Particulars of the Agency / Officer responsible for placement of the persons with disabilities for National Award (Annexure-C)
I. PERSONAL DATA
| 1 | Name in English(in BLOCK Capital letters) and Hindi | |
| 2 | Date of Birth | |
| 3 | Educational qualification | |
| 4 | Postal address | |
| 5 | Telegraphic address / FAX No. | |
| 6 | Telephone Number: Office : Residence: |
|
| 7 | Web-site / E-mail address, if any | |
| 8 | Name of the employer with complete address (Give all the employers with Whom employed during the last five years, last name to be given first) | |
| 9 | Total service in the capacity. |
II. PERFORMANCE DATA: Placements and follow-up Give the information for the last five years.
| S.No. | Year | No. of Persons with Disabilities | No. / %age of placement to Registration | No. of cases followed up | % of dropouts from employment with brief reasons | |||
|---|---|---|---|---|---|---|---|---|
| Registered | Placed | |||||||
| Male | Female | Male | Female | |||||
| (Disability wise) | ||||||||
| (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) |
| (i) | 2003 | |||||||
| (ii) | 2004 | |||||||
| (iii) | 2005 | |||||||
| (iv) | 2006 | |||||||
| (v) | 2007 | |||||||
III. Brief particulars of the Placement Officer:
Signature of the applicant with date
Signature of the recommending authority with date
Broadly, "Placing" means an employer's acceptance of a persons into a remunerative job as a result of the following Employment Exchanges operations as a result of the
- Booking on an order prior to submission;
- Pre-submission of the persons to be referred to the employer;
- Submission of the selected persons and verification that the persons have been engaged.
(Definition as given in the National Employment Service Manual).
