Application Form For Financial Assistance to Conduct Study/Survey/Workshops/ Seminars Relating to Food Safety, Quality 1. Name of the Organization Complete Address Tel. No. Fax No. 2. Type of Organization (Central/State Government Organizations, IITs, Universities, Co-op. Society/ Individual/NGO/others (specify). 3. Main activities of the Organization 4. Purpose and subject of Study/survey/Workshop/Seminar 5. Methodology to be adopted 6. Terms of Reference 7. Benefits from the proposed activity 8. Time/implementation schedule for completion of proposed Activity 9. Cost of proposed activity along with detailed break up. 10. Assistance sought from MFPI 11. Payment Schedule 12. How does the organisation propose to finance the balance? Requirements of funds 13. Previous study/Workshop/Seminar conducted by the Organization. Please furnish a copy of best report with following Details: Subject of Study Organization Year Amount /Workshop for which done received 14. Assistance already Component/ Amount year Availed from MFPI Activity for which received (Give name of assistance was (Rs.) The Scheme) taken 15. Whether Utilisation Certificate in form 19-A duly counter-signed By Chartered Accountant has been sent in regard to Grant-in-aid received earlier from MFPI. 16. Enclosed a technical bio-data of persons proposed to be Appointed for the project. 17. List of Enclosures Place: Authorized Signatory Date: Name (block letters) Designation (with special seal of organization/individual)