DIRECTORATE OF OFFICIAL LANGUAGE
Government of Goa
Scheme for Publications in Official Language – Konkani and Marathi - on the subjects Science & Technology, Sociology, etc.
APPLICATION FORM
1. Name of the manuscript………………………………………………………….
2. Stream/Subject of the manuscript………………………………………………...
3. (i) Name of the writer/writers………………………………………………..
(ii) Full Address(with pin code)………………………… …………………..
…………………………………..……………………………………….
(iii) Telephone/Fax No. ……………………………………………………….
(iv) E-Mail Address …………………………………………………………..
4. Had the manuscript been sent for any other competition previously?
If yes, please give full details thereof :-
(a) When sent ………………………………………………………………...
(b) To whom sent (complete address) ……………………………………….
……………………………………………………………………………
(c) Had any award been given? If yes, give full details ……………………..
……………………………………………………………………………
5. Has the author won any award under any Scheme For Original Book
Writing? If yes, give the following details :-
(i) Name of the prize winning book …………………………………………
(ii) Year of the prize ………………………………………………………….
(iii) Amount of prize ………………………………………………………….
(iv) Year of publishing of the book …………………………………………..
(iv) Full address of publisher …………………………………………………
(vi) Price of book ……………………………………………………………..
6. I/We certify that
(i) I/We am/are Indian citizen(s).
(ii) The manuscript has been written originally in Konkani / Marathi by me/us
(iii) The copyright of any other person is not violated by entering my/our manuscript in this scheme.
I/We promise to abide by the provisions of the regulations of the Scheme for Publications in Official Language on the subjects Science & Technology, Sociology, etc.
Place:
Date: Signature of Author/Authors
Note: 1. This form duly filled in along with three copies of the manuscript, may be sent to Directorate of Official Language, 1st Lift, 5th Floor, Junta House, Panaji, Goa – 403 001.
2. A gist of the book, duly signed by the author may be enclosed.
Right to relax Regulations:
If the Government deems it necessary or appropriate, it may relax any of the provisions of these regulations by an order and after recording the reasons thereof.