Raj Bhavan

Last Date of Submission: 05/12/2025 By 5.00 pm

Online Application Proforma for Individual / Organization / Institutions for the Hon’ble Governor’s Awards for Excellence – 2025

Application for :
Individual Institutions/Organizations

Application Proforma for the Institutions/Organizations/Societies/Trusts
to apply for the Hon’ble Governor’s Awards for Excellence – 2025

Details of work done in any one of the following categories: * Women Empowerment Tribal Development Rural Health & Medical Philanthropy Corporate Volunteering

Name of the organization/Institution/Society/Trust *

Date of registration/incorporation With registration No. and details *

Registration No *

Upload Registration Doc * (Upload 1 support file: PDF. Max 5MB)

Address of the organization/Institution/Society/Trust*

Mobile Number*

Fax No.

Email ID*

Name of the Applicant*

Address*

Mobile No*

Passport size photo * * only jpg file (max size 30kb)

Attach photo id proof * (Upload 1 support file: PDF. Max 5MB)

Details of work done in the field applied for the last five (05) years i.e., from the year, 2020 onwards. * (Up to 1000 words allowed) (Upload 1 support file: PDF Max 5MB)

Please furnish brief data of impact/outcome of the work done for the last five (05) years i.e., from the year, 2020 onwards along with supporting document and photos * (Upto 500 words allowed) (Upload 1 support file: PDF Max 5MB)

Specific narration of credible contribution in the selected filed for the last five (05) years i.e., from the year, 2020 onwards (Upto 250 words allowed)

Power Point Presentation (P.P.T) on the activities (not more than 10 slides) as handouts (hard copies) to be attached.* (Upload 1 support file: PPT Max 5MB)

Name, address and mobile no.s of three references of eminent persons who can be contacted for details*

S.No.	Name	Address	Mobile No.
1
2
3

Declaration : I hereby agree to abide by the decision of the Governor/ Selection committee and waive my right to challenge or question the decision in any forum.

Application Proforma for the Individuals to apply for the Hon’ble Governor’s Awards for Excellence – 2025
(for Women Empowerment, Tribal Development, Rural Health & Medical Philanthropy,Corporate Volunteering)

Details of work done in any one of the following categorires: * Women Empowerment Tribal Development Rural Health & Medical Philanthropy Corporate Volunteering

Name *

Photo * * only jpg file (max size 30kb)

ID Proof * * only pdf file (max size 5MB)

Date of Birth * 0 Y

Gender* Male Female Transgender

Postal Address*

Mobile Number *

Email ID *

Details of work done in the field applied for the last five (05) years i.e., from the year, 2020 onwards. * (Up to 1000 words allowed) (Upload 1 support file: PDF Max 5MB)

Specific narration of credible contribution in the selected filed for the last five (05) years i.e., from the year, 2020 onwards (Up to 250 words allowed)

Power Point Presentation (P.P.T) on the activities (not more than 10 slides) as handouts (hard copies) to be attached.* (Upload 1 support file: PPT Max 5MB)

Name, address and mobile no.s of three references of eminent persons who can be contacted for details *

S.No.	Name	Address	Mobile No.
1
2
3

Declaration : I hereby agree to abide by the decision of the Governor/ Selection committee and waive my right to challenge or question the decision in any forum.

Online Application Proforma for Individual / Organization / Institutions for the Hon’ble Governor’s Awards for Excellence – 2025

Application Proforma for the Institutions/Organizations/Societies/Truststo apply for the Hon’ble Governor’s Awards for Excellence – 2025

Application Proforma for the Individuals to apply for the Hon’ble Governor’s Awards for Excellence – 2025 (for Women Empowerment, Tribal Development, Rural Health & Medical Philanthropy,Corporate Volunteering)

Application Proforma for the Institutions/Organizations/Societies/Trusts
to apply for the Hon’ble Governor’s Awards for Excellence – 2025

Application Proforma for the Individuals to apply for the Hon’ble Governor’s Awards for Excellence – 2025
(for Women Empowerment, Tribal Development, Rural Health & Medical Philanthropy,Corporate Volunteering)