Nomination Category
Please select one: [i] Self-Nomination [ii] Nomination of a Fellow professional.
Nominator Information
Name : [You may mention ‘Self’ if you are nominating yourself].
Title [Mr./Mrs/ Ms./Dr.] :
Organization:
Your Mail ID:
Your WhatsApp Number:

Nominee Information
Name:
Title [Mr./Mrs/ Ms./Dr.]:
Organization:
Your Mail ID:
Your WhatsApp Number:

Please fill up these details to help us take the decision to induct you into the Hall of Fame:
1. Did you present OKT as a SME; if ‘Yes’, please share the date and topic of discussion.
2. Did you contribute to the success of the OKT by taking up the role of [i] Speaker introduction, [ii] moderate Q-A sessions, and [iii] Volunteered for Vote of thanks. By the way, THIS IS ALSO A CONTRIBUTION.
3. How many trainings did you conduct under the aegis of J & A Bharat HSE Foundation?
4. Were you instrumental in facilitating MOUs with organisations of repute?
5. Have you been a regular knowledge sharer on the WhatsApp platform, vis-à-vis Knowledge Capsules, case studies, HSE quizzes, etc.
6. Have you enabled scholarships for deserving students under the various scholarship schemes of J & A Bharat HSE Trust. THIS IS ALSO A CONTRIBUTION.
7. Anything else you would like to tell us why you deserve to be inducted into the HoF: [say it in less than 50 words].

Please submit this nomination form and supporting documents [if any] to the Editorial Team members to their Emails at:

1. Chief Editor Mr. NC Madhu Chakravarthy: madhunc@hotmail.com
2. Editorial Member Dr. Laxminarayan Proddutoor: pls29653@gmail.com

All those who meet the criteria given in the following link can submit their details through the following link : Microsoft Forms