Nomination form

A. Type of Submission (Select One)

I am recommending someone else for this award I am applying for myself (Self-Nomination)

B. Recommender / Nominator Details (Only if recommending someone else)

Full Name:

Email:

Mobile Number:

Profession / Affiliation:

Relationship with the Nominee:

Note: If this is a self-nomination, you may skip the above.

C. Self-Applicant Details

Full Name:

Date of Birth (DD/MM/YYYY):

Age (as on 16 October 2025):

Gender:

Male Female Other Prefer not to say

Mobile Number:

Email ID:

Full Address (State and Pin code):

Profession / Organization:

Social Media Handles (LinkedIn / Twitter / Instagram – optional):

Academic Qualification:

Professional Qualification:

Any Recognition/Award So Far:

Father Name:

Mother Name:

D. Upload Photo of Self-Applicant/Nominee

(Recent passport-size photo in JPG or PNG)

Upload Photo

E. Field(s) of Contribution (Select One or More)

F. Description of Achievements

Up to 1000 words, please explain your/nominee's key contributions, innovations, social or national impact, recognitions, and other relevant information.

0 / 1000 words

Upload Supporting Documents(Aadhaar/PAN/Passport, Must)

PDF format only, Max file size 10 MB

Upload File(s)

H. Declaration

I hereby declare that the information provided above is true to the best of my knowledge. I understand that the decision of the Jury will be final and binding

A confirmation email will be sent upon successful submission.
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Self-Nomination/Recommendation Proforma