Partner Affiliation (PI) Form

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Institution form
1. Registration Details / पंजीयन का विवरण * अनिवार्य फिल्डस (Mandatory fields)
Name of the Institution *
Post Address of the Institution *
Country *
State *
Pincode *
2. Institution Head:
Name *
Telephone (Office)
Mobile *
Fax No.
E. Mail. *
Adhar No.
3.Contact Person:
Contact Person: (name) *
Telephone (Office)
Mobile *
E. Mail. *
Adhar No.
4. Institution Details
Nature of Institution *
Registration Number (if any)
Date, Month & Year of Registration
Whether All our country Organization * Yes No
Does the organization have any previous experience in Any work? * Yes No
If yes, was any grant sanctioned from Government or other Organization? *
Whether the office of the organization is located in own building or rented building? * Yes No
Brief History of the Agency, list objective and activities.(200 Words)
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I, hereby declare that the particulars submitted by me in the online application form of ESSC are true to the best of my knowledge and belief. I agree to abide by the rules and regulations of ESSC and also to the decision of ESSC regarding any action. I will not held ESSC responsible for any damages.
मैं घोषणा करता हूं कि ब्यौरे ईएसएससी के ऑनलाइन आवेदन पत्र में मेरे द्वारा प्रस्तुत अपने ज्ञान और विश्वास के अनुसार सत्य हैं। मैं नियमों और किसी भी कार्रवाई के बारे में ईएसएससी के निर्णय के पालन करने के लिए सहमत हूं । मेरी किसी प्रकार की क्षति के लिए ईएसएससी उत्तरदायी नहीं होगा।
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