Eligibility Determination Form

Kindly enter your details below

Official Name * :
Other Name :
Headquarters Address * :
Highest-Ranking Official * :
Name :
Address * :
Telephone * :
Mobile * :
Fax * :
E-mail * :
Award Category For-Profit/ Nonprofit Designation (Check as appropriate) * :
Size and Location of Applicant
A. Total Number of
Employees (Business) :
Faculty/Staff (Education) :
Staff (Health Care)
(this includes contract workforce) :
B. Sales in the preceding fiscal year (in Crores) :
Number of Sites :
Terms and Condition * :
Signature and Name of the Highest-Ranking Official :
 
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