Registration form

Event Registration Form (#20)

First Name

Last Name

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Please select your professional field from the options below.
Our team will contact you and share the list of relevant award categories based on your profile.

Select Your Field

Healthcare / Medical / Wellness

Doctor (General / Specialist)

Nurse / Paramedic

Physiotherapist

Mental Health Therapist

Dietitian / Nutritionist

Alternative Medicine Practitioner (Ayurveda, Homeopathy)

Wellness Coach / Yoga Instructor

Public Service / Government

IAS / IPS / Government Officer

Police / Fire Services

PSU Employee

Government School Principal / Teacher

Panchayat / Municipality Leader

E-commerce / Digital Services

Amazon / Flipkart Seller

Shopify Store Owner

Dropshipping Business

Freelance Designer / Developer

Digital Product Seller

Would you like to submit a 30-50 second video clip for your award announcement?

Yes

Message (if any)

Company

Support