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CavinKare Ability Mastery Award Nomination
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CavinKare Ability Mastery Award Nomination
CKA Mastery Awards
Nomination Details
First Name
Last Name
Nominee Mobile
Email
Gender
- Select -
Male
Female
Other
Date of Birth
Educational Qualification
Address
City
State
Photo
Choose File
Photo ID card (Upload Aadhar / Voter ID card)
Choose File
Nature of Disability
- Select -
Blindness
Low-vision
Leprosy Cured persons
Hearing Impairment (deaf and hard of hearing)
Locomotor Disability
Dwarfism
Intellectual Disability
Mental Illness
Autism Spectrum Disorder
Cerebral Palsy
Muscular Dystrophy
Chronic Neurological conditions
Specific Learning Disabilities
Multiple Sclerosis
Speech and Language disability
Thalassemia
Hemophilia
Sickle Cell disease
Multiple Disabilities including deafblindness
Acid Attack victim
Parkinson's disease
Write a note about your disability and degree of difficulty
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Work Details
Details of Current Work
Rationale for the nomination
Rationale for the nomination
Choose File
Give link to videos / photos that you may wish to upload
Nomination Type
- Select -
Self Nomination
Nominating a person I know
Name of the nominator
Phone/Mobile
City
Email
Street Address
Pincode
State
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1st Reference Details
1st Reference Name
Phone/Mobile
Email
Address
City
State
PIN
2nd Reference Details
2nd Reference Name
Phone/Mobile
Email
Address
City
State
PIN
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Source Details
How did you hear about the CAVINKARE ABILITY awards? (Please tick as applicable)
Ability Foundation
CavinKare Pvt. Ltd.
Dainik Bhaskar
The Hindu
Ability Foundation - Facebook
Ability Foundation - Instagram
Ability Foundation - LinkedIn
Ability Foundation - Other Social Media
TV Channels
Other
If Other, Please specify
Declaration
I hereby declare that I am willing to accept the CAVINKARE ABILITY award, if selected.
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For any clarification, contact:
89396 75544
awards@abilityfoundation.org
