APPLICATION FORM
For participation in Domestic/International exhibitions/trade fairs through NSIC
(It is mandatory to fill all the fields)
1 Exhibition
Name
2 Duration/Date &
Venue
3 Brief description of
event
4 Objective to attend
the event
5 Details of unit seeking assistance from NSIC
a Unit Name (with
website, if any)
b Sector as per
UAM/Udyam
Registration
Certificate Manufacturing Service
(please tick the
appropriate
column)
c Category as per MICRO SMALL MEDIUM
UAM/Udyam
Registration
Certificate (please
tick the appropriate
column) MICRO
d UAM/ Udyam
Registration
Certificate No.
e Details of Products
manufactured/
Services rendered
(Must match with
UAM/Udyam
Registration
Certificate)
f PAN No.
Registered on
g MSME Databank Yes No
Import Export
h Code No.
i GSTIN
j ISO Certified Yes No
k Category of General Scheduled Scheduled Women North-East
promoter (attach Caste Tribe entrepreneurs
documents in r/o
SC, ST, Women
or NER)
(Please tick
appropriate
column)
l Name of
Promoter/
Chief Executive
m Contact Person
n Factory/Unit
address
o Contact details Phone Fax Mobile E-mail
p Promoter’s
Residence
address
6 Details of product
to be displayed
a Nature of Machines Equipments Brochure display etc. Electronics Any other
Display proposed (audio/ visual etc.) (Pl. specify)
in the exhibition display of products
& services
Pl. tick the
appropriate
column(s)
7 Passport Details
a Name as in Passport Date of Birth Passport No. Place of Issue Date of issue Date of Expiry
8 Payment Details Amount (in INR) Bank Name Bank Address DD Number Date of DD/
(Only through Online Payment
DD/RTGS/NEFT)
9 Whether the unit has availed assistance from the corporation during the last 3 financial years & current Yes No
financial year under Special Marketing Assistance/International Cooperation Scheme. (Please Tick)
a If Yes, please provide the Name/date/place of the Exhibition participated Benefits Accrued out of previous
details participation
11 I have read the terms and conditions/ Guidelines of International Cooperation Scheme/Special Marketing Assistance Scheme for
participation through NSIC and agree to abide by them. The above information, as provided by me, is correct & true to my belief.
Date: Place: Name & Signature:
Exhibition Division, National Small Industries Corporation Ltd.
NSIC Bhawan, Okhla Industrial Estate, New Delhi-110020
Tel. 011-26926275
Email: exhb@[Link], website: [Link]
