Application Form for Excellence Award Certificate

Personal Information

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Full Name(As Per Certificate)

Date of Birth

Age

Mobile Number

State

country

Zip Code

Email Address

Facebook URL

Linkedin URL

Address

Mother Tongue

Marital Status

Single Married

Father's Name

Languages Known

Qualification Information

Qualification	Name of School / College	Year of Completion	Subjects (Place "," after Subject)
SSC (10th)
HSC (12th)
Graduation
Post Graduation
Other

Document Checklist

1.Please provide a concise autobiographical summary (max 3,000 words) highlighting your journey .Focus on your innovation, customer care, marketing strategies, entrepreneurial approach, and their impact on brand growth, business expansion, digital transformation, and consumer engagement. If associated with a start-up, describe how your marketing & strategies efforts have driven visibility, customer acquisition, and scalability. For Excellence Award

Words: 0 / 3000

2. Please attach all the following documents in PDF, JPG, PNG format:
a). Curriculum Vitae(CV)/Resume

b). Recent Passport-Size Photographs

c). Copies of all relevant Educational Certificates and Supporting documents

d). Recommendation Letters (if applicable)

e). News articles / Media coverage (if any)

f). A Copy of a Valid identification document (Passport, Voter ID , Aadhar ID or any other Government Issued National ID)

3. Work related certificate/ Achievement/ Experience need to upload.

Reference Contacts

Relation 1

Name

Relation

Contact Number

Occupation

Relation 2

Name

Relation

Contact Number

Occupation

SECTION G: Declaration

I hereby declare that the information provided in this application is true and correct to the best of my knowledge. I understand that submission does not guarantee the conferment of the Honorary Doctorate Award (Honoris Causa) and that the institution reserves the full right to approve or reject the application based on its internal review process.

I also grant full permission to the university to use my name, photograph, biography and any related articles or materials for institutional archives, publications, digital records and promotional purposes.

Date of Declaration

Upload Signature

Note: It is the responsibility of the person(s) completing this form to provide supporting information on the nomination to enable the Lifetime Achievement Award Committee to make a decision.

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