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Award Nomination Form

Nomination Fee
 Government:  Nil
 Hospitals:  Nil
 Corporate:  INR 10,000 + GST(23.9%) = INR 12,390/-
 Other's:  INR 10,000 + GST(23.9%) = INR 12,390/-
Note: GST 18% + (Online Bank Transfer Charges + Transfer GST charges) @ 5.9% = 23.9%

Nominate Now

Select Sector :*
Award Category :*
Product/Project Title:*

Nomination Fee:

Zone:*

Details of Applicant

Name:*
Designation:*
Name of Organisation:*
Address:*
City:*
State:*
Country:*
Postal Code:
Telephone No:*
(with area code)
Mobile No:*
(with country code)
E-Mail:*
Website:*
Facebook page of the Organisation:
LinkedIn page of the Organisation:
Twitter Handle of the Organisation:

Project Details

Brief Description:*

(Maximum file size 1 MB in doc or pdf format)
Project USP:*
Target Group:*

Upload Organisation Logo:
(Maximum file size 1 MB in jpeg, jpg or png format)

Upload supporting documents:
(Maximum file size 1 MB in pdf or doc format)

Registration Fee*
 Online Payment