10th Edition

WHO IS YOUR UNSUNG HERO FOR BENGALURU?Tick only one from the categories listed below / Only one nomination per form

Age

Nominee Name Mr/Miss/Mrs:

Organisation :

Designation :

*Reason For Nomination /

_________________________________________________________________________________________( Describe Service, Impact, Uniqueness)*

_________________________________________________________________________________________

______________________________________________________________________________________

Website (if any) : ____________________________Phone / Mobile : ____________________________ Email Id : _________________________________

Your Name: ________________________________ Email Id: __________________________________

Your Relationship with the Nominee

_________________________________________

Your Signature:

___________________________

NOMINATOR DETAILS (YOUR DETAILS)

Phone Number: ____________________________

If you have access to supporting documents like the nominee resume, online information such as website URL/Blogs, letters of recommendation , articles, details of other commendations or recognition they have received and evidence of the contribution such as photographs/ videos and

financial support documents, please enclose them. The information you send will increase the chances of your nominee to win.

Terms and Conditions Apply:- Finalists are based on jury deliberation and the decision of the jury shall be final. For more information, visit www.nammabengaluruawards.org

Please Note:

Please submit the filled forms to the office Namma Bengaluru Awards, No. 54, Rockline Centre, Richmond Road, Bengaluru - 560025. You can also log on to www.nammabengaluruawards.org to file an online nomination. For more information please write to nba@nammabengaluruawards.org or call 9591985287

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• All starred fields (*) are mandatory• One nomination per form

• You can nominate more than one individual • Please use seperate forms for each nomination

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