Photo of Photo of head of
Proposed RC In- Organization
Application format for
Charge Authorization of NAC as Regional Council
Under PGS-India Programme
1. Name of the Applicant
Organization
Address
City, State
Pin code
Telephone No with STD 1.
code 2
3
Mobile No (if any) 1.
2.
Fax No.
Email
2. Name of the head of
organization
Designation
Address
Phone No 1
2
3
Email
3. Name of the Person
responsible for operation
of Regional Council
Address
Phone No
Email
4. Status of Organization Central Govt
State Govt
Central/State Govt Agency
Cooperative
NGO
Company
Other
1
5. In case of Cooperative/
NGO/ Pvt. Company etc
Registration No with act
under which Registered
(Attach copies of
Registration, bye laws)
6. Financial category Government
(In case of Cooperative/ Govt Funded
NGO/ Pvt. Company etc Self financed
attach last 3 years Other (Pl specify)
audited balance sheets)
7. Facilities available Technical staff
(Attach list with photos, qualifications and experience)
Computer
Internet
Vehicles
Office
(Own building or rented)
Specify area
Total staff strength
(Attach list of staff members with photos, designation and
qualifications and assigned work)
8. Experience / competence
in Organic farming
(Attach proof)
9. Whether worked as
service provider of
Central/state Govt/ other
agency for organic
adoption and certification
(Attach proof)
10. Experience in any
Participatory Guarantee
System (Attach proof)
11. Experience in organic
certification system or
ICS (Attach Proof)
2
12. Knowledge in organic PGS-India
standards NPOP
NOP
EU standards
Others (Pl specify)
13. Proposed area of
operation
14. Whether already have
registered farmers as per
the requirement of PGS
guidelines (If yes then
provide details, Group
wise with list of farmers
in each group and their
organic status)
15. Regional Council
Operational manual
prepared or not
(If yes then provide a
copy)
16. Local Group operational
manual prepared or not
(If yes then provide a
copy)
17. Detailed strategy of
operation as Regional
Council.
(If required attach on
separate sheets)
3
18. Approximate time for
making Regional Council
functional
19. Any other information
20. List of enclosures
attached
I/We the members of the organization hereby declare that the information provided above
is true to the best of my/ our knowledge.
I/ We have read the PGS-India operational Guidelines and are convinced that the
proposed organization ………. (Give name of Organization) …….. fully meets the
eligibility criteria prescribed in PGS-India guidelines.
I/We understand that PGS-India Programme do not provide any financial assistance and
the entire operation shall be taken up from the organization’s sources
I/We declare that the organization is in sound financial health and capable of meeting the
expanses needed for operation of Regional Council.
I/ we declare that on being selected as Regional Council under PGS-India programme we
undertake to abide by the PGS-India guidelines and instructions issued by the NAC/ PGS
secretariat from time to time and shall implement the programme in true spirit of PGS
Principals
Signature Signature
Name Name
Designation Designation