APPLICATION FORM

FOR

AFFILIATION OF TRAINING PROVIDERS (TP)

TO

TELECOM SECTOR SKILL COUNCIL (TSSC)

UNDER

PRADHAN MANTRI KAUSHAL VIKAS YOJANA (PMKVY)

 Pradhan Mantri Kaushal Vikas Yojana

The Affiliation Proposal to be sent only in one single Spiral Bound form. It would not be accepted
in loose, stapled, cobra / box file.

GENERAL INSTRUCTIONS

1. TPs to follow SSC’s affiliation process

2. The application has to be applied offline by the training providers interested for affiliation
to a particular SSC

3. The link to the process of application will be available via SSC and NSDC website

4. Copies of all the relevant documents should be scanned and uploaded with the online
application form

5. In addition to online application, a print-out of this application form along with hard copies
of the relevant documents has to be sent to the concerned SSC by the VTP/ Institution

6. Please sign and stamp every page of the document

Application for Affiliations for the Following Job Role(s)

(As Per Qualification Packs Valid For The Scheme):

S. No. Job Roles Qualification Pack Reference Number

1.

2.

3.
4.

5.

6.
7.

(More columns may be added, as required)

 Pradhan Mantri Kaushal Vikas Yojana

Section 1: Institution and Management Profile

1. Name of the Training Provider:

_________________________________________________________________________
_______________________________________________________________________

2. Whether NSDC or others

☐ NSDC
☐ Others

3. Name(s) of all Director(s) / Owner(s) as on date:

S. No. Names

1.
2.

3.

4.

4. Contact Details of the Institution:

Postal Address

Pin Code

Phone Number with STD Code

Fax No

5. Year of Establishment: _____________________________________________________

 Pradhan Mantri Kaushal Vikas Yojana

6. Prior Exposure of the TP in Skill Development Space – (Provide details of affiliation with
NSDC. Please attach relevant proof)

7. Institute’s Medium of Instruction:

☐ English ☐ Hindi ☐ Any Other

Please specify: ______________________________________________________________

8. Does the Institute have branches?

☐ Yes ☐ No

(If yes, attach the list of Branches as Enclosure 1)

9. PAN: ________________________________________________________________

10. TAN: _______________________________________________________________

(Attach photocopy of the PAN and TAN card as Enclosure 2)

11. Turnover of the TP: ______________________________(Last Financial Year)

14. Is the Institute recognized with any bodies or affiliated with any Regulatory body?
☐ Yes ☐ No

15. If yes, please mention the following:

Name of the body with which recognized or

affiliated regulatory body
 Pradhan Mantri Kaushal Vikas Yojana

Recognition no./ affiliation number

Year of recognition/ affiliation

Validity of recognition/ affiliation

(Attach recognition and/or affiliation certificate as Enclosure 3)

21. Educational Qualifications and Experience of the Director(s), Management Team

members, Operational Head(s) and Affiliation Coordinator(s) for VTP/Institution:
Name of Director(s),
Management Team Overall Work Prior Experience
members, Educational Key Achievements in
Experience in the Skills
Operational Head(s) Qualifications the Skills Development
(in years) Training Space
and Affiliation
Coordinator(s)

22. Provide the Contact Details of the Director(s), Management Team members, Operational
Head(s) and Affiliation Coordinator(s) for VTP/Institution:
Contact Numbers –
Email-ids
Name Contact Address Both Land Line and
Mobile
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23. Provide your bank details:

A/C Number

Bank Name

IFSC Code

Section 2: Training Operations - Processes

24. Details of documented process for management of Human Resources.
Aspect Yes/No
Recruitment guidelines and criteria based on required competencies

Training and professional development plan and processes

Maintaining records of qualifications and experience

SSC Specific add-ons

25. Details of the Teaching Staff/ Trainers

Sector Instruction SSC
S. Degree/ Training Regular
Name Designation / Trained
No Diploma Certificate Experience Experience ?
(Years) (Years) Visiting
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1.
2.

9.

26. Administrative support staff

S. No. Staff Permanent Temporary/Part-time Total
1. Office Manager

2. Office Staff

3. Lab Attendants
4. Accountant

5. Support Staff

6. Others
7. Total

27. Details of the curriculum of the all the courses offered

Aspect Yes/No Remarks

Process of adoption and/or development of

curriculum on the basis of QP and NOS
developed by the SSC

Review process to gauge the effectiveness of the

curriculum developed
Clear demarcation of time to theory and practical
as per the criteria set by regulatory bodies

Activity based pedagogy inclusive of time

schedule and lesson plan

Process of SME engagement in curriculum

design and development

Review process for approval of curriculum from

the SSC
SSC specific inputs (if any)
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28. Details of the courseware of all the courses offered.

Aspect Yes/ No Remarks

Process of adoption and/or development of

courseware on the basis of QP and NOS based
curriculum approved by SSC
Existence of Facilitators Guide

Existence of Trainer Guide

Existence of Participant Manuals

Existence of Assessment Guides

Existence of participant feedback forms

Existence of Training Delivery Plans

Review process to gauge the effectiveness of the

courseware developed
Process of SME engagement in courseware
design and development

SSC specific inputs (if any)

29. Details of the Training Process for the courses offered.

Aspect Yes/ No Remarks
Time table

Delivery plan

Monitoring and evaluation process of students –

continuous assessments, tests, examination etc.
Management of student evaluation records

Lab/ workshop exposure and its linkage to

theoretical delivery

Industry visits
SSC specific inputs (if any)

30. Details of Methodology adopted for Continuous Evaluation.

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Aspect Yes/ No Remarks

Documentation process of Continuous Evaluation

Documented process on student monitoring on

learning

SSC specific

31. Details of Methodology adopted for Industrial Interface.

Aspect Yes/No Remarks

Documentation process of engagement of

experts from the industry

SSC Specific

32. Details of Methodology adopted for Student Development.

Aspect Yes/No Remarks

Documented process of imparting soft skills

training

Documented process of providing guidance to

students on placements

Documented process on OJT/ Placement

facilitation
SSC Specific

33. Details on Student Admissions.

Aspect Yes/No Remarks

Printed brochure/ prospectus

Documented policy and procedures for
admissions

Concessions policy

Process of keeping the safe custody of student

documents

Student agreement with the institution at the time

 Pradhan Mantri Kaushal Vikas Yojana

of admission
SSC Specific

34. Details on Health and Safety of the learners.

Aspect Yes/No Remarks

Documented process of staff training on crisis

handling

Availability of equipment required for covering

indoor and outdoor emergencies
Documented process on providing training on the
equipment on indoor and outdoor emergencies

Availability of equipment required for fire safety

Documented process on providing training on the

fire safety equipment
Health policy including collection of required
medical record of staff and students
Compliance to the regulatory norms related to
health and sanitary conditions

Documentary proof of compliances certified by

the competent authority

SSC Specific

Section 3: Performance Measurement and Improvement

35. Documentary evidences of suitable indicators to monitor and measure the performance.
Key aspects that need to be certified by the applicant are:
Aspect Yes/No Remarks
Documented process of trade learning progress

Documented processes of workshop upkeep and

modernization
 Pradhan Mantri Kaushal Vikas Yojana

Documented process on tracking health and

safety incidences

Documented process on gathering feedback of

placed students with the employers

Documented process of tracking trends in

employability and placement record

SSC specific

36. Documentary evidences of practicing continual improvement. Key aspects that need to
be certified by the applicant are:
Aspect Yes/No Remarks
Documented process of taking student feedback
on curriculum

Documented processes of taking student

attendance

Documented process on tracking student

dropouts

Documented process on tracking student

performance on tests
Documented process of tracking teacher
attendance

Documented process of tracking placement

patterns

SSC Specific

37. Documentary evidences of mechanism on Complaint Handling. Key aspects that need
to be certified by the applicant are:
Aspect Yes/No Remarks

Documented process on Information Sharing on

complaints with all stakeholders

Documented processes of acknowledgement of

receipt of complaint

Documented process on investigation of the

 Pradhan Mantri Kaushal Vikas Yojana

complaint

Documented process on tracking training needs

of the faculty by the management

Documented process of tracking student

complaints and redress of the same

Documented process of investigating the student

complaints

Documented process of closure of the student

complaint

Documented process of keeping record of

student complaint

SSC specific

Other Relevant Information

48. Does the Institute receive any grant from Govt. of India / State Government/ Union Territory
or any other source?

(Attach details of grants received in last 3 years as Enclosure 4)

Performance Review
a. Overall
S. No. Performance Criteria Unit of 2012-13 2011-12 2010-11 Remarks
Measurement

1. Utilization of Students %
seating capacity

2. Retention Rate (Of %

students admitted)
3. Students/Teaching Ratio
Staff

4. Pass out (Of students %

 Pradhan Mantri Kaushal Vikas Yojana

appeared)
5. Students on %
completion got jobs

6. Total yearly %
expenditure / Initial
budget sanctioned

9. SSC specific

I declare that I agree to the tenets laid down in the Process Manual.

I hereby confirm that my training center, used in the training of trainee under the above
mentioned Scheme meets the specifications for becoming an Affiliated Training Partner as per
the standards defined by SSC and NSDC. The criteria are mentioned on the NSDC and
respective SSC website. I also declare that the above mentioned information is true.