Nomination Form Category you are applying for:
Last Date oCt 25 For Receiving Nominations
2016
Name of CEO/MD/Chairman: ................................................................................... Address: ............................................................................................................................ .............................................................................................................................................
Name of the Company:
Mobile: ..............................................E-mail: ................................................................ Market share of brand: ............................................................................................... No of Products: .............................................................................................................
Brand:
Year wise Growth: ........................................................................................................
Industry:
Credentials/ Quality Certification if any: (Enclose Details)
State/Country:
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About the Company
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Manufacturer/ Distributor: ........................................................................................ Address: ................................................................................ ..................................................................................................
State/s covered for promotion: ...............................................................................
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No of Institutes covered: ...........................................................................................
Mobile: .................................................................................
Utility/Innovation/Future plans: .............................................................................
Landline: ..............................................................................
Awards received National /International: (Enclose Details)
Alternate number: .............................................................
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E-mail: ....................................................................................
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Company website: ............................................................
Produce publicity & Media coverage: (Enclose Details)
List out all your brands: ................................................... Market Share of Specific Brand: ...................................
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Details of Contact person for any other information:
Name:............................................................................................... Designation:.................................................................................... Phone:.............................................................................................. Email:.................................................................................................. Note: Any other relevant information may be enclosed with the form.
Send the nomination to:
8-3-191/565/K, Vengala Rao Nagar, SR Nagar Post, Hyderabad-500 038, Telangana, India Tel: 040- 65 51 51 51 +91 9494 43 9444 Email: bfiea2016@brainfeedmagazine.com www.brainfeedmagazine.com