APPLICATION / NOMINATION FORM

 

Eligibility for Individuals /Group of Individuals:

* Age of the applicant should be less than 70 years.

* Applicant should have minium 5 years of grassroot level work experience.

* The recipient(s) volunteering in individual / Group Capacity working for social cause can be from any profession.

* Should not have received any National &/or State level Premium award.

Eligibility for Organisation:

* Should have minium 5 years of grassroot level work experience.

* Should not have received any National &/or State level Premium award.

Eligibility for Nominations:

* An individual or an organization can nominate any individual/group of individuals or an organisation working for social cause.

* Age of the Individual Applicant should be less than 70 years.

* An applicant / nominee should have minimum 5 years of grassroot level work experience.

* An applicant / nominee should not have received any National &/or State level Premium award.




APPLICANT'S BACKGROUND

 

Select Applicant Type :

*Note : If you are NOMINATING an Individual / Group of Individuals /Organisation please fill up the required details and then fill up your own details.

 

Note : (For Any Queries) Please Contact : IMFA Building, Bomikhal, Bhubaneswar 751010. Odisha, India. Tel: +91 674 2611000, 2580100 FAX: +91 674 2580020, Email: mail@bipf.org.in