Nomination Form for Small firm Company Name: Contact Person Name: Mobile: Telephone No.: Email: Web Address: Details of Nominee: Nomination Category: Choose from BellAward Website: www.bellaward.com Nomination Title: Name of Product/Service/Solutions Team Lead Name: Cell no.: Email: Please enclose the following other documents: 1) Brief profile of team lead 2) List other team members and brief profile 3) Submit a white paper/ proposal/ concept note/ project details. The white paper should contain an abstract of the idea not more than 1000 words or one page and the paper itself should not exceed three to five pages. If required we may ask for further details. Confidential Page 1 30/01/2016 4) Case Study if the product or solution has been deployed in practical 5) 5 critical Comparison with other similar products in Market Terms & Conditions: 1. Nomination Processing Fee: (*14% service tax extra) Small firm: USD$450 ; o Small Organization: Annual Turn Over < $1Mn 2. If you have nominated your product/solution in previous awards, you cannot nominate the same product/solution. 3. Participation of entry does not guarantee getting an award. 4. If you have to rectify the form after submission, you will have to submit a new form requesting to cancel the previous one. 5. By submitting this nomination you accept that we can pass this information to judges and that, if the project wins, we can publish this information in print and online before, on or after award ceremony without further reference to any of the companies involved. 6. Categories may be realigned or reconsolidate with the mutual consent of Jury Members and Knowledge Partner 7. Final decision would be entirely based on the judgement of Jury members. You have following payment options: 1) For payment send a DD to Delegation office in Mumbai in the name of “Aegis Knowledge Trust A/c Aegis Graham Bell Awards” payable at Mumbai. 2) For Bank Transfer: You can transfer the money to Aegis Graham Bell Awards Business account Bank Name: Axis Bank Ltd Account Name: Aegis Knowledge Trust A/c Aegis Graham Bell Awards Account Number: 911010027349782 Bank: Axis Bank Ltd, CBD, Belapur, Navi Mumbai 400614, MH, India. MICR Code: 400211068 IFS Code: UTIB0000861 Confidential Page 2 30/01/2016 Nomination Deadline: 10 April 2016, Mumbai, India Dates for Jury Round: 18-20 May 2016, Mumbai, India Please Fill this form and Send the soft copy of the nominations from organization to: Mukesh Vaghela Manager, Corporate Communication Aegis Graham Bell Awards |Cell +91 983 385 4488| [email protected] Gyavin Picardo Manager-Sales & Marketing Cell: +91-902 289 3868 | [email protected] Aegis Graham Bell Awards | 1101, 11th Floor, B Wing, Kukreja Centre, Sector 11, CBD Belapur, Navi Mumbai – 400614 India. www.bellaward.com Confidential Page 3 30/01/2016
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