SDA
Nominations Form
Nominations
Previous Year Winners
 
SDA
       
Satyendra K. Dubey Memorial Award was instituted by IIT Kanpur in the memory of Mr. Satyendra K. Dubey (BT/CE/1994/IITK) and his exemplary life and supreme sacrifice.
 
Satyendra K. Dubey Memorial Award -- Nomination Form
Name *
Home Address
City State Zip
Job Title
Business Name
Business Address
City State Zip
Telephone Fax
E-mail
Graduation year, degree, branch at IIT
IIT Kanpur IIT Chennai IIT Delhi IIT Mumbai IIT Kharagpur IIT Guwahati
IIT Roorkee
Other higher education degrees (please specify institutions)

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.

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 Nominator Information
Name *
Degree/Branch/Pass Year *
IIT Kanpur IIT Chennai IIT Delhi IIT Mumbai IIT Kharagpur IIT Guwahati
IIT Roorkee
Address *
City * State * Zip
Telephone * Fax
E-mail *
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