10 th 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 [email protected] or call 9591985287 ¨sÀwð ªÀiÁrzÀ £ÀªÀÄÆ£ÉUÀ¼À£ÀÄß £ÀªÀÄä ¨ÉAUÀ¼ÀÆgÀÄ ¥Àæ±À¹Û PÉÃAzÀæ £ÀA.54 gÁPï¯ÉÊ£ï ¸ÉAlgï jZïªÀÄAqï gÀ¸ÉÛ, ¨ÉAUÀ¼ÀÆgÀÄ-560025 F «¼Á¸ÀPÉÌ vÀ®Ä¦¹. ºÉaÑ£À ªÀiÁ»wUÁV E ªÉÄÃ¯ï ªÀiÁr [email protected] CxÀªÁ ¸ÀA¥ÀQð¹: 9591985287 D£ï¯ÉÊ£ï ªÀÄÆ®PÀ £ÁªÀĤzÉÃð±À£À ¸À°è¸À®Ä www.nammabengaluruawards.org UÉ ¨sÉÃnPÉÆr. • All starred fields (*) are mandatory • One nomination per form •You can nominate more than one individual • Please use seperate forms for each nomination • • • • ªÀåQÛUÀ¼À . Rising Star GzÀAiÉÆãÀÄäR vÁgÉ Media Individual ªÀiÁzsÀåªÀÄ ªÀåQÛ Citizen Individual £ÁUÀjÃPÀ ªÀåQÛ Social Entrepreneur ¸ÁªÀiÁfPÀ GzÀå«ÄÛ Government Official ¸ÀPÁðj £ËPÀgÀgÀÄÛ