Elets Digital Learning 40 Under 40 Nomination Form

Fill Personal Details

Full Name*: - (Nominee’s First and Last Name) Date of Birth*: *Note: Nominees must be under 40 years of age at the time of submission.* Email Address*: - (Nominee’s Email) Phone Number*: - (Nominee’s Contact Number) LinkedIn Profile*: - (URL link Social Media Profiles*: - (Optional: Include links to any other relevant social media platforms)

Fill Professional Information Details

Current Job Title - (Nominee’s Title or Role)

Company/Organization: - (Nominee’s Employer, School, University, Startup, or Consultancy Name)

Professional Experience: - (Years of experience in the education sector)

Education Background: - (Degrees, institutions attended, certifications)

Fill Achievements & Impact Details

Describe the nominee’s contributions to the education sector: - (Max 400 words)

How has the nominee’s work impacted students, institutions, or the education industry: - (Max 300 words)

Why do you believe this person should be recognized in the Elets Digital Learning 40 Under 40 magazine? - (Max 250 words)

Fill Supporting Documents Details

Supporting Documents (Optional but recommended):

- Upload any supporting materials, such as:
- Resume/CV
- Articles, publications, or media mentions
- Awards, honors, or recognitions
- Document for DOB Proof

Fill Nominator Information Details (if different from nominee)

Your Name: - (First and Last Name)

Your Email Address: - (Nominator’s Email)

Your Relationship to Nominee - (Colleague, mentor, self, etc.)

Final Step Details

Regular Nomination Fees: (Ends on 15th November)

Individual Nomination: INR 35K
Duo Nomination: INR 60K
Group Nomination: INR 75K

Terms and Conditions:
I certify that the information provided in this form is accurate to the best of my knowledge.
I consent to the use of my information for the purposes of this nomination and publication in the Elets Digital Learning 40 Under 40 Awards.