APPLICATION FOR COMPREHENSIVE ENTREPRENEURSHIP DEVELOPMENT PROGRAMMES IN BIOTECHNOLOGY IN NORTH EASTERN REGION

PART-A (Introductory information) 1. Personal Information of the candidate

Name :

Dawrul Islam

Date of Birth:

02-May-1991

Sex:

Male

Occupation:

Student

Permanent Address :

Syeid wara Mohalla Ghazipur

Mailing Address:

Khan 529KA/136 SHYAM NAGAR KHURRAM NAGAR NEAR MOUNTBERRY COLLEGE PIN 226022

Telephone/Mobile:

09565568970

e-mail:

Dawrul_GE@rediff.com

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2.Educational Qualification: (Please give details of your educational qualification in the chronological order) S. Degree/Diploma No. 1. 10th University/Board Subjects % of Marks Year of completion 2007

CBSE

2.

12th

CBSE

Eng, SSt, Maths, Science, CS, Hindi PCB, English and Computer Science As per UGC and AICTE credits

72 %

71%

2009

3.

B.tech Biotechnology

Integral University

75 %

2013

3. Experience of the candidate (starting from recent) S. No Name of the Organization Position From Period To Nature of work

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4. Whether you have already had exposure to similar trainingworkshops? Yes If yes, please provide the following S. No Type of Training Organized by Duration No

5. Are you already engaged in any entrepreneurial activity? Yes No

If yes, please provide the following Name of the organization : GECP-2012

Type of organization : Private (Proprietorship firm, Partnership, Public, Private, Others, please specify)

Nature of work of the organization

: Good

Number of employee

: 10-20

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PART-B (Concept note)

1. Area of interest for biotech venture (Tick any one) Micropropagation Orchid culture Biofertilizers and Biopesticides Production Medicinal and Aromatic Plant Extraction Secondary Agriculture (Value added products from ginger, rice, chilli, tomato etc) Any other please specify: Genetic Engineering

2. Briefly highlight your vision and specifics objectives for starting the biotech venture in the identified area

3. What are your proposed products in the identified area? Have you calculated the market potential of the products? If yes, give details

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4. What is proposed production capacity and marketing strategy? (if any home work has been done)

5. Are you prepared to contribute minimum of 30-40% of the total project cost for establishing selected venture (as per the requirement of banks for providing loans to bankable projects)

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Part C (Declaration and undertaking)

I hereby declare that all the information provided by me are true and complete to the best of my knowledge and nothing has been concealed/distorted. I also undertake to participate in the whole programme starting from orientation programme to preparation of detailed project report,if selected.

Place : Lucknow

Signature: Dawrul Islam

Date: 17/08/12

Name: Dawrul Islam

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