Alumni Association

Indian Institute of Technology Kanpur

Distinguished Alumnus/Alumna Award -- Nomination Form

The Distinguished Alumnus Award (DAA) is the highest award given by the Indian Institute of Technology Kanpur to its alumni in recognition of achievements of exceptional merit in the fields of (a) Entrepreneurship, (b) Management, (c) Professional Excellence, (d) Academic Excellence, and (e) Service to the Society at large. Nominations are now sought for the year 2016. The nomination can be made by alumni and faculty of IITK, and also by head or an appropriate person of the organization where the concerned alumnus/alumna has been working. Self-nominations are discouraged. Nominations MUST accompany the details of the activities undertaken and outstanding achievements/contributions made by the nominee.

Procedure followed for going through the nominations received, and the final decision making is given below. The nominations are evaluated by an Award Evaluation Committee and the final decision is made by the Board of Governors of the Institute.

The Evaluation Committee for recommending the awards, as approved by the BOG, IIT Kanpur, is constituted by the Director and consists of the following:

Director, IIT/K (Chairman), An Industrialist/Manager (Member), The Dean of Students Affairs at IITK (Member), The Dean of Resources and Alumni at IITK (Member), One nominee of the BOG (Member), One non-alumnus faculty member of IIT/K (Member), and the Secretary of the Alumni Association (Member-Secretary).

The nominations for the award are invited and compiled by the Secretary, Alumni Association IIT Kanpur who is also the Member Secretary of the Evaluation committee.

The nominations once received, remain active for consideration for three consecutive years.

The nominations are invited through various media like Alumni Newsletter, letters, mails, etc.

Self nominations are discouraged.

Home Address

Name*
Address*
City If any other please specify
State If any other please specify
Country If any other please specify
Zip
Telephone*
Fax
Email*

Curriculum Vitae

Educational background at IITK and others *
Current employment(occupation) *
Name of employer
Address of employer
Other positions occupied, if any

Past employment, position and name of employer, period

Name of Employer Designation Period Remark
Honorary positions held
Publications, if any
Honours, awards or recognition received, if any
Reasoned justification of the claim*
(maximum 2000 words)

Past employment, position and name of employer, period

It is requested that nominations be accompanied by as much relevant material (in form of bio-data, Newspaper articles/profiles, information on other awards and commendations etc.) as is possible for the nominator to supply. Attachments can include, but is not limited to career/professional highlights, membership/leadership in professional organizations, professional honors, awards and/or recognition, publications, or noteworthy special work. Service to the community and/or civic organizations: can include, but not is limited to involvement with Institute, college or department committees, Alumni Association support, participation and membership, financial contributions, participation in University programs, teaching at the Institute, other volunteer membership, leadership or service. Can also include leadership, membership or support of civic organizations, charitable organizations, religious organizations, or other community related volunteer or financial support.
Attach Curriculum Vitae (only .doc, .pdf, .jpg format & Size not more than 800 KB)  
Additional supporting document (only .doc, .pdf, .jpg format & Size not more than 800 KB)  
Additional supporting document (only .doc, .pdf, .jpg format & Size not more than 800 KB)  
Additional supporting document (only .doc, .pdf, .jpg format & Size not more than 800 KB)  
Additional supporting document (only .doc, .pdf, .jpg format & Size not more than 800 KB)  

Nominator Information

Name*
Degree/Branch/Pass Year if IITK graduate*
Address*
City* If any other please specify
State* If any other please specify
Country* If any other please specify
Zip*
Telephone*
Fax
Email*
 


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