Nominations form great ideas

9th CavinKare-MMA Chinnikrishnan Innovation Awards – 2020

Name of the Nominee* * If in case of partnership / co-ownership, please specify names of all individuals

Address Line 1

Address Line 2

Address Line 3

Address Proof* (Max 2mb)

PAN Card* (Max 2mb)

Address Line 1

Address Line 2

Address Line 3

Mobile No*

Landline No

E-mail*

Name of Authorized Representative of Nominee:

Nature of the Organization: State Whether
privatepartnershipindividual

Name of Business to which the idea is applicable:

A Brief write-up in 300 words - “Why My Idea is Great!”

Nominated by

Designation

Representing(Company)

Mobile No.

Landline No.

E-mail

Filling Date

Attach Signature (Max 2MB)