GOA - EAP Registration

Registration for Business Management Training

Program Name^*

Name of the Candidate (Which will be printed on the Participation Certificate)^*

State of the Candidate^*

District of the Candidate^*

Taluka^*

Address

Mobile Number^*

Email Id^*

Gender^*

Date of Birth^*

Social Category^*

Education Qualification ^*

Aadhaar Number

Are you a Person with Disability?

Awareness about the program? ^*

Type of Entrepreneur ^*

Business Name/Firm name (As per UDYAM)^*

Type of Business

Date of Incorporation

Number of full-time workers in your enterprise

Annual Turnover in Rs.(INR) (Total Sales Value in a Year)

Udyam Registration Number

Industry Type

Category of MSME Unit

Details of Business (Provide major business Activities)

Copy of Udyam

The information provided above is true and correct to the best of my knowledge. Also I understood the Consent of the Participant ^*
I Agree