NCW & ISF - MENTORING PROGRAM
APPLICATION & DECLARATION FORM
Name : _________________________________________________________________
Paste Your
Name of Father / Husband : ________________________________________________
Passport Sized
D. O. B. : _______________________ Highest Qualification : _____________________
Photo
City : _____________________________ State : _______________________________
Company / Firm / Enterprise Name : ______________________________________________________
Nature of Business: ____________________________________________________________________
Describe the Business : __________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
APPLICATION & DECLARATION
I, _____________________________________declare that I have been selected to undergo
mentoring program free of cost, by NCW & India SME Forum, as a mentee and I hereby apply to
enroll in the program for a period of 6 weeks.
1. I hereby warrant and represent the following
- I am at least eighteen (18) years of age; and a citizen of India
- I already have a business and own at least 30% of the enterprise represented by me
or
- I am starting a full time business, with the Idea presented by me.
(Strike out what is not applicable)
2. In case any information submitted by me in my/ interview, application is found to be hidden /
falsified / incorrect in any manner, I shall automatically stand disqualified with no further
recourse/ explanation whatsoever.
3. All information sent / shared by me is subject to verification and I, as the applicant agree to
furnish / produce the documentary proofs as demanded, from time to time, for any significant
variations noticed and communicated.
4. I realize the importance of the program and this investment in me and my business. I agree to
attend all the sessions in the program, without missing any sessions / workshops or coaching
time as per the mentoring calendar. I shall inform the organizers in case of inability to attend any
class in case of an emergency and understand I may be disqualified for missing it.
Speed Post to : Mentor Desk, India SME Forum,
DD 30, Block DD, Near Post office, Kalkaji, Nehru Enclave, New Delhi - 110019
NCW & ISF - MENTORING PROGRAM
APPLICATION & DECLARATION FORM
5. Sending in my entry, or submission of the Idea, in no way grants / transfers any rights therein or
otherwise to ISF or NCW or any other person. I will/have register(ed) the copyright /
patent of any intellectual property before submission to protect my rights under applicable
copyright / IP laws and I am solely responsible for protecting my rights in the Idea.
6. I agree to use of my information / picture/ story for promotion or reporting by NCW & ISF,
however, selection of participants for further support / publishing/ featuring as success stories, is
the sole decision of the Program Committee and I shall abide by their decision and I understand
that no discussion or correspondence shall be entertained in this matter.
7. I understand that all the mentees should have a full-time business and with full focus, spend full
time on the program and any mentee who is doing it part-time or as hobby will automatically be
disqualified.
8. I understand that all mentees have to complete the weekly assignments on time, in the
Mentoring program and failing to submit any assignments before the next session, may lead to
disqualification.
9. I understand that I may be disqualified under the following circumstances, in case :
- The mentor assesses / evaluates that I am not able to successfully progress or unable to complete
the program.
- I fail to respond adequately within a reasonable time to engage with the pace of the program of
my inability to submit assignments on time and adhering to the schedule.
- I skip any class without prior notice to Mentor / Program Manager
- If I share any information about the program or its participants, without written permission
I acknowledge that I have read, understood and accepted all the aforementioned Terms &
Conditions.
I declare that all information given by me is true and accurate and understand that any false
/incorrect information given by me during the course of application and mentoring or indulging in
spreading falsehoods, misinformation or miscommunication about the program, may lead to legal
action.
Signed by me :
Full Name: ________________________ Signature: ________________________
Date : ____________________________ Place : ____________________________
Speed Post to : Mentor Desk, India SME Forum,
DD 30, Block DD, Near Post office, Kalkaji, Nehru Enclave, New Delhi - 110019
