Apo Biodata Form-aks

candidate’s bio-data (please type or print)

project code: 05-ev-ge-wsp-09-a project title: forum on global opportunities in environmental sustainability (goes) duration & timing : 7-9 november 2005 (3 days) venue : singapore a. personal data name

dr./ : ✓mr./mrs./ms other (

)

sinha anjan kumar (please type your name as indicated in your passport. underline surname / family name. include chinese character, if any)

p a s s p o r t

number:

z 016427

date and place of issue:

30 - 05 -2000 calcutta expiry date: 29-05 -2020

nationality

indian

date of birth yr: 1957

m: 01

d: 02 sex: ✓male /female

present position name of company/ organization address of the company/ organization

director ii

since when date joined

national productivity council

type of organization

1981

url: http:// npcindia.org address: 9, syed amir ali avenue, 2nd floor,

kolkata – 700 017, west bengal, india tel: 91 – 33 – 2287 6069 / 2280 3116/2280-0269 2280 3919 email: [email protected]

type of business

2002

techno-managerial consultancy & training ✓ govt ministry/ agency

university/ institutions

in case of private company:

fax: 91 – 33 – total no. of employees locally owned

500 approx.

joint venture govt/ state/ local govt owned enterprise home address of the candidate

contact person in case of emergency

dietary restriction

ngo/ association

address: sayak, block “o” 16, patuli, garia kolkata- 700 094 west bengal, india tel: - 91-33-2436-9400 name: smt. sagarika sinha address: sayak, block ‘o” 16, patuli, garia kolkata- 700 094 west bengal, india tel: 91 –33-2436-9400 email: -

foreign owned

fax: -

hand phone: 98308 92627 email: relationship: wife

fax: -

if any, please specify: no beef, no pork

(kindly be informed that this bio-data form must be submitted and processed through national productivity organization (npo) of the respective member country. forms, sent directly to the apo secretariat would be neither processed nor acknowledged. a soft copy of the form could be downloaded from the apo website at www.apo-tokyo.org.)

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b. university/institution

academic qualification

major field of study

cert. /diploma/degree bachelor of engineering degree

year

(bachelor and post graduate only) 1.

regional engineering college, durgapur, west bengal.

mechanical engineering

2.

ahmedkar institute of productiity (formerly tipie)

energy conservation & management

1978

post graduate diploma 1981

3.

c. university/ institute/ org. nic isnt

training/ seminar (last 5 years only) major field of training/seminar

year 2004 2004

workshop on e – governance ir thermography

D. participation in other apo projects (last 5 years only)

yes

✓

no

if yes, please specify below

project

dates

year

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e. present job duties/activities state your present job duties and other activities in consultancy, training, research and publication relevant to the project. please attach organization chart, and highlight your position. providing techno-managerial consultancy services, training, research and associated activities for improvement of productivity in the region both at macro and micro level. this is done through intervention at the existing level of entrepreneurs as well as through innovative knowledge based training of budding entrepreneurs.

f. previous employment / job experience (last five years) for each previous employment / job experience, please give designation, organization worked for, period of employment, and job duties. designation – shift engineer maintenance organisation worked for : m/s. india paper & pulp paper company limited, naihati, west bengal. period of employment : 1978-79. job duties : preventive & breakdown maintenance of plants & equipments.

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g.

objective for participation

kindly refer to project notification, and state relevancy of project to your work, and indicate your expectation (s) from the project. 1) the present work as director and chief consultant , energy management group i am expected to deliver the following : (a) increase productivity & competitiveness with existing client population. sectors - * in present focussed areas * in newer emerging areas towards sustainable development . (b) increase productivity & competitiveness by building new clients population * in existing focussed areas * newer emerging areas towards sustainable development . . 2)

with challenging task given to developing nations towards meeting the environmental standards in various protocols, the programme will give an opportunity to share and enrich in the environmental management leading to sustainable development.

3) it is expected that the study meeting will discuss and explore some of the above challenging areas / best practices in geos to enable me as a participant to gain knowledge in the fast changing competitive world economic scenario and enable me to disseminate the same

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h. declaration by candidate i hereby declare that i have read and understood the apo project notification for this project. i further declare that the information as provided by me in this document is true and accurate. i understand and accept that any false declaration of information on my part will disqualify me from the project, even when it is in progress. i hereby also undertake to abide by the regulations prescribed by the apo, the host country(ies), and the implementing organization(s) during the entire period of this project, and to participate fully in it.

signature: ___________________________ date: october 28 , 2005 name: anjan kukar inha i. confirmation of candidate’s english language proficiency (to be filled by apo director/alternate director/liaison officer) the candidate’s english language proficiency has been evaluated as follows:✓ as fluent as the candidate’s native language. ✓ competent to participate in discussion and express himself. proficient enough to follow lectures/discussions, but will have difficulties in expressing ideas and giving comments. i further certify that the candidate belongs to: profit-making organization ✓ non-profit making organization

signature: nam : designation: 5

date:

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asian productivity organization

apo medical and insurance declaration form only for applicant without any of the health conditions listed on the reverse side 1. name (last name, first name, middle name) 2.

sinha anjan kumar date of birth 02-01-1957

3.

nationality indian

4. sex

( (

✓ ) male ) female

project title: forum on global opportunities in environmental sustainability (goes) duration & timing : 7-9 november 2005 (3 days) venue : singapore i hereby declare that : a. i have read carefully the project notification of the above apo project and declare that i have the physical and mental fitness to attend the apo project; b. i have had no health conditions listed on the reverse side during the last 5 years and am free from any ailment likely to impair the health of others or affect my participation in the apo project; c. i shall secure the required comprehensive travel insurance as specified in the project notification of the above apo project; d. i understand that neither apo nor the implementing organization shall be liable for any medical or other costs incurred during the project, except for those specifically stated in the project notification; and e. i shall bring with me the necessary medicines for minor illness as prescribed by my physician since they may not be readily available at the venue of the above apo project. i affirm this declaration on medical and insurance requirements of the apo project as specified in the project notification.

date: october 28 , 2005

applicant’s signature

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apo medical and insurance certification form only for applicant having any of the health conditions stated under item. 6 below 1. name (last name, first name, middle name) – not applicable – 2. date of birth 5.

3. nationality

4. sex

(

) male ( ) female

apo project code and name (venue)

6. please indicate “yes” or “no” if you had ever had any of the following during the yes no last 5 years : a. tuberculosis, asthma, emphysema, or other lung illnesses b. high blood pressure, heart by-pass, heart attack or other heart diseases c. stomach ulcer, liver (hepatitis), gall bladder disease d. kidney problem, stone or blood in urine e. diabetes, sugar or glucose in blood or urine f. depression, attempted suicide, or other psychological symptoms g. tumor, abnormal growth, cyst or cancer h. bleeding disorder, blood disease (sickle cell anemia) i. malaria, cholera, small pox or epidemic disease j. allergy k. other serious illnesses (please specify) i certify that the above information is true and correct to the best of my knowledge. i understand that neither apo nor the implementing organization shall be liable for any physical or mental problem that i may develop during my participation in the apo project and that i shall be responsible for bringing with me necessary medicines as prescribed by my physician since they may not be available at the venue of the project. further, i understand that i shall have to secure the required comprehensive travel insurance as specified in the project notification of the above apo project.

date: october 28 , 2005

applicant’s signature

to be completed by a medical doctor based on above given information, i have examined the above applicant and certify that he/she is free from any ailment likely to impair the health of others and fit to participate in the apo project referred to in this form. hospital/clinic’s name

:

examiner’s name & title

:

examiner’s signature

:

remarks, if any

:

date :

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national productivity council rong, kolkata inter office memo from : rpmg, kolkata to : dg, npc, new delhi.

no. 121/aks/ oct. 28, 2005

kind attn : shri k.v.r. raju, director (mkt. plng.) project title: forum on global opportunities in environmental sustainability (goes) duration & timing : 7-9 november 2005 (3 days) venue : singapore this has reference to your iom no.m 31517/05 dated 24th oct. 2005, received by us on 27/10/05 on the above subject. as desired, enclosed please find the duly filled in following documents in triplicate for your doing the needful. 1. apo bio-data form duly filled in (3 copies) 2. latest passport size photographs (3 copies) kindly acknowledge its receipt. enclo: as stated

(a.k. sinha ) chief consultant for head rpmg

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