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Application for National Award for Best Applied Research / Innovation / Product Development aimed at improving the life of persons with disabilities (Annexure-G)

1. Name in English and in Hindi (in BLOCK Capital letters)
2. Address of the applicant (In full) with telephone and fax number.
3. Web-site / E-mail address, if any
4. Date of birth
5. Educational qualifications
6. Professional / Official Designation & Address of Organization with telephone & fax numbers.
7. Title of Invention / Innovation
8.
  1. When and where the development work was carried out.
  2. Was the proposal undertaken as a research project in a Research Laboratory / Institute or any other Organization.
9. Detailed technical description (Use separate sheets)
10. Present stage of development (Strike out items which do not apply) Idea / Model / Working Model / Prototype / Commercialised
11. Claim of Originality
  1. How it is different from known Indigenous and imported Pin-Point in detail, the originality / novelty claimed (Use separate sheet).
  2. Has it been patented? If so give patent no. and dates of application / acceptance and sealing?
12. Advantage claimed over alternative products (Strike out whichever is not applicable).
  1. Reduced capital cost / operating cost / Weight / volume.
  2. Improved performance / safety / output serviceability/range of applications / utility directly or as attachment.
  3. Aiding import substitution and self-reliance.
  4. Any other special merits.
13. Tests / Demonstrations carried out:
  1. Give details of the tests carried out and results obtained (Use separate sheets)
  2. Has the working model / prototype been demonstrated / supplied for use?
If yes, give names(s) and address of the persons / testing agencies and details of their observations / test results / opinions obtained.
14. Details about commercialisation, has it been exploited commercially?
  1. If yes, date(s) of comercialisation, names and addresses of the parties manufacturing and annual sales.
  2. Name and address of the users, if any.
15. Has your invention / innovation been Published in technical or scientific Magazine? If so, enclose reprints / cuttings.
16. Has the invention / innovation been submitted for consideration or consideration for any International / National Awards? If so, give particulars.

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