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Name *

Organization Name *

Mobile No *

E-mail Address *

Postal Address *

Award Sector Category Number *

Mention the Sub-category *

Current Occupation *

Achievements *

(Highlight the key achievements, initiatives, or contributions that make you or your organization eligible for the award)

Evidence *

(Provide specific details, data, and evidence of your accomplishments)

Impact *

(Describe the impact of your work on your field or community)

Photos / Videos *

(Provide Google Drive / WeTransfer / online link)

Details of Payment (NEFT / DD / CHEQUE) *