Application under ST Category
A1. Name of applicant
*
First Name
Last Name
A2. Upload a passport size photo
*
jpeg or png format not exceeding 300 Kb size limit
A3. Current Address
*
A4. Permanent Address
*
A5. Attach permanent address proof
*
pdf format not exceeding 300 Kb size limit
A6. Are you located in Pune
*
Yes
No
If No, are you planning to relocate to Pune if selected for NIDHI-EIR support
*
Yes
No
A7. Email Address
*
A8. Mobile Number
*
A9. Alternate Number
A10. Date of Birth
*
-
Day
-
Month
Year
Date
A11. Gender
*
Male
Female
A12. Aadhar Card No.
*
A13. Attach Aadhar Card
*
pdf format not exceeding 300 Kb size limit
A14. Attach proof of Indian Citizenship
*
pdf format not exceeding 300 Kb size limit | Voter's ID, Passport, etc.
A15. Attach Caste Certificate issued by any one of the following competent authorities:
*
(pdf format not exceeding 400 Kb size limit) 1. District Magistrate/Additional District Magistrate/Collector /Deputy Commissioner/Additional Deputy Commissioner/ Deputy Collector/ 1st Class Stipendary Magistrate/Sub Divisional Magistrate/Taluka Magistrate/Executive Magistrate/Extra Assistant Commissioner. 2. Chief Presidency Magistrate/ Additional Chief Presidency Magistrate/Presidency Magistrate. 3. Revenue Officer not below the rank of Tehsildar. 4. Sub-Divisional Officer of the area where the candidate and/or his family normally resides.
B1. Current Career Status
*
Studying
Employed
Unemployed
Start-up Founder
Other
B2. Basic undergraduate training/education
*
B3. Any experiences relating to entrepreneurship, leadership, fund raising, organizing activities/ events etc.
*
B4. Attach CV or Resume in pdf format with details of education and work experience, if any (In prescribed format)
*
pdf format not exceeding 400 Kb size limit
To download the CV format
Click Here
C1. Please describe the technology for which you are seeking market opportunities or market for which you are seeking technology opportunities.
*
(Max. character limit -500)
0/500
C2. Please highlight innovative elements in your technology and also show the comparison with the existing similar product.
*
(Max. character limit -250)
0/250
C3. Specify applications of the technology.
*
(Max. character limit -500)
0/500
C4. Please specify quarterly milestones that you will achieve if supported under this programme.
*
(Max. character limit -750)
0/750
C5. Select any categories that may apply
*
Technology business ideas with larger technology uncertainties and/ or long gestation periods
Technology business ideas leveraging technology or IP from publicly funded research or academic organizations
Technology business ideas with considerable potential for social impact.
D1. Applicant confirms that he/she has not been a recipient of the NIDHI-EIR previously. NIDHI-EIR can be used only once
Yes
No
D2. Applicant is planning to pursue NIDHI-EIR full-time with no other concurrent commitments
Yes
No
D3. Applicant confirms that he/she will not be in receipt of any other remuneration or fellowship during the duration of the NIDHI-EIR
Yes
No
D4. Applicant confirms that he/she is fully committed to exploring a business idea. NIDHI-EIR support recipient should not treat this support as a stop gap arrangement to support them in their academic pursuits or transition between jobs
Yes
No
D5. Applicant confirms that he/she is not the promoter or significant (>10%) share holder / beneficiary of another company at the time of applying for and receiving the NIDHI-EIR support
Yes
No
D6. The NIDHI-EIR has or is planning to register for the pre-incubation or incubation program at Science and Technology Park, Pune for the entire duration of NIDHI-EIR support
Yes
No
I confirm that the above mentioned information is true.
I confirm that I have read and understood the guidelines.
I confirm that I meet requirements of the programme and shall abide by the rules of the programme.
I confirm that I shall provide all requested data and information to the Science and Technology Park, Pune and PIP in a timely manner.
I commit to keeping Science and Technology Park, Pune promptly informed about all key business related developments including incorporation of company, success in raising grant/equity/other funding etc.
If selected as NIDHI-EIR, I will avail support under NIDHI EIR scheme from only one NIDHI-TBI for the shortlisted idea.
I will not avail the funding support from both the schemes i.e NIDHI-PRAYAS and NIDHI - EIR simultaneously, from the same or different NIDHI-TBIs.
None of my team members will avail support under NIDHI EIR scheme for the project which has already been funded under NIDHI-PRAYAS and/or NIDHI – EIR under any of the current or previous rounds.
Signature
Sign with mouse cursor or through touch gesture on your smartphone
Date
*
-
Day
-
Month
Year
Place
*
Submit
Should be Empty: