Application Form

 

Rashtriya Swamyamsiddh Samman

Identifying & Honouring Untold Stories of Courage

Fourth Edition, 2021

An honorarium of 1,00,000 each will be awarded
to 20 Change Agents from across India

 
Last Date for Submission: 15th September, 2021
 

You are requested to fill up the questionnaire as per the instructions below and please provide answers in no more than the prescribed words.

General Information

Specific Information

Which of the below areas do you work in? (Please mention any one that is deemed most important)
Which geographies do you operate in?
Please mention about a unique project / initiative that you have taken up in the last 3 years.(Not more than 300 words)
Why was the project/initiative unique?(Not more than 300 words)
What was its impact on community?(Not more than 300 words)
What was the innovation in project / Initiative or how was it different?
Do the project / initiative have any policy relevant angle?(Not more than 300 words)
Has the project / initiative led to any specific collaboration or partnership?(Not more than 300 words)
Has the project / initiative been replicated by someone else in the area or anywhere in the country?
What was the source of funding the project/ initiative?
Has the project / initiative been covered by media?
Has the project / initiative been covered by media?
How many people or communities have benefitted from the project / initiative? (Not more than 300 words)
How does the individual plan to expand the project / initiative? (Not more than 300 words)
Have you communicates the project's/ initiative's outcomes to partners or communities or government ?
If yes, please provide brief details of outreach or communication method

The information entered herein is true to the best of my knowledge and the information provided may be used for publicity of the organization/initiative through various modes and channels.

Disclaimer:The selection of the awardees is the sole discretion of the jury based on pre-decided parameters. We reserve your right to withdraw the award if information provided is found to be incorrect.

Duly filled questionnaires can be forwarded to:

Email: awards@jsplfoundation.co.in

For more information reach us at : +91 92890 98181
Time : 9am to 6pm

Address:Rashtriya Swamyamsiddh Samman, Ms. Maitreyee Mishra, Jindal Steel & Power Limited, 3- Forest Park, Bhubaneswar, Odisha – 751009

Rashtriya Swamyamsiddh Samman

Identifying & Honouring Untold Stories of Courage

Fourth Edition, 2021

An honorarium of 1,00,000 each will be awarded
to 20 Change Agents from across India

 
Last Date for Submission: 15th September, 2021
 

You are requested to fill up the questionnaire as per the instructions below and please provide answers in no more than the prescribed words.

General Information

Name of the Head of the Organization and his / her contact details (only applicable in case of organizations)
Is the organization registered?
Please specify
Does the organization have a board?
Does the organization have a website?
Link if any
Does the organization bring out an annual report?
Please give link, if any
Is the organization registered with FCRA and year?
If yes, please mention FCRA number and year of registration
No. Of Employees
If yes, please mention FCRA number and year of registration
Any other Please Specify...
How does the organization get funded?
Any other (please mention)
Has the organization won any awards in the last 3 years?
If yes, please give details
Any other information that you would like to share with us which is important for the Jury to know.

Specific Information

Which of the below areas does the organization work in? (Please mention any one that is deemed most important?)
Which geographies your organization operates in?
Please mention about a unique project / initiative / programme that your organization has taken up in the last 3 years.(Not more than 300 words)
Why was the project / initiative / programme unique?(Not more than 300 words)
What was its impact on community?(Not more than 300 words)
What was the innovation in project / initiative / programme or how was it different?
Does the project / initiative / programme have any policy relevant angle?(Not more than 300 words)
Has the project / initiative / programme led to any specific collaboration or partnership?(Not more than 300 words)
If yes, please give details
Has the project/ initiative/ programme been replicated by someone else in the area or anywhere in the country?
If yes, please give details
What was the source of funding the project / initiative / programme?
Has the project / initiative / programme been covered by media?
If yes at what level
How many people or communities have benefitted from the project / initiative / programme?(Not more than 300 words)
How does the organization plan to expand the project / initiative / programme? (Not more than 300 words)
Does the organization communicate project / initiative / programme outcomes to partners or communities or government?
If yes, please provide brief details of outreach or communication method
If yes, by whom

The information entered herein is true to the best of my knowledge and the information provided may be used for publicity of the organization/initiative through various modes and channels.

Disclaimer:The selection of the awardees is the sole discretion of the jury based on pre-decided parameters. We reserve your right to withdraw the award if information provided is found to be incorrect.

Duly filled questionnaires can be forwarded to:

Email: awards@jsplfoundation.co.in

For more information reach us at : +91 92890 98181
Time : 9am to 6pm

Address:Rashtriya Swamyamsiddh Samman, Ms. Maitreyee Mishra, Jindal Steel & Power Limited, 3- Forest Park, Bhubaneswar, Odisha – 751009

Rashtriya Swamyamsiddh Samman

Identifying & Honouring Untold Stories of Courage

Fourth Edition, 2021

An honorarium of 1,00,000 each will be awarded
to 20 Change Agents from across India

 
Last Date for Submission: 15th September, 2021
 

You are requested to fill up the questionnaire as per the instructions below and please provide answers in no more than the prescribed words.

General Information

Which category of 'Samman' are you nominating for?
Name (Individual or organization)
Contact Details (Individual or organization)
Name of the Head of the Organization and his / her contact details (only applicable in case of organizations)
Is the organization registered?
Please specify
Does the organization have a board?
Does the organization have a website
Link if any
Does the organization bring out an annual report?
Please give link, if any
Is the organization registered with FCRA and year of registration?
If yes, please mention FCRA number and year of registration
No. Of Employees
Which of the partners does the organization work with?
Any other Please Specify...
How does the organization get funding?
Any other (please mention)
Has the organization won any awards in the last 3 years?
If yes, please give details
Any other information that you would like to share with us which is important for the Jury to know. (Individual or organization)

Specific Information

Which of the below areas does the organization / individual work in? (Please mention any one that is deemed most important?)
Which geographies organization / individual operates in?
Please mention about a unique project / initiative / programme that the organization / individual has taken up in the last 3 years.(Not more than 300 words)
Why was the project / initiative / programme unique?(Not more than 300 words)
What was its impact on community?(Not more than 300 words)
What was the innovation in project / initiative / programme or how was it different?
Does the project / initiative / programme have any policy relevant angle?(Not more than 300 words)
Has the project / initiative / programme led to any specific collaboration or partnership?(Not more than 300 words)
If yes, please give details
Has the project / initiative / programme been replicated by someone else in the area or anywhere in the country?
If yes, please give details
What was the source of funding the project / initiative / programme?
Has the project / initiative / programme been covered by media?
If yes at what level
How many people or communities have benefitted from the project / initiative / programme?(Not more than 300 words)
How does the organization / individual plan to expand the project / initiative / programme? (Not more than 300 words)
If yes, please provide brief details of outreach or communication method
Has the NGO / organization ever been blacklisted? (Applicable in case of organization only)
If yes, by whom

The information entered herein is true to the best of my knowledge and the information provided may be used for publicity of the organization/initiative through various modes and channels.

Disclaimer:The selection of the awardees is the sole discretion of the jury based on pre-decided parameters. We reserve your right to withdraw the award if information provided is found to be incorrect.

Duly filled questionnaires can be forwarded to:

Email: awards@jsplfoundation.co.in

For more information reach us at : +91 92890 98181
Time : 9am to 6pm

Address:Rashtriya Swamyamsiddh Samman, Ms. Maitreyee Mishra, Jindal Steel & Power Limited, 3- Forest Park, Bhubaneswar, Odisha – 751009