Nomination Form

Details of the person who is making the nomination

Full Name *


Designation:*


Company:*


Email:*


Nominee Details

Full Name: *


Designation:*


Organization/Institute:*


Email:*


Mobile Number:*


Location:*


Date of Birth:*


Twitter Handle:*


Linkedin URL:*


Nominating for:



Please tell us in 250 words or less why the nominee should be considered for this recognition


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