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Qimpro Awards 2012
Celebrating excellence in quality for over two decades
NOMINATION FORM
Nominee
* Mandatory Fields
[This is the candidate/individual who is being nominated for Qimpro Awards]
Name of Nominee*
Designation
Organization*
City*
Email ID
Category*
Please select the category
Qimpro Platinum Standard - Business
Qimpro Platinum Standard - Education
Qimpro Platinum Standard - Healthcare
Qimpro Gold Standard - Business
Qimpro Gold Standard - Education
Qimpro Gold Standard - Healthcare
Nominator
[This is the person who is nominating the candidate. The Nominator need not be from the same organization as the Nominee]
Name*
Designation*
Organization*
Site / Unit
Department
Address*
City*
Pin*
STD*
Desk Phone*
Mobile*
Official Email*
Personal Email
Application Coordinator
Same as above
[This is the person in the Nominee's orgainzation whom Qimpro should be in touch with for the application]
Name
Designation
Organization
Site / Unit
Department
Address
City
Pin
STD
Desk Phone
Mobile
Official Email
Personal Email
4B Sindhu House, Nanabhai Lane, Fort, Mumbai 400 001, India
Contact Jigisha Lulla at
awards@qimpro.com
or
call (022) 66348701
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