MSMEs
MSME'S ASSOCIATION/ Govt. Organizations
MSME Unit
DESIGN SERVICE PROVIDER
Design Consultant
Design Firm
Design Institution
Design Student
18th May, 2012
Suruchi Shikshan Vasahat Trust,
26th May, 2012
Design Awareness Seminar
Jharkhand Small Tiny Service & Business Enterprises Association,
EAST Zone
Bokaro, Jharkhand
May, 2012 (date tentative)
NORTH Zone
Mau, Uttar Pradesh
May, 2012 (date tentative)
Design Awareness Seminar
MSME DI, Roorkee
Survey & Drawing Instruments
NORTH Zone
Roorkee
May, 2012 (date tentative)
Design Awareness Seminar
Foundation of MSMEs,
Sports Goods,
NORTH Zone
Jalandhar
May, 2012 (date tentative)
Design Awareness Seminar
Hosur Small & Tiny Industries Association,
Engineering,
SOUTH Zone
Hosur, Tamil Nadu
May, 2012 (date tentative)
Design Awareness Seminar
Moga Agro Industries Association,
Agro Products,
NORTH Zone
Moga, Punjab
May, 2012 (date tentative)
Design Awareness Seminar
Sewing Machine Association,
Sewing Machines,
NORTH Zone
Ludhiana, Punjab
May, 2012 (date tentative)
Design Awareness Seminar
Solar Energy Society of India,
Solar Equipments,
NORTH Zone
Delhi
DESIGN CLINIC REGISTRATION FORM FOR
Design Firm
APPLICATION FOR DESIGN CLINIC SCHEME FUNDING ASSISTANCE
(To ensure the easy and correct processing of your application, please ensure that the application form is filled up completely and neatly. Where information is not available or applicable, please indicate accordingly. Please enclose all supporting documents as
requested in the form).
1. GENERAL
a.
Registered name of Firm
*
b.
Registered as (please tick)
*
Sole Proprietorship
Private Limited
Other (please specify)
c.
Total Numbers of Consulting and Technical Staff
*
Less Than 10
10 to 50
50 to 100
100 and more
2.
CONTACT INFORMATION
Contact Person (please mention initials as Mr.,Ms.,Mrs. etc.)
*
Address
*
District
*
State
*
PIN Code
*
E-Mail
*
Phone No
Mobile
Fax
Website
3.
DESIGN EXPERTISE DETAILS
a.
Work experience (In Total number of years)
*
b.
Functional area of Specialization / Interest
*
Industrial design
Branding and Advertising
Visual Communication
Products/service specialization.
Design and systems Thinking (Product / Process / Business Design )
Other (please specify)
c.
Preference for Industrial Sector (Textile, Automobile, Pharmaceuticals, etc)
*
d.
Consulting and service activities Information and references
i
ii
iii
iv
4.
DESIGN CLINIC INFORMATION
If already registered with MSME Design Clinic or Other such programmes please mention Other MSME projects information
*
Yes
No
5.
Please mention the activities you would be interested to take up for DC
Design Sensitizing Workshop -
1 Day workshop/seminar
Need Assessment Survey and Design Clinic -
3-4 Days workshop/seminar
Design Projects -
Scheduled project
6.
Prefered Zone for Design Clinic Projects.
East Zone
West Zone
North Zone
South Zone
7.
Attach a file (e.g. Visiting Card, Portfolio...)
(Maximum size of the zipped folder attachment should not be larger than 10mb)
SUBMIT
