Awards Nomination

If you wish to nominate yourself or any individual or organisation which has been working to improve the health of school going children or community, kindly fill up the nomination form given below.

Nomination

Nomination form for Awards

"*" indicates required fields

Name*

First Last

Email*

Phone*

Designation*

Name of the Organization/Educational Institution*

Complete Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Select Category

Mention Citation

Please write the special / notable contribution done by the Individual or the organization in the above field for the award. (Preferably 150words only)

Have You Registered as a Delegate

Total Payment

Untitled

This field is for validation purposes and should be left unchanged.