Expert Empanelment Form | Bengal Agro Farming

1 BASIC INFORMATION

Full Name Father’s / Husband’s Name Date of Birth

2 CONTACT DETAILS

Mobile Number Email ID Address State City PIN

3 PROFESSIONAL DETAILS

Area of Expertise Years of Experience Current Occupation / Designation Organization Name (if any) Educational Qualification

4 EXPERTISE & SERVICES OFFERED

Key Skills

5 DIGITAL PRESENCE (OPTIONAL)

Website Social Media Links

6 BANK / PAYMENT DETAILS

These optional details are stored with your private submission and are visible only to authorized BAF administrators.

Account Name Bank Name Account Number IFSC Code Branch

7 DOCUMENTS ATTACHED

A profile/passport-size photo and exactly one identity proof are mandatory at final submission. JPG, PNG, and PDF files are content-checked; profile photos must be JPG or PNG. Maximum 2 MB per file on this server.

Profile / Passport Size Photo JPG or PNG, 200×200 px minimumNo saved photo yet One Identity Proof File PDF, JPG, or PNGNo saved identity proof yet Educational CertificatesOptional PDF, JPG, or PNGNo saved certificate yet Experience ProofOptional PDF, JPG, or PNGNo saved experience proof yet

8 DECLARATION & NO OBJECTION (NOC)

Declaration

I hereby declare that the information provided above is true and correct to the best of my knowledge.

I accept this declaration.

NO OBJECTION (NOC)

To, Bengal Agro Group Pvt Ltd

I, the expert named in this form hereby consent to Bengal Agro Farming to:

Use my name, photograph, profile, and professional details
Publish and promote my profile on Website / Social Media / Marketing Materials
Site visit visuals/ Professional profile/ Photographs/Official website/Brochures
Videos and project documentation7Digital Campaigns

I give the above NOC consent.

Signature (type your full name) Date

Official note: Empanelled experts may be considered for revenue-sharing, project-based assignments, or future partnership opportunities based on performance and engagement.

Join our expert network.