Life Empowerment Awards for Schools 2014 -15 - Promotion & Recognition of Co-Scholastic Development - APPLICATION FORM NOMINEE Name of the School : ________________________________________________ Address : __________________________________________________ Phone Number : (Tel.) _____________________ (Mob.)__________________ Fax Number : __________________________________________________ Email : __________________________________________________ Website : __________________________________________________ NOMINATION FOR Sl. No. Award Categories for Best Practices in Promotion of... Jeevan Kaushal – Teacher I. Leadership for Promoting Life Skills, Attitudes and Values II. School, Family and Community Partnership III. Counseling Services in Schools IV. Inclusive Education in Schools V. Indian Art & Culture VI. VII. Health & Physical Wellbeing Principal Leadership for Outstanding Endeavours Name of Nominee & Designation (School/Individual) Contact Number Mobile Landline Email Contact details for further communication. Contact Person : ___________________________________________ Designation : ___________________________________________ Contact Number : (Tel.) ________________ (Mob.)__________________ Email ID : ___________________________________________ Seal of Institution Authorized Sign. & Designation Date ___/___/______ Please Note: The application fee for participation is Rs. 3500 per school (applicable to either 1 or more categories). The fee may please be submitted through a demand draft in favour of “EXPRESSIONS INDIA” payable at New Delhi, latest by 20th April 2015. Super-scribe the envelop with “APPLICATION FOR NOMINATIONS IN LIFE EMPOWERMENT AWARDS FOR SCHOOLS 2014-15” and address to: Dr. Jitendra Nagpal Program Director - Expressions India No. 38, Pocket – I (Behind Asia Pacific Institute of Management) Jasola Vihar, New Delhi- 110025 To avoid any lost in transit, you are requested to reconfirm your participation via email along with scanned copy of the application form and Demand Draft at [email protected] Post the assessment rubric, self assessment forms and supporting documents by 20th July 2015.
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