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Name of Company*

Name of Contact Person*

Email Address*

Mobile Number*

Address of Company*

Company Website

Awards Groups(Kindly fill the the award group CITIUS/ALTIUS/FORTIUS)*

Award Category*

Award Entry Ticket No.(It's required, If you are paying online payment)

Give a brief description of your organization(Limit – 200 words)*

When did the CSR project begin, who are the Stakeholders/ social groups for which the activity is undertaken and what is the unique proposition that your initiative offers?(Limit – 200 words)*

What is the impact that this initiative has had across the last one year (1 April 2016 - 31 March 2017)? (Limit – 200 words)?*

In what specific ways is this scalable to ensure a far-reaching effect?*

How are the activities in the areas of CSR integrated into enterprise processes?*

Kindly send the supporting documents to support@indiahealthsummit.com (Size Limit: 10 MB, PDF only). Please mention your Category & Organisation Name in the Subject Line.

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