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APPLICATION FORM

FOR

AFFILIATION TO INSTRUMENTATION AUTOMATION

SURVEILLANCE &

COMMUNICATION

SECTOR SKILL COUNCIL (IASC SSC)

S i g n a n d S t a m p h e r e : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

P a g e | 1 IASC SSC Affiliation Protocol Document Ver 1.1

PROCESS OF AFFILIATION

a) All forms duly filled as mentioned should be submitted to IASC SSC with supporting

documents and attachments.

b) The fees for the Pre-assessment activities should be deposited upfront with the

application form.

c) IASC SSC on receiving the application form and the required fees shall nominate a

designated Assessment Agency to carry out the due diligence process.

i. Due-diligence for affiliation of Training Partner

A complete evidence based check of the documents, process, tools and

equipment, trainers and supporting hard and soft infrastructure at the training

centre will be carried out in two steps:

1.Offsite due diligence 2.Onsite due diligence (Only if required)

The due-diligence will include but not necessarily be limited to the following

tasks:

3.Management & Administrative Setup4.Availability of Trainers and Master Trainers5.Training Infrastructure (Hard & Soft Elements)6.Environment, Health and Safety7.Placement and Industry Connect8.Human Resource Policy9.Management Information System10. Feedback & Grievance Handling

Based on the evidence collected during the due diligence process, the training

centres will be graded as A/B/C/D.

ii. Capacity Building of the Affiliated Training Partner

The following capacity building interventions will be offered to all affiliated

training providers/centres based on the above due-diligence process.

1.Curriculum Alignment as per QPs/NOS2.Training/ Re-Orientation of Trainers to deliver competency based

training3.Strengthen the internal assessment system

These will be mandatory to all training centres in B, C and D category and

optional for Category A.

d) A feedback on due-diligence will be shared with the training centre/partner.



e) The affiliation will be for one year during which both IASC SSC and the training institute

will strive to improve the output.

f) The affiliation will be applicable for training at the training centre and the industry shop

floor. It will also be applicable for implementing Recognition of Prior Learning (RPL).



GENERAL INSTRUCTIONS

1. The application has to be applied by the Vocational Training Providers(VTP) /Institution interested for affiliation to IASC SSC for the IASC SSC Qualification Packs

2. The Affiliation Form is provided in the Microsoft Word format. Deletion or Amendment to the master form may result in rejection of the application form.

3. The copy of the affiliation application form would be made available by IASC SSC. The form may be revised from time to time. The same can be checked from its version number mentioned at the bottom of each page.

4. Copies of application form along with all the relevant documents should be signed on each page by the competent authority , scanned and uploaded on our website as enclosures.

5. No hard copy of the documents is required. Please mention the annexure number/name in remarks column where ever required. All the documents along with enclosures/annexure needs to be sent in word/pdf/scanned format in two(2) non-rewritable CD/DVD only.

6. For different centres and courses selected, kindly attached/include additional Part B as per the requirement in the application form.

7. The guidelines, processes, report, curriculums and other documents mentioned in the form needs to be made available to the IASC SSC team during the centre visit.

8. Insert more rows or table, if required

9. The details of availability of tools, equipment’s and trainers as required for each selected job role are available on website.



PART-A(General Information)

APPLICATION FOR AFFILIATING FOR THE FOLLOWING JOB ROLE(S)(AS PER QUALIFICATION PACKS)

S. No. Qualification Pack Reference Number

Job Roles Number of Training Centres

(More columns will get added, if required)

Section 1: Institution and Management Profile

1. Name of the VTP/Institution:____________________________________________________________________________________________________________

2. Whether Government or Private (Please tick the appropriate box)☐ Government ☐ Private

☐ Company/Firm☐ Society ☐Trust



☐ Any other, please specify _____________________________________

3. Whether NSDC Partner for Instrumentation, Automation, Surveillance and Communication (Broadcast side only) sectors (Please tick the appropriate box)☐ Yes ☐ No

4. Prior Exposure of the VTP/Institution in Skill Development Space – (Provide Details of affiliation with government scheme/NSDC.) (Please attach relevant proof as Enclosure) ______________________________________________________________________

5. List of Training Centres for Affiliation on the above mentioned Job Roles.S.

No.Name & Address

of Training Centre

Qualification Pack Reference

Number(Use comma for more than one course)

Contact Details(Name,

Designation, Mobile Number

and Email ID)

Centre Status ( Being run by the applicant or their

Franchisee)

123456789

10

6. Name(s) of all Director(s) / Owner(s) as on date:S. No. Names1.2. 3. 4.

7. Contact Details of the Institution:

Postal Address:

Pin CodePhone Number with STD Code



Fax No:

8. Year of Establishment/Incorporation: _______________________________________9. Medium of instructions in Institute (Please tick the appropriate box):

☐ English ☐ Hindi ☐ Any OtherAny other, please specify: ______________________________________________________

10. Does the Institute have branches? (Please tick the appropriate box)

☐ Yes ☐No (If Yes, attach the list of all Branches as Enclosure)

11. PAN No: _____________________________________________________

12. TAN No: _____________________________________________________ (Attach photocopy of the PAN and TAN card as Enclosure)

13. Audited Turnover of the VTP/Institute: ______________(Last Financial Year) (Attach Copy as Enclosure)

14. Provide your bank details:

A/C Number

Bank Name

IFSC Code



15. Educational Qualifications, Experience and Contact Details of the Director(s), Management Team members, Operational Head(s) and Affiliation Coordinator(s) for VTP/Institution:

Name & Designation of Director(s),

Management Team members and

Operational Head(s) of the Training Provider

Educational

Qualification

Overall Work

Experience(in years)

Prior Experience in the Skills

Training Space and/or in related

sectors

Key Achievements in

the Skills Development

or/ and related sectors

Contact Details including

Mobile Number and Email ID



PART-BCentre Specific Information

(Different Part-B form for each training centres is required)1 Name & Address of the Training

Centre2 Name & Contact Details of the Co-

ordinator for Centre3 Job role and QP Code (For multiple

job roles please fill separate details under serial number 20, 21, 25, 31, 32, 34, 35, 39 and 40)

16. Centre set up/affiliated by Government (Please tick the appropriate box and attach relevant proof)☐Government/Private ITI affiliated to NCVT ☐ Institutions approved by Central Government agencies like AICTE, ☐ College/Institutes affiliated to a university set by Central or State/UT Government or

recognized by UGC☐Schools/Institutes approved by Central or State Board of Secondary Education (or

equivalent) or Boards of Technical Education.☐ Private Institutions independently operating in Vocational Space☐ Training Institution setup by private companies ☐ Any other, please mention details……………………………………………………………….

If any one of the above is Yes, Please mention the following:Name of the Body with which

recognized or affiliated Regulatory BodyRecognition No./ Affiliation Number

Trades or Courses of AffiliationYear of Recognition/Affiliation

Validity of Recognition/ AffiliationAny other information , that may be of

relevanceCertificate/Proof of

affiliation/recognition enclosed with annexure number



17. Provide the details of the Centre Management Team, Trade Head, Trainers & Lab Assistants, Operational Head(s), Affiliation Coordinator(s) & Placement Head for the centre:

Name & Designation

Educational

Qualifications

Overall Work

Experience(in

years)

Prior Experience

in the Skills

Training Space or Industry

Key Achievements

in the Skills Development.

Or Industry

Employment details

(employed by applicant or

their franchisee)

Contact Details

includingMobile Number

and Email ID

Section 2: Training Operations - Processes

18. Has the trainer certified or has undergone any specialized training? ☐Yes ☐No(If yes, please provide the details including where, by whom, duration, date etc. in the table below)

19. Details of the Trade/Teaching Staff, Lab Attendants & Curriculum/Content Development TeamPLEASE SEE ANNEXURE-A ATTEACHED AT THE END

20. Administrative Support Staff of Training CentreS.

No.Staff Permanent/Temporary/Part-

timeEmployment details

(employed by applicant or their franchisee)

Total

1.2.3.4.5.6.

21. Layout and Learning Environment: (Enclose supporting documents and mention in remarks)



Aspect Yes/No RemarksProperty Ownership (Owned/ Rented) Attach relevant

documentsAvailability of proper layout Please attach the layout

with dimensions and atleast 5 Photographs covering the building exterior

Availability of well-developed space for Class Room, Library and Audio Visual Room etc.

Please attach atleast 5 photographs

Availability of well-developed and planned space for the workshop activities


Proper foundation of the machines and equipment’s


Sufficient Illumination and Ventilation of the class rooms and workshop


Cleanliness and Weather protection of the centre

22. Power Connection (Enclose supporting documents and mention in remarks)Aspect Details Remarks

Does the institute have adequate power connection? Please mention the sanctioned load and attach the last paid bill.

Attach copy of latest electricity Bill

Does the institute have Power Backup? Please mention the make and rating of the Generator Set.23. Library details a. Total number of Books related to the trade:

TechnicalNon Technical

b. Number of Magazines:_____________________________________________ c. Number of Dailies (newspapers):________________________________________

d. Availability of Audio Visual Content for the stated job roles______________________

24. Details of Equipment (as per requirement of QP) that are more extensively used for Trade Training in the Workshop

PLEASE SEE ANNEXURE-B ATTACHED AT THE END



25. Does the institute have Simulators for the Trainings in the workshop? ☐ Yes ☐ No

If yes, please mention the details ________________________________________________

26. Details on Health and Safety of the learners. (Enclose supporting documents and mention in remarks)

Aspect Yes/No RemarksAvailability of equipment required for covering indoor and outdoor emergenciesDocumented process and providing training on the equipment on indoor & outdoor emergenciesAvailability of equipment required for fire safety Attach atleast 2

photographsDocumented process and providing training on the fire safety equipmentHealth policy including collection of required medical record of staff and studentsCompliance to the government regulatory norms related to health and sanitary conditionsDocumentary proof of compliances certified by the competent authority

Attach proof

27. Details of the Industry Linkages

S. No.

Name and Address of

the Organization

Contact Details (Name , phone

number and

email ID)

Scale (Small/Medium/Large)

Website Number of

trainees placed in past one

year

Remarks (If any)

Attach relevant proof

28. Details of Industrial Interface. (Enclose supporting documents and mention in remarks)



Aspect Yes/No RemarksDocumentation process of engagement of experts from the industry Industry engagement for course curriculum developmentDoes the institute provide/support On-Job Training for the CourseDoes the institute organizes guest faculty from the industry for the course

Section 3: Performance Measurement and Improvement

29. Documentary evidences of practicing continual improvement. (Enclose supporting documents and mention in remarks)

Aspect Yes/No RemarksProcess of taking student feedback on curriculum Processes of taking student attendance Attach atleast two

picturesProcess on tracking student dropouts Process on tracking student performance on testsProcess of tracking teacher attendance Attach atleast two

picturesProcess of tracking placement patterns Attach atleast two

picturesProcess of improvement over time

30. Documentary evidences of mechanism on Complaint Handling. (Enclose supporting documents and mention in remarks)

Aspect Yes/No RemarksProcess on acknowledgment & keeping records on complaintsProcess on investigation, tracking and closure of the complaints Process on tracking training needs of the teaching faculty



31. Please provide the details of training batches enrolled for similar courses which can be aligned to QP.

S. No

QP Reference ID QP Name

Name of

Course

Number of

Trainees

Start Date

of the course

Completion date of the

course

Any other

relevant details

32. Performance Review S. No. Performance Criteria Unit of

Measurement2012-13 2011-12 2010-11 Remarks



Annexure-A

21. Details of the Trade/Training Staff, Lab Attendants & Curriculum/Content Development team along with their relevant documents. (Trainers should qualify the minimum Trainee Qualification as laid down by the SSC)

S. NoName &

Designation

Degree/

Diploma/CTI etc.

(Trade)

QP Name

Training

Certificate

Instruction experience(

Yrs)

Instruction

Experience (Yrs)

Specialized Training

details(Refer Point 20)

Full Time/Par

t Time

QP Name ( To select only one QP as mentioned at point 3 above):

QP Name ( To select only one QP as mentioned at point 3 above):

Please increase columns as per requirement.



Annexure-B

31. Details of Equipment (as per requirement of QP) that are more extensively used for Trade Training in the Workshop along with Photographs

S. No

.QP

Equipment Name

(Operational)Number

Company Make

Technical Specifications

Average age in No. of Years

Student-Machine Ratio

Key Purpose of Equipment in Training

(In 1-2 lines only)

Photograph attached (Yes/ No)



Fees Structure for Affiliation Process

Fees Structure for Affiliation Process Pre-Affiliation-Due Diligence

S. No.

Category

Unit

Fees(In Rs)

NSDC & Non-NSDC Partner

1 Application and Document Compliance 15,0002 Physical Inspection (In one visit)# Per Centre 15,000

Post-Affiliation*1 Affiliation Fee Per Centre 20,000

2 QP-NOS Curriculum CompliancePer job role review of QP-NOS aligned curriculum after every QP review

7,500

3 Training of TrainerPer trainer cost. Does not include cost of travel and stay of the trainer.

10,000

# Only as on required basis.*The training institute who are eligible for fee exemption from SSCs (pre-affiliation) according to any applicable government scheme will be required to remit fees for activities post-affiliation from time to time without any conditions.

All cheques should be payable to “Instrumentation Automation Surveillance & Communication Sector Skill Council” at New Delhi.



(UNDERTAKING TO BE GIVEN ON COMPANY LETTERHEAD)

I _________________________________on behalf of _______________________________hereby declare that I am the competent authority for signing and submitting the application form for affiliation to Instrumentation Automation Surveillance & Communication Sector skill Council (IASC SSC) and that all the information and enclosures mentioned above are correct. The training centre(s) mentioned above is used for training and it meets all the specifications for becoming a IASC SSC Affiliated Training Partner as per the QP/NOS defined criteria.

I on behalf of the training centre and training partner confirm that we will abide by the terms, condition, decisions, fees and guidelines introduced by IASC SSC/ NSDC from time to time.

I understand that the affiliation can be rejected in case of any false information. I also understand that the affiliation can be terminated without any refunds in case of unethical practices or false information, if any, found after affiliation.

I further agree to the following terms and conditions of IASC SSC

1. The Training Institutes and their respective applicant skill center(s) should provide the trainings as per curriculum prepared by IASC SSC compliant to the respective National Occupational Standards.

2. The Training Institutes and their respective applicant skill center(s) should ensure that admission of students is as per the eligibility conditions prescribed in the NOS for the applied job role.

3. The Training Institutes and their respective applicant skill center(s) should ensure that trainers or facilitators are IASC SSC trained and certified.

4. The affiliation shall be granted for period of one year and shall be subject to on-site surprise inspection, which may be conducted by IASC SSC anytime during the validity of affiliation. The renewal of affiliation shall also depend on satisfactory performance of skill center.

5. The training institute shall offer to IASC SSC or its representative cooperation during physical inspection in:

a. Access to the facility.

b. Assess to the attached/associated facility relevant for training.

c. Access of all relevant information and documentation.



d. Access to all records and relevant personnel.

6. The Training Institutes and their respective applicant skill center(s) shall provide well equipped facility for theory and practical assessment of the students.

7. On grant of affiliation, the Training Institute shall:

a. claim affiliation in only those skill centers, which has been affiliated by IASC SSC (applicable for Training Institute having more than one skill centre)

b. not state its affiliation in a manner as to be considered misleading or unauthorized and bring IASC SSC to disrepute

c. Make reference to affiliation in its documents, brochures or advertising only in compliance with the requirements of IASC SSC.

8. The applicant training Institute shall pay all the applicable (pre-affiliation) fees such as application fees; document compliance fees; physical inspection fee, annual affiliation fee for affiliation with IASC SSC time to time as per fees structure laid down by IASC SSC enclosed above, unless institute is eligible for fee exemption (pre-affiliation) according to any government scheme, for which they have to attach the supporting documents with application form.

9. The affiliated training Institute shall pay all the applicable (post-affiliation) fees such as QP-NOS curriculum compliance fee, fee towards training and certification of trainers, fee towards assessment and certification of trainees, etc. as shall be determined by IASC SSC from time to time. The training institute, who are eligible for fee exemption (pre-affiliation) according to any Government scheme, are also liable to remit fees for activities post-affiliation time to time without any conditions.

10. The training Institute shall inform IASC SSC within 30 days of significant changes affecting the operation of the Institute/centre relevant to affiliation, such as:

a. Its legal, commercial, ownership or organizational status

b. The organization, top management and key personnel

c. Main policies

d. Addition of new job role in the affiliated skill centre

e. Training institute shall continuously keep in touch with IASC SSC to keep itself updated.

11. The applicant/affiliated training Institute shall respond promptly to the changes initiated by IASC SSC in its affiliation criteria, policies and procedures. However they will be given sufficient notice and time, as in the opinion of IASC SSC is found reasonable, to carry out adjustments in its system. The applicant/affiliated training Institute shall inform IASC SSC when such adjustments have been completed.



12. IASC SSC may suspend or withdraw affiliation of the training Institute / stop processing application of an applicant institute, as per IASC SSC policy, on one or more of the following grounds:

a. During a physical inspection, applicant training Institute does not comply with the affiliation requirements

b. Non-payment of affiliation process fee and post affiliation fees.

c. Non-cooperation with IASC SSC

d. Refusal to allow examination of relevant skill centre, documents and records by IASC SSC & its appointed representative

e. Result of complaint analysis or any other information, which indicates that the training institute no longer complies with requirements of IASC SSC.

13. The affiliated training institutes shall enroll batch minimum of 20 learners/ day and maximum of 30 learners/ day for assessment.

14. The affiliated training institute and its respective skill centre upon suspension or withdrawal of its affiliation shall immediately cease its use of all promotion material that contain any reference to the affiliation status.

15. The affiliated training institute is required to inform IASC SSC, if any of the proposed assessor(s) happens to be associated with them in any other capacity.

16. IASC SSC absolves itself of any legal or financial liability arising out of any act involving any accidental or consequential damages to personnel/equipment at any time.

Date:...........................

Name:

Designation:

Stamp:



CHECK LIST

Enclosures in CD/DVD (Two CD/DVD)

S. NO Detail/Item Yes/No Document name & Comments (If any)

1 Application Form Part A2 Details of affiliation with government scheme/NSDC.

(Attach relevant proof, if any)3 List of Branches for affiliation (As annexure, If applicable)4 Application form Part B for each centre5 Attach photocopy of the PAN and TAN card as Enclosure 6 Copy of Incorporation Certificate, MOA etc7 Copy of any affiliation certificates (Sr. No. 3 & 4)8 Documents of Trainers and Equipment

9 Availability of aspects related to the Learning Environment (under various points mentioned at Sr. No. 21 )

10 Availability of aspects related to the Health and Safety (under various points mentioned at Sr. No. 26 )

11 Availability of aspects related to Industry Linkages (under various points mentioned at Sr. No. 27 )

12 Attach details of grants received in last 3 years (If applicable)

13 Registration Certificate of Trust/ Society/ Company14 Lease Agreement/ MOU or copy of duly signed copy of the

agreement with partner institute15 Electricity Bill of the training centre (Last Paid)16 Audited Balance Sheet of Last Three Years17 Legal Undertaking

