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அயலகத் தமிழர் தினம்-2024
NOMINATION FORM FOR NRT AWARD-2024
Category
*
Select Category
Tamil Literature
Education
Social development
Women
Business
Science & Technology
Sports
Medicine
DETAILS ABOUT THE NOMINEE
Personal Information
First Name
*
Last Name
*
Father's Name
*
Passport Size Photo
*
Gender
*
Select Gender
Male
Female
TransGender
Date of Birth
*
Place of Birth
*
Place of Origin in Tamil Nadu
*
Marital Status
*
Select Marital Status
Yes
No
Nationality
*
Country of residence
*
Address of nominee in Tamil Nadu
*
Mobile Number
*
Email-Id / மின்னஞ்சல் முகவரி
*
Profession of the nominee
(a) Name of the organization
*
(b) Designation
*
OTHER INFORMATION
(a) Name of the nominee’s ancestor who migrated from Tamil Nadu
*
(b) Relationship with the nominee
*
(c) Approx. year when he/she migrated from Tamil Nadu
*
(d) Last known address of ancestor in Tamil Nadu
*
In the case of Non-Resident Tamil, please provide the following information for the past five years:
Country of stay
*
Period of stay From
*
Period of stay to
*
Significant achievements of the nominee in his profession, i.e. area of work (Describe in 100 words)
*
JUSTIFICATIONS FOR NOMINATION
Please provide justification for nomination in approximately (100 words):
*
Previous awards, decorations, citations given to the nominee (Only those of national / international importance can be mentioned)
Name of Award / Decoration / Citation
*
Year in which it was granted
*
Name of country / Organization which gave the award
*
Work / Reasons/ accomplishments for which Award was given
*
Person/body proposing the nomination for NRT Awards (In case of self- nomination, it is not required)
Name
*
Position
*
Address
*
Mobile
*
E-mail
*
I certify that the information furnished above is true to the best of my knowledge and belief.
Date
*
Place
*
Signature
*
Submit / சமர்ப்பிக்கவும்
nrtchennai@gmail.com
+91 1800 309 3793
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