MESC Media Skill Portal

1. General Details

2. Contact Details

3. Financial Details

4. Address Details

5. Submit

Please fill all the details carefully. No information can be changed once the form is submitted

Name of the Training Provider (TP) *

Name of TP should match with that written in the registration certification of the TP.

Type of Training Provider *

Website *

Name of CEO / MD / Head *

Email of CEO / MD / Head *

Mobile No. of CEO / MD / Head *

Designation of CEO / MD / Head *

Gender of CEO / MD / Head *

Name of the Authorized Signatory *

Same as above as CEO / MD / Head

Email ID of the Authorized Signatory *

Mobile Number of Authorized Signatory *

Designation of Authorized Signatory *

Gender of Authorized Signatory *

Name of the Single Point of Contact (SPOC) *

Same as above as Auth Signatory

Email ID of SPOC *

Mobile number of SPOC *

Designation of SPOC *

Gender of SPOC *

Landline No. of the TP

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Year of Incorporation *

Corporate Identification Number (CIN) of the TP *

Provide valid CIN Number

Certificate of Incorporation *

Please upload the specified document. Allowed File Type JPG | JPEG | PNG | GIF | BMP | PDF. Allowed File Size 5MB Max.

Permanent Account Number (PAN) of the TP*

PAN Proof *

Please upload the specified document. Allowed File Type JPG | JPEG | PNG | GIF | BMP | PDF. Allowed File Size 5MB Max.

GST No. of the TP

Provide valid GST Number

GST Proof

Please upload the specified document. Allowed File Type JPG | JPEG | PNG | GIF | BMP | PDF. Allowed File Size 5MB Max.

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Address Line 1 *

Address Line 2

Pin code *

State/Union Territory *

District/City *

Sub district (Tehsil/Mandal)

Parliamentary Constituency

Post Office

If Pincode provided is not available then make manual entry of the Post Office

Landmark

Address Proof *

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Number of Years of Experience in Skill Development

Total Number of Trainees Trained

Financial Year	Govt Funded Count	Corporate Social Responsibility(CSR) Count	Self Paid Count
2015-16
2014-15
2013-14

Total Number of Trainees Certified

Financial Year	Govt Funded Count	Corporate Social Responsibility(CSR) Count	Self Paid Count
2015-16
2014-15
2013-14

Total Number of Trainees Placed

Financial Year	Govt Funded Count	Corporate Social Responsibility(CSR) Count	Self Paid Count
2015-16
2014-15
2013-14

Recognitions/Accolades Type

Brief

Upload File

Allowed File Type JPG | JPEG | PNG | GIF | BMP | PDF. Allowed File Size 5MB Max. Please upload the related document(s)

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The applicant entity registering as Training Provider shall ensure the veracity of the information being provided through this form. It is attested by the applicant entity that the applicant entity has never been blacklisted or suspended by the Government of India, or any State Government or by any of its agencies, be it affiliated or autonomous. In case the information given here is found to be incorrect / misrepresented or misleading in any respect, National Skill Development Corporation (NSDC) shall have the right to initiate appropriate legal proceedings against the applicant entity and its director(s)/ proprietor(s)/ partners/ members of Managing Committee / officers. In such case, the applicant entity agrees to indemnify NSDC and its directors /officers for the same.
Further, NSDC shall have the authority to suspend or blacklist the applicant entity from participating in Accreditation, Affiliation, Continuous Monitoring and any other process. It is also agreed that the information about the suspension/ blacklisting would be made public and provided to all the Ministries implementing the Skill Development Schemes along with other relevant stakeholders.

WVT16A

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