GOVERNMENT OF MEGHALAYA

DEPARTMENT OF AGRICULTURE AND FARMER'S WELFARE

APPLICATION FORM FOR SETTING-UP SMALL SCALE OYSTER MUSHROOM PRODUCTION UNITS

Applicant's Details

Applicant's Full Name *

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Father's/Mother's/Husband's Name *

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Date of Birth *

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Gender *

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EPIC Number *

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Highest Educational Qualification *

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Do you have a Pan Card? *

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Yes

No

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PAN Card *

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Mobile Number *

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Applicant Present Address

District *

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Block *

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Village *

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Address/Locality *

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Address of the location where the oyster mushroom cultivation is planned

Same as above

Yes

District *

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Block *

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Village *

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Address/Locality *

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Service Specific Details

In how much area of land are you planning to do oyster mushroom cultivation (in Sq.m)? *

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Land Ownership *

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Own Land

Community Land

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Do you have prior experience in mushroom cultivation? *

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Yes

No

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Have you been trained in mushroom cultivation before? *

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Yes

No

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Details of experience in mushroom cultivation

What variety of mushroom do you cultivate? *

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Button

Oyster

Others

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Other variety

What is the current annual production (in Kgs)? *

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In how much area of land are you currently cultivating mushrooms (in Sq.m)? *

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Training details in mushroom cultivation

In which Country training was imparted? *

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State where the training was imparted? *

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Name of Institute *

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Which year were you trained? *

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What variety of mushroom have you been trained to cultivate? *

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Buttons

Oysters

Others

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Other variety of mushroom *

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DECLARATION

1. This is to certify that the information furnished as above are true to the best of the applicant's knowledge and belief and that the applicant would be liable for prosecution if found otherwise

2. I also certify that there are no other applicants from the same household

I Agree *

Application Submission location *

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Mobile number is required to provide status of their application.