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Application for Agripreneurship Orientation Programme YOCH-2019
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ACHARYA N.G. RANGA AGRICULTURAL UNIVERSITY
REGIONAL AGRICULTURAL RESEARCH STATION, TIRUPATI - 517502
RKVY-RAFTAAR ABI'S SCHEME SUPPORTED AND FUNDED PROJECT
"ANGRAU-AGRI INNOVATIONS AND ENTREPRENEURSHIP DEVELOPMENT CELL"
ANGRAU POSHAN INCUBATOR
YOCH – 2019
Application for Agripreneurship Orientation Programme
Note to the applicant: Don’t edit or delete any portion in this application and please fill the
details in the given format. If you wish to add additional information, please furnish at the end
of this application form in separate section. Please read the details carefully in the guidelines
given in the website www.angraurabitpt.org
LAST DATE OF APPLICATION: 14/08/2019
1. GENERAL INFORMATION
1.1 Applicant’s Name Mr./Ms./Dr. ___________________________________________________
1.2 Age (Years): _____
1.3. DOB (DD/MM/YYYY): ___/___/________
1.4. Gender :__________
1.5. Address for correspondence: ____________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please affix
recent passport
size photograph
For Office use only
Date Received:
Reference No:
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1.6. Mobile:___________________________ Alternative number _________________________
WhatsApp Number___________
1.7. Email ID:__________________________ Alternate email ID ________________________
1.8. Native State:__________________________________
1.9. Educational Qualifications:
SI.No Qualification Course Details Year of Passing 1. Secondary School
2. Higher Secondary School or 10+2
3. Graduation
4. Post-Graduation
5. PhD
6. Other Academic Qualifications
1.10. Professional Experience:__________ (No. of years)
1.11. Applicant/ Team details: Please tick () the applicable option
a. Individual: Yes No
b. Applicant representing a Team / Company Yes No
If applicant representing a Team / Company then the following details to be furnished:
S.
No Name Gender Educational
Qualification Experience
(Years) Current
Profile Role in the
proposed idea /
startup
**Note: Please furnish the details in Annexure I given in this application form and duly get the
signatures accordingly
1.12. Do you have any startup at present? If yes Please furnish the details.
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2. INNOVATIVE IDEA DETAILS:
2.1 How did this idea generated?
2.2. Basis for your idea:
2.3. Which sector does your idea/product/service belongs to: (Please Note: Please pick the
suitable sectors which are given in the YOCH – 2019 Poster. If it is different from the areas given,
please indicate it.)
2.4. How long will it take for this idea to completely develop into prototype?
(Please tick ( ) the applicable option)
Already in active use now Please tick
1 – 6 months
7 – 12 months
12+ months
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2.5.Please explain your innovative idea in brief: Idea / description: Intended product or service (Define
scope carefully).
2.5.1. Name of the technology:
2.5.2. What is it? (Machinery/ Equipment / new process/new material or any other).
2.5.3. What does it do? (Use simple and non-technical terms).
2.5.4. What problem does it solve?
2.5.5. Who is the primary customer of your innovative idea?
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2.5.6. Explain USP (Unique Selling Proposition) of your product? Please focus on “benefits” rather
than “features” of the technology.
2.5.7. Does your technology have any Intellectual Property protection? If not, what is your plan to
protect your technology from competitors?
2.5.8. Does your idea work towards innovation, development or improvement of products
or processes or services?
2.5.9. Is your innovative idea is a scalable business model with a high potential of
employment generation or wealth creation.
2.5.10. Is your Idea / product already available in the market?
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2.5.11. How much money you intend to invest in this business?
2.5.12. What is your market strategy for your idea based product?
2.5.13. Did you conduct any Market survey? If yes, please give details:
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3. EXECUTIVE SUMMARY / BRIEF OVERVIEW OF YOUR INNOVATION/ PRODUCT/
TECHNOLOGY (In not more than 500 words, Please attach a separate sheet of paper if the space
provided here is not sufficient).
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4. PROPOSED STARTUP DETAILS:
4.1. Are you intended to setup a new Agri startup?
Have you registered your start up?
Yes No
If yes, please furnish the details.
4.2. Where would you want to establish your startup?
4.3. How many employees would you require for your proposed new startup?
4.4. Explain your proposed start up business model.
4.5. What is the basic infrastructure that you require in developing your idea (for
production)?
4.6. The final product which will come out of your idea is a Raw material or consumable?
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4.7. Status of your product development / path to market process?(Please tick ( ) the
applicable option)
Description Select Concept- Idea stage
Proof of Concept: Some experiments done. Preliminary proof of concept exists.
Prototype: Several proofs of concept demonstrated.
Pilot: Minimum Viable Product (MVP): Pre-commercialization use. Prototype made and
performance claims tested, trials have been done on sufficient scale to demonstrate interest of
potential customer.
Production: Commercially ready. Real life testing conducted by potential customers. Product is
ready for commercial sales.
4.8. Do you require any specific raw material to bring your idea into final product? If yes,
please furnish the full details.
4.9. What is the overall estimated cost of developing your idea/ product and bringing into
the market?
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5. COMMERCIAL AND EXISTING TECHNOLOGY LANDSCAPE
5.1. What is the competitive advantage of your technology with respect to existing
products/services/technologies in the market today?
5.2. Have you done Market assessment with regard to size and growth? Please give an
estimate of your target market segments.
5.3. Who are your major competitors?
5.4. What are the key risks/ barriers that you face in bringing your idea/ technology to the
market? Please explain (Technical/ manufacturability, Freedom to operate, Regulatory,
compliance, finance, scale of investment barriers, team etc.)
5.5. Other reasons (besides commercial) for your idea / technology attractiveness–strategic,
social impact etc.
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6. OTHER DETAILS :
6.1. Have you presented this idea/ technology elsewhere? If yes, please give the details.
6.2. Did you receive any awards or certificates for presenting this idea? If yes, please give
the details.
6.3. Does your business idea depend on application of certain technology which needs to be
developed? If so, Please briefly describe the same?
6.4. Is this technology your own? Or obtained from any other sources?
6.5. Is your technology an outcome of academic research / any other research / idea of team
work? If Yes, Please furnish the full details.
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7. FACILITIES EXPECTED FROM THE INCUBATOR:
7.1. What are the services you would like to avail from ANGRAU Poshan Incubator?
Services Please tick Details, if any
Office space
Production space
Capacity building
Mentoring
Funding support
Technical Assistance
IP facilitation
Lab facilities
Licensing and registration
Any other facilities
7.2. Have you sought collaborations with any Government agencies / Private companies for
your idea development?
8. ARE YOU READY TO ATTEND THE EIGHT WEEKS OF RESIDENTIAL PROGRAM AT
ANGRAU AIED CELL, RARS, TIRUPATI? (Please tick () the applicable option)
Yes No
9. HOW DID YOU GET TO KNOW ABOUT THE YOCH 2019 PROGRAM?
(Please tick ( ) the applicable option)
ANGRAU Website Facebook Notice board of your
organization
Your own institute
website Twitter Exhibition
Print Media-
Newspaper Emailer Brochure
Any Other Website Reference from a
person Posters
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10. ANYTHING ELSE YOU WOULD LIKE TO SHARE ABOUT YOUR IDEA,
DREAMS, NEEDS AND EXPECTATIONS?
Note: **Please do not include any confidential information while describing any aspect of your
technology, your company, or your business plans in this application.
DISCLAIMER
Selection to the YOCH – 2019, Agribusiness Orientation Programme does not automatically
ensure the grant-in-aid support. The decision to that will finally depend on appropriate Selection
Committee. The proposals will be sent to the Ministry of Agriculture and Farmers Welfare, Government
of India for pre seed stage funding. The decision of the appropriate committee will be final and binding
Every effort will be taken to treat and handle this information as confidential. However
by signing and applying to Agripreneurship Orientation Programme (YOCH – 2019), you agree
not to make any claim or demand compensation in any form, at any point of time, on the
information or technology details provided by you as Trade Secret or Proprietary Intellectual
Property. This information will be used by YOCH – 2019 to assess your application for the
purpose of providing available funding facility. Furthermore, YOCH – 2019 does not guarantee
acceptance of your proposal until and unless the selection process is over and YOCH – 2019 has
the right to reject any proposal at any point of time without assigning any reason to it. The
decision of YOCH – 2019 will be final and no explanation or justification for any aspect of the
selection process shall be given.
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DECLARATION
I hereby certify that the information provided above are true and correct to the best of my
knowledge. I understand that any false statement may disqualify me from the YOCH – 2019
even after the selection for Pre-seed stage funding. I have gone through all the guidelines present
in the website www.angraurabitpt.org and hereby declare that I will abide by the set forth
guidelines from time to time.
Date: Signature
Place: (Name)
The filled in application along with all the required documents need to be sent to the below address
on or before the last date by Registered post.
Address:
To
The Principal Investigator & Chief Executive Officer, ANGRAU Agri Innovations and Entrepreneurship Development Cell,
ANGRAU Poshan Incubator,
Regional Agricultural Research Station,
S.V.Agricultural College Campus, Chandragiri Road,
TIRUPATI– 517502.
Andhra Pradesh
***
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ANNEXURE - I
Authorization Letter (To be submitted by applicant representing a Team/ Company)
To,
Principal Investigator – Chief Executive Officer,
ANGRAU Agri Innovations and Entrepreneurship Development Cell,
ANGRAU Poshan Incubator,
Regional Agricultural Research Station,
S.V.Agricultural College Campus, Chandragiri Road,
Tirupati, Andhra Pradesh – 517502.
Subject: Letter for Authorized Signatory
Dear Sir,
With reference to our Application for YOCH – 2019, Agripreneurship Orientation Programme,
Mr. /Miss/Mrs. _______________________________________ is hereby authorized to submit
the application on behalf of M/s.________________________________________________
(Company Name).
If the Team or Company is a registered body, then the authorizing person has to put up the
signature. Name of the representative : _________________________________
(Signature of Representative) :__________________________________
Signature of Authorizing Authority :_________________________________
Name of Authorizing Authority and Designation: _________________________________
Company Seal:
If the Team or Company is not a registered body or unorganized group, then the signatures
of all the team members have to be specified, for the details as given by the representative
in the Section 9b of this application:
SI.No Name Address Signature
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ANNEXURE - II
Documents to be furnished: (duly self-attested photocopy shall be provided)
Sl.
No
.
Documents Required
Please tick against the
respective documents
you have attached
1
Identification Proof viz. Aadhaar card/Passport /PAN card/Company
Registration Certificate/GST Certificate / Any Government authorized
Certificate
2 Electricity/Mobile/Telephone Bill/Driving License etc. stating the
address
3 Passing Certificate in support of Educational Qualification
4 Experience Certificates from respective Employer regarding Work
Experience
5 Certificate of Prize/Awards w.r.t your Technology/Business Idea if any
6 Details of Intellectual Property filed/granted (if any)
7
Self-declaration from the incubatee about non-receipt of grant-in-aid
funding from other Govt. of India ministries for the same
activity/product
In case of Team/Company following documents also need to be furnished in addition to
above:
SI.
No Supporting Documents Required
Please tick
against the
respective
supporting
documents you
have attached
1 Authorization Letter to be submitted by applicant representing a Company (as per Annex. II)
2 Self-attested Copy of Startup India DIPP registration
(if company is registered)
3 Self-attested Copy of GST Registration or GST exemption certificate/PAN
Card (in the name of company)
4
Electricity/Telephone Bill or any other supporting document stating the
address of company duly certified by the Authorized Representative of the
Company
Name:
Signature: