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10th Udgam Women's Achiever Award Last Date For Submission: 15th Feb 2019
To nominate for the 2019 Awards please complete this form and submit the necessary information as requested. If you have any problems uploading your nomination please contact us at
Email address *
Award Category
Nominee's Full Name *
Residence Address: *
Phone / Mobile Number *
Email Address & Website: *
Birth Date (MM/DD/YYYY): *
Height: *
Qualification: *
Business details (If any):
Business Contact details with Email & website:
The person filling and submitting this form is: *
Name of the nominator if applicable *
Phone number for nominator *
Email address for nominator *
A. Please summarize the nominee’s most recent accomplishments (minimum 50-70 words): *
B. Please share a brief story that illustrates a specific contribution made by your nominee, as well, their overall impact(minimum 300 words): *
C. Other information about the nominee. (Awards, honors, community recognitions, personal qualities, etc.) *
C.1 Attach Your Document
D. Why do you think nominee’s/your nomination should receive the 10th Udgam Women’s Achiever’s Award? *
Additional information
We would suggest including the following supporting material with your entry.
Please upload the nominees CV
High quality photo of nominee that will be used within marketing and printed materials if shortlisted. Please provide a high quality head shot of at least 2MB.
At least 2 statements of recommendations with Contact Details.
If you are not able to upload your documents. Please send your documents using email at with your name and contact number.
Declaration & Marketing Permission
I hereby authorize the verification of the information provided on this form and submit this nomination form for the Udgam Women’s Achiever’s Award. I hereby certify that, to the best of my knowledge, the statements and calculations alculations contained herein accurately reflect the details reported. Yes I confirm the nominee will attend the whole event on 9th March 2019.
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