Application form for Availing Incubation Services at SINED (TBI),

NDRI Campus, Karnal

(Please read the footnote before filling in/submitting the application)

Name of Business:
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( If business entity has not been formed yet, please indicate the name of the
lead entrepreneur)
Name of Lead Entrepreneur (A separate resume may also be attached)
Full Name: Mr/Ms/Dr/Prof
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Father Name: ___________________________________________________
Age: __________________________________________________________
Phone: Res: _______________ Office: ______________________________
Mobile: __________________________________________________
Email: ________________________________________________________
Postal Address / Residential Address: ________________________________
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City___________________ State: _____________Postal Code____________
Country:

Educational Qualification:
Highest Qualification: _______________________________________
Year of Passing

: _______________________________________

Grades Obtained

: ______________________________________

Area of Specialization: ______________________________________

Name of Institute/ University:
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Research Experience:_____________________________________________
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Non-Academic Achievements: ____________________________________
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Industrial Experience: ___________________________________________
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Entrepreneurial Experience: _____________________________________
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Research & Development Experience: ______________________________
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Business Experience: ____________________________________________
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Marketing Experience: __________________________________________
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Why you want to become an entrepreneur?*: (Attach separate sheets, if

required)
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List the name(s) of co promoters (If any)
(Add additional sheets, if required)
(An individual resumes of each member may also be attached)
1. Name: _______________________________________________________
Educational Qualification: _______________________________________
No of years of experience: _______________________________________
Address: _____________________________________________________
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Phone: _______________________________________________________
2. Name: _______________________________________________________
Educational Qualification: _______________________________________
No of years of experience: _______________________________________
Address: _____________________________________________________
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Phone: _______________________________________________________

Business Proposal
GENERAL DESCRIPTION OF BUSINESS

(Provide detailed information. Attach extra sheets or business plan if

necessary. However please do not write See business plan.)
Details of the product(s) proposed*
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Does your business require any governmental or regulatory approvals?
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Legal entity (proposed)
(Proprietorship/Partnership):________________________________________
Core Competence of the Promoters: _________________________________
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How do you think your past experience is going to help you in this new
venture?
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Technology Details:
Is this technology your own? Or obtained from other sources?
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If your own, have you completed technology development? Or what stage you
are in the development process? What is the estimated time for completion of
the development of the technology?

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Is your business idea depends on application of certain technology, which
needs to developed? If so, please briefly describe the same?
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Do you need technology development and research assistance?
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Ownership of IP (Whether NDRI or NDRI Faculty owns it or any other?)
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Has NDRI has given permission to use IP/NOC in case of IP owned by NDRI
faculty?
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How IP has been generated? (With details of Consultancy/Sponsored
Research/ Student projects involved in it.)
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If technology for your project is provided by another lab or agency, please
indicate the name of agency.
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What is your arrangement for technology transfer and royalty payment etc
with the technology providing source?

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Do you envisage any modification to the original technology obtained from
the technology-providing agency? Please describe the same with facilities
required for customizing the technology obtained.
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Do you have markets export market for your products?
Yes (

No

If so, which nations / regions?

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Have done any research or survey to validate your assumption on this?
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Funding*:
Have you estimated and identified your seed funding needs/ source?
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Do you need any machinery or capital item for starting of your venture?
If yes, please specify the same with the purpose.
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Have you estimated your Project cost? (Detailed Business Plan may be
enclosed)
If yes, please give the break-up, as below:
Pre-operative expenses

Rs.

Prototype Development

Rs.

Test marketing

Rs.

Fixed Costs (Equipments, etc)

Rs

Working Capital

Rs.

Other Requirements

Rs.

Total

Rs.

What sales volume is needed to break even and in what timeframe?

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Investment requirements for first 36 months of operations (indicate amount
and sources of finance):
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Cash flow projection for the next 36 months.
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Major business activities planned for the next 36 months:
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Attach recent balance sheet and income statement if available. If not then give
reasons there for:
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Marketing
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Have you done market survey?

(If yes, briefly describe the method and results including target markets)
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What unmet market need or demand your product(s) fulfill (end usage)?
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Details of your potential customers:
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Details of your major competitors:
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What are your competitive advantages?
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Describe your pricing strategy:
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How will you promote/ advertise your products/ services?
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How will you procure raw materials?

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Who are your major suppliers?
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How will you distribute your products?
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What are the major risks attached with your business?
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Other factors that you wish to provide for consideration of your proposal:
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FACILITIES REQUIREMENTS IN BUSINESS INCUBATOR:
Why do you want to locate in the NDRI Technology Business Incubator?
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Infrastructure requirement for space, equipments, etc:
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Minimum services expected from NDRI-TBI* (Please tick appropriate option)

1.
2.
3.
4.
5.
6.
7.

Telephone
Fax
Shared laboratories access
Business Consulting service
Web Access
Use of conference rooms
Advisory services

:
:
:
:
:
:
:

Yes (
Yes (
Yes (
Yes (
Yes (
Yes (
Yes (

) No (
) No (
) No (
) No (
) No (
) No (
) No (

)
)
)
)
)
)
)

List any special requirements for usage of NDRI laboratory facilities:

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Specify requirement of Mentoring and other professional services/ support:
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Indicate how your business might benefit from access to NDRIs human and
physical resources.
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If accepted as an incubatee, when would you want to start occupancy in the
Incubator?
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Manpower skills required*

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How many total employees will be occupying space? (Give details year wise)
Full- Time ______________
Part-Time ______________
Job creation: (Indicate precisely how jobs will be created/ retained)
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Are you currently occupying a facility (either in your home or at a commercial
location)?
If yes, what is your current occupied area in square ft.? What is your
approximate monthly cost for this facility?
Rent: Rs.______________ Utilities: Rs. ____________________
Any other relevant information
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How did you learn about NDRI-TBI?
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References*: (Give two references here, verification will be done after
completion of the selection process)
1. Name of the Reference: _________________________________________
Organization/ Designation_______________________________________
Address________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Phone: ___________________email:_________________________________
_______________________________________________________________

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2. Name of the Reference: _________________________________________

Organization/ Designation________________________________________
Address________________________________________________________
_______________________________________________________________
Phone____________________ E-mail:_______________________________
Declaration:
The information that I/we have provided is correct. I further declare that the
information that I have provided herewith are not proprietary in nature and
that I would not make any claim on same. I have also read and understood and
accepted the terms and conditions set forth in the disclaimer given in the
footnote of this application.

Date

Signature of Applicant(s)

Place:
(Please check whether you have filled in all the details and attached all the
relevant information as described /required here)
* Marked fields are mandatory
The completed application with all enclosure may be emailed to
aksndri@gmail.com. Filled & printed copy may be sent by courier or
post to:
Dr. A.K. Singh
Sr. Sci. (DT), NDRI & Secretary,
Technology Business Incubator (TBI)
Society for Innovation & Entrepreneurship in Dairying (SINED)
National Dairy Research Institute Campus (NDRI)
Karnal 132 001, (HR)
India
Tele: +91 184 2259291
Mob. No.: +91 9416292406
E-mail: aksndri@gmail.com
A note to the applicant:
1. It is mandatory for all incubatees to become member of Society for Innovation & Entrepreneurship in Dairying
2. Disclaimer: Every professional effort would be made by SINED-TBI to treat and handle this information provided
here as confidential. However, by signing and applying to SINED-TBI for incubation assistance on this application
form, you agree not to make any claim or demand compensation unconditionally in any form, at any point of time,
now or any time in future, on the information / technology details provided by you here as trade secret or proprietary
intellectual property. This information is required by SINED -TBI to assess the candidature for the purpose of
providing incubation services. Further SINED-TBI does not guarantee acceptance of your proposal until and unless
the selection process is over and SINED-TBI has the right to reject any proposal without assigning any reason what so
ever. SINED-TBI will not pay any compensation to you in any form for the delay in communicating the decision or
rejecting the proposal at its own discretion

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