Organization Awards Nomination Form

Lt.DIPANKAR GHOSH MEMORIAL AWARDS

Award Nomination Form
Nominated/Authorised Person*
Organization name
Position
E-mail*
Phone Number*

Area CodePhone Number
Nominator:

Person submitting the nomination
Full Name*

First NameLast Name
Company*
Position*
E-mail*
Phone Number*

Area CodePhone Number
Nominee Information

Please indicate details about your nomination
Categories:*

Best SchoolBest Sport PersonBest Cultural ActivitistBest Social WorkerBest Social Development Theme(Execute)Best Anganwari CentreBest Foreign ContributerPerson of the YearBest Blood Donar Org.Best Tourism Development Org.
Describe*
Should be Empty:

Lt.DIPANKAR GHOSH MEMORIAL AWARDS