An Event for celebrating successful women in manufacturing & allied industries and recognizing their outstanding contribution to society

Nomination Form

[Please fill this up and submit to Divya Media before 5th May 2023]

If you are human, leave this field blank.

Name *

Designation *

Organisation *

Email *

Address *

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City

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Zip code

Personal Profile / Bio-sketch (upto 150 words): *

Professional Achievements (upto 150 words): *

A Brief Account of your contribution to your organization, helping it excel in its chosen sphere (upto 150 words):

Social Activities / CSR initiatives, if any, with Achievements (upto 150 words): *

How do you balance your work, home and leisure (upto 150 words): *

Favorite Hobbies (upto 150 words): *

Your Passion and Goal (upto 150 words): *

Beliefs & Values (upto 150 words): *

Any two references (name, phone, email ID): *

Terms & Conditions *

Read all the terms and conditions below, Submit Button

Read and agree with all terms and condition

Submit your nomination form

Terms & Conditions

• Per nomination- 1+1 Entry passes will be provided
• Nomination fees will be non-refundable and non-transferable.
• All rights reserved with Divya Media Publications for any modifications related to the event.