS Code (vi) Type of account (Savings / Current etc.) 25 Permanent Account Number (PAN) of the Agency 26 Whether exempted from TDS? If yes, attach the copy of exemption certificate as per Section 10 (23 c) of Income Tax Act, 1961 Note : Please submit all the details as per the format, including banking and tax related details to facilitate the process Signature of Organising Secretary/ convenor: Name of Organising Secretary/ convenor: Designation of Organising Secretary/ convenor Place: Date: Recommendation by the Head of Institution Signature of the head of the Institution: Name of the head of the Institution: Place: Date: Seal of the Institution*: (* Seal of the institution - on all the pages of the application form)

6 ADRESSESS OF NABARD REGIONAL OFFICES ANDAMAN & NICOBAR NABARD Complex, Kamaraj Road (VIP Road), PO Junglighat Port Blair Tel No : (03192) Fax No: (03192) portblair@nabard.org ANDHRA PRADESH , RTC 'X' Roads Musheerabad Hyderabad Tel No: (040) Fax No: (040) apro@nabard.org ARUNACHAL PRADESH Bank Tinali VIP Road Post Box No. 133 Itanagar Tel No : (0360) Fax no: (0360) itanagar@nabard.org ASSAM G.S. Road, Dispur Guwahati Tel No :. ( 0361) FAX No. (0361) guwahati@nabard.org BIHAR Block B, 4 th & 5 th Floor Maurya Lok Complex Dak Bunglow Road Patna Tel No : (0612) Fax No. (0612) patna@nabard.org MAHARASHTRA 54, Wellesley Road Shivaji Nagar Pune Tel No : (020 ) / Fax (020) pune@nabard.org MANIPUR Leiren Mansion 2nd Floor, Lamphelpat, lmphal Tel No.: (0385) Fax No: (0385) imphal@nabard.org CHHATISGARH 1 st & 2nd Floor Pithalia Complex Fafadih Chowk, K K Road Raipur (C.G.) Tel. No. (0771) Fax No. (0771) raipur@nabard.org GOA 3rd Floor, Nizari Bhavan, Menezes Braganza Road Panaji Tel No : (0832) / / Fax No. (0832) panaji@nabard.org GUJARAT NABARD Tower, Opp. Municipal Garden Post Box no. 8, Usmanpura Ahmedabad Tel No : (079) /58/59 Fax No. (079) ahmedabad@nabard.org HARYANA Plot No.3, Sector 34-A, Chandigarh Tel no: (0172) / Fax: (0172) , haryana@nabard.org HIMACHAL PRADESH Block No. 32, SDA Complex, Kasumapti Shimla Tel No : (0177) , Fax No. (0177) shimla@nabard.org NAGALAND NSCB Head Office Admn. Building 4th Floor, Circular Road, Khermahal, Dimapur Tel No : (03862) /235600/ Fax : (03862) dimapur@nabard.org NEW DELHI NABARD Tower, 24, Rajendra Place New Delhi Tel No (011) / Fax : (011) delhi@nabard.org JAMMU & KASHMIR B-2, 4th Floor South Block, Bahu Plaza, Jammu Tel No: (0191) Fax No : (0191) jammu@nabard.org JHARKHAND Opposite Adivasi College Hostel Karamtoli Road Ranchi Tel No : (0651) Fax No : (0651) id : ranchi@nabard.org KARNATAKA NABARD Towers, 46, Kempe Gowda Road Bangalore TEL No : (080) Fax No: (080) bangalore@nabard.org KERALA NABARD Punnen Road, Statue Thiruvananthapuram Tel no. (0471) / Fax No. (0471) trivandrum@nabard.org MADHYA PRADESH E-5, Arera Colony, Bittan Market, Bhopal Tel No : (0755) Fax No : (0755) bhopal@nabard.org PUNJAB Plot No. 3, Sector 34-A, Chandigarh Tel No : (0172) ; Fax: (0172) , chandigarh@nabard.org SIKKIM Om Niwas Church Road Gangtok Tel No : (03592) / Fax No: (03592) gangtok@nabard.org

7 MEGHALAYA U Pheti Kharmihpen Building 2 nd & 3 rd Floor, Plot No. 28 (2) Dhankheti, Shillong Tel No : (0364) / / / Fax No : (0364) E mail : shillong@nabard.org MIZORAM Ramhlun Road (North), Bawngkawn, AIzawl Tel No :. (0389) / / Fax No aizawl@nabard.org TELANGANA , RTC 'X' Roads Musheerabad Hyderabad Tel No: (040) Fax No: (040) hyderabad@nabard.org UTTARAKHAND 113/2, Rajpur Road, Hotel Sunrise Building Dehradun Tel No : (0135) Fax No : (0135) dehradun@nabard.org BOLPUR Bankers Institute of Rural Development, Bolpur Lodge P.O. Bolpur Dist. Birbbhum PIN West Bengal Tel No Fax No : / rtc.bolpur@nabard.org LUCKNOW National Bank Staff College, Sector H, LDA Colony, Kanpur Road, Lucknow Tel no : Fax No nbsc@nabard.org ODISHA Ankur, 2/1, Nayapalli Civic Centre Bhubaneswar Tel no - (0674) / Fax number (0674) bhubaneswar@nabard.org RAJASTHAN Plot No. 3, Nehru Place, Tonk Road, Jaipur Tel No. (0141) FAX No : (0141) jaipur@nabard.org TRIPURA Shilpa Nigam Bhaban,Ground Floor, Khejur Bagan near Ginger Hotel PO. Kunjaban Agartala Tel No : (0381) Fax No: (0381) agartala@nabard.org WEST BENGAL 'Abhilasha', 6 Royd Street Kolkata Tel No : (033) Fax : (033) kolkata@nabard.org TAMIL NADU 48, MAHATMA Gandhi Road Nungambakam Post Box No Chennai Tel No. (044) Fax No. (044) chennai@nabard.org SRINAGAR CELL 459, Jawahar Nagar Behind DAV Institute Srinagar Tel No : (0194) , Fax No : (0194) srinagar@nabard.org UTTAR PRADESH 11, Vipin Khand, Gomti Nagar Lucknow Tel No : (0522) / Fax No : (0522) lucknow@nabard.org TRAINING ESTABLISHMENTS LUCKNOW MANGALORE Bankers Institute of Rural Bankers Institute of Rural Development Development Sector H, LDA Colony, Behind Government Polytechnic for Kanpur Road, Lucknow Women Tel No : Krishna Nagar Road Fax No : Bondel bird@nabard.org Mangaluru Tel No : (Joint Director) Fax No : / rtc.mangalore@nabard.org