BOARD OF APPRENTICESHIP TRAINING (SOUTHERN REGION)

BOARD OF APPRENTICESHIP TRAINING (SOUTHERN REGION) Autonomous Body of Ministry of Human Resource Development Department of Higher Education, Government of India IV Cross Road, Taramani, Chennai 600 113. Ph: 044-2254 2236 / 2254 1292 Fax: 044 2254 1563, 2254 2492 E-mail: boat_sr@vsnl.net Website: www.boatsr-apprentice.tn.nic.in Webportal ID : www.boat-srp.com NWP/PL/09 Survey Information Proforma for Apprenticeship Training of Graduates & Diploma Holders in Engineering / Technology under the Apprentices (Amendment) Act 1973 & 1986 To be Sent to our office within 15 days (Enclose details separately if required) PART-1 (EMPLOYER S DETAILS) 1. Name of the organisation / Establishment : 2. Name of CEO / CMD / MD : 3. Address for Communication (i) Head Office / Corporate Office (ii) Factory Door No: Street / Road: Locality: Place: Door No: Street / Road: Locality: Place: Pincode : Pincode : Phone with STD Code : Phone with STD Code : Mobile No. : Mobile No. : Fax : Fax : E-mail : E-mail : Website : Website : 4. Name and Designation of the Officer(s)In-charge of Apprenticeship Training (i) Training officer : (ii) Officer In charge for Claim : 5. Year of Establishment :

PART-II NATURE OF INDUSTRY (SECTOR & ACTIVITY) 6. Nature of Industry / Organization (Sector) (i) (ii) (iii) (iv) (v) (vi) Central Government State Government Public Sector Undertaking (Central) Public Sector Undertaking (State) Co-operative Society Private Establishment (a) Public Limited Company (c) Partnership Firm (b) Private Limited Company (d) Sole Proprietorship (vii) Any Other Form of Organisation (Specify) 7. Nature of Technical Activity (i) Manufacturing (ii) Processing (Chemical / Food) (iii) Construction (iv) Automobile (v) Communication (vi) Power (vii) Project (viii) Software (ix) Services (a) Health (b) Education (c) Hotel (d) Hotel (e) Communication (f) Hardware

PART-III MAN POWER DETAILS 8. Number of persons employed in Managerial/Supervisory positions with Degree or Diploma in Engineering / Technology. Sl.No. Field of Engineering / Technology Degree in Engg. Total Diploma in Engg. 1. 2. 3. 4. 5 6 Mechanical Engineering Electrical and Electronics Engineering Electronics and Communication Engineering Computer Science & Engineering Other fields (Specify) Total Grand Total PART- IV INFRASTRUCTURE FOR IMPARTING TRAINING 9. ( i ) Do you have a separate Training / Department / Section Yes No (a) If yes, (Provide organization Chart of the Training Department) If not, who co-ordinates the training activities? (Give Name, Designation and Qualification of the person.) 10. Do you have exclusive workshop facilities Yes No For training? 11. Do you have lecture-halls/rooms for Yes No Conducting group discussions & meetings? 12. Do you have a technical library under the Control of the training department Yes No 13. Do you have hostel facilities for accommodating trainees? Yes No 14. A. Do you have canteen facilities for Trainees? Yes No B. Do you have Transport facilities for Trainees? Yes No 15. Do you involve your trainees in the normal production activities of the Organisation? Yes No 16. Do you have your own management training Scheme 17. Where do you draw the faculty from? Yes No a) Training Department Yes No b) Other functional areas within the Organisation Yes No c) Outside faculty Yes No

PART- V : APPRENTICES REQUIREMENT : 18. Indicate field wise and category wise no. of Apprentices required. Proposed Training Slots Sl. No 1. Fields of Engineering/ Technology Mechanical Engineering Current year Next year Grad Tech Grad Tech Monthly Stipend / Salary in ` 2. 3. 4. 5 Electrical and Electronics Engg Electronics and Communication Engg Computer Science Engineering Other fields (Specify) TOTAL : 19. Any other relevant details you wish to give : Yes NO (Please ) If yes, Please attach separate sheet 20. Check list for issuing notification (Please ( )). 1. Covering letter Yes NO 2. Company Profile Yes NO 3. SIP filled in all respect Yes NO 4. Authority Signature and Office seal Yes NO 5. Structured Training Module Yes NO 6. Latest Income Tax Return Yes NO 7. Copy of MoA Yes NO 8. Certificate of Incorporation Yes NO 9. Category wise no. of apprentices required. Grad. Tech. 10 Subject field wise no. of apprentices required. Grad. Tech. 11. Any other documents pertains to Training Yes NO Place : Date : Signature : Office Seal : Name : Designation : Mobile : Landline No. :

ONLY FOR BOAT (SR) OFFICE USE (Organization need not fill up the below mentioned particulars) PART-VI TRAINING SLOT ASSESMENT 1. Name Of The Establishment : 2. File No. BAT / SRP / Date : 3. Survey Report Received On : 4. Whether the survey is Fresh / Resurvey ( ) 5. Recommendation for Notification Of Training Slots : Sl. No. Discipline Grad Tech Total TOTAL: 6. Total Numbers of Industries as per Survey Report in the respective Sector : Graduate Technician 7. Total Number of Training Slots as per Survey Report in the respective sector : : 8. Any other Remarks : Dealing Asst. Dy. Director / Asst. Director Submitted For Approval Director of Training