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Service Request
TECHNOLOGY SERVICE REQUEST
Date:
Ref. No.
(For office use)
COMPANY PROFILE (Enclose Company Brochure and Annual Report)
1. Company Name
*
2. Contact Person/Applicant
*
3. Year of establishment
*
4. Address
*
5. Telephone
*
Fax
*
E-mail
*
Website
6. Ownership
Private Public
Government
Owned
Joint venture
7. Manufacturing
Trade
Consultancy/Services
8. Turnover Rs.
Sales Rs.
Export Rs.
Import Rs.
Auth.Capital Rs.
9. Name Address of affiliates,subsidiaries,parent companies, if any (attach separate sheet)
10. Product(s) currently produced
11. Raw material source: Domestic
Foreign
Both
12. Manpower-Technical Permanent
Non-technical Seasonal
13. Main Production Equipment & Facilities (attach separate sheet)
14. In case of Fresh Entrepreneur, give details of educational,professional & financial background (attach separate sheet)
CATEGORY OF SERVICES REQUIRED
Technology Search/Sourcing Request
Technology Marketing/Promotion Request
Project Execution Assistance Request
Assistance in Preparing Project Report
Project Evaluation
Technology Finance
Implementation
Monitoring
Technical Problem Solving
Market Promotion
Technology Audit
Testing facility
Common utility / waste facility
Certification Assistance
Any other technical service
Please explain in Detail
(add documents if necessary)
All (*) fields are mandatory
Copyrights 2009 Tamil Nadu Technology Development & Promotion Centre.
