Nomination Form 2026 – Rohini Nayyar Prize

Nominate yourself or someone you know for Rohini Nayyar Prize

Nomination form

Nomination form for Rohini Nayyar Prize

Please ensure that you have read about the Rohini Nayyar Prize and are aware of the terms and conditions before filling and submitting the nomination.

Name (of nominee) *

First

Last

Photo (of nominee) *

Click or drag a file to this area to upload.

Date of Birth *

Proof of Age (Aadhar Card/ Voter ID/ Class X certificate *

Click or drag a file to this area to upload.

Address for Communication (City, Street, State, Pin Code) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Email *

Confirm Email

Mobile No. *

Alternative Mobile No.

Website / Social media links (of nominee)

Are you Self Nominating?

(Please note that if you work in an organization of which you are not the Founder or CEO, the head of your organization should be your nominator). *

Occupation, Organisation and Designation of Nominator

In what capacity, and for how long, has the Nominator known the Nominee? (Maximum 50 words)

Please provide the names, email addresses,and mobile telephone numbers of two referees who are familiar with your work.

Referee 1
Referee 2

Work / Impact Related Information

Question 1: Specify the precise location of the nominee’s work: village, block, sub-division, district and State. (Maximum 75 words)

Question 2: Describe the nominee's work? (Maximum 250 Words)

Question 3: Describe how the nominee has contributed to one or more aspects of rural development, including climate-action, environmental-conservation, bio-diversity, energy, food-systems, agriculture, education, health, water, sanitation, enterprise development, employment-creation, women’s empowerment, child development, micro-finance, and related activities.(Maximum 250 words) *

Question 4: Describe how the nominee's work satisfies one or both of the following criteria: (a) Innovative work which is ahead of the curve (including the use of emerging technologies)OR (b) Sustained impact on a significant scale(which either affects many people in larger geographical spaces, or brings about transformative change in a small community). (Maximum 250 words *

Nomination form

Nomination form for Rohini Nayyar Prize

Are you Self Nominating?

Work / Impact Related Information

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