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Nomination Form
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Young Alumni Award Nomination Form
*Who are you nominating?
--Select--
Nominating Yourself
Nominating Someone Else
Your Contact Information
*Title:
*Your Name:
*Email ID:
*Your Phone Number:
*Your Role in IIITD:
--Select--
Faculty
Staff
Fellow Alumni
Student
Other
Your Nominee's Contact Information
*Nominee's Title:
*Nominee's Name:
*Nominee's Email ID:
Nominee's Phone Number:
Program Details
*Program:
--Select--
B.Tech.
M.Tech.
Dual Degree
Ph.D.
Diploma
*Year of Graduation:
--Select--
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
*Current Organisation:
*Current Designation:
*LinkedIn profile Link (In case you / your nominee do not have a Linkedin account, kindly share any other professional URL to verify):
*You may enter multiple URLs by separating the links with a comma
*Please briefly tell us why you feel you / your nominee should be considered for the Young Alumni Award (suggested: 200 words).
Please select the category you want to nominate yourself in (you can select more than one)
Notable contribution to field of work/technological innovation/discipline
Notable contribution to society/community/alma mater
Notable contribution to leadership/entrepreneurship
* Please select at least one category.
Notable contribution to field of work/technological innovation/discipline
Please share your notable accomplishments in the current role:
1. In case there are any specific projects/collaborations with higher contributions from your end, please provide the details along with necessary proofs:
2. Notable publications in journals/conferences, books/book chapters with contribution as first author (Please categorize the publications into Tier 1, Tier 2, A*, A, etc.):
3. Have you given any invited talks related to your field of work? If yes, please share the list of these talks along with necessary proofs:
4. Have you received any awards for your work? If yes, please share the details along with necessary proofs:
5. Have you made any contribution to professional services (eg: editor/reviewer in journals)? If yes, please share the details along with necessary proofs:
6. Do you have any patents? If yes, please provide the details along with necessary proofs:
7. Do you have any research projects/innovations that have been deployed as technology transfer on ground? If yes, please provide the details along with necessary proofs, and mention the Technology Readiness Level (TRL) of each project:
8. Have you received any awards for your innovation? If yes, please share the details along with necessary proofs:
Notable contribution to society/community
1. Have you contributed to any projects that have made a significant impact on society? If yes, please provide the details along with necessary proofs:
2. Have you been involved in any community work that has had a major impact? Please provide the details along with necessary proofs:
3. Have you been involved in any service to your alma mater i.e. IIIT-Delhi? Please provide the details along with necessary proofs:
4. Have you received any awards for your community work? If yes, please share the details along with necessary proofs:
Notable contribution to leadership/entrepreneurship
1. Please describe your significant accomplishments/initiatives in a leadership role:
2. Have you founded or co-founded any venture/company? If yes, please share information about your company along with the website link:
3. What is the USP of your business, and how is it making a contribution in the upliftment of society or the nation?
4. What is the current valuation of your startup? Please share necessary proofs:
5. Has your startup received any investments or funding? If yes, please share the details along with the necessary proofs:
Testimonies
Please attach testimonies in a single document to support your candidature:
* Please upload a PDF file.
Supporting Document
Please attach document to support your candidature:
*Please create a single document with all the necessary proofs
* Please upload a document.
