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 bureaucracy today,  agency 18 marketing (P) Ltd

CATEGORY CODE (Please refer to the brochure): CODE BT-  

     

ORGANISATION/ COMPANY’S NAME:

 ADDRESS: 

CITY, STATE, PIN:

TELEPHONE NUMBERS: FAX No:

CONTACT PERSON’S NAME: 

CONTACT PERSON’S DESIGNATION:  

 

 

 

               Mobile: 

Landline Phone Number with city code: Direct line:

Email address (for all official communications with respect to the BT-CSR EXCELLENCE AWARDS 2017):

 

NAME and DESIGNATION of the competent authority signing the entry form:

Name: 

Designation: 

(All entries must carry the signatures of the authority and the seal of the organization)

DETAILS OF THE ENTRY PROCESSING FEE:

Cheque/DD No:                                 Dated:                       for Rs. 10,000/- Drawn on

NEFT Payment acknowledgement Number and date: 

In favour of AgEnCy18 mArkETing PVT. LTD. 

nAmE OF THE SEniOr mAnAgEmEnT OFFiCiAL WHO WiLL ACCEPT THE AWArD On BEHALF OF THE 

COmPAny in CASE DECLArED A WinnEr; 

 

Name: 

Designation: 

Email: Mobile:

   Landline:

DECLArATiOn: I/We hereby declare that the above information is true. We also acknowledge that I/we 

have read the rules and regulations and all the conditions relating to the award and we accept them.

Signatures

Date

ENTRY FORM

BT- CSR EXCELLENCE AWARDS 2017

"

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The BT - CSR Excellence Awards 2017

1.    Please give the details of the Director/ Chairman of the CSR Committee in the following format:

2. 

Write the 

‘Company CSR Statement’ 

(write up of about 500 to 2000 words) indicating the following;

I. 

Brief about the nominated CSR Project

II. 

The impact of the nominated CSR project

III.  CSR policy of the company
IV.  Give details of implementing agency, if any

FeaRLeSS JoURnaLISm, oUR HaBIt, oUR HIStoRy!

Corporate, Head Office: 

2, Big City House, Opposite CSOI (Civil Services Officers Institute),

Kasturba Gandhi Marg, New Delhi - 110 001 (INDIA) 

Telephone: +91-11-23076664, 23073042 Fax: +91-11-23073042 Email: csrawards@bureaucracytoday.com

Important Note: Please refer to the BT-CSR Excellence Awards 2017 booklet for the details of categories, 

process,  rules  and  regulations  before  filling  in  this  application  form. Alternatively  you  may  refer  to  the 

booklet Online for the details of guidelines. You may also download this application form in MS-Word format 

Online from 

www.bureaucracytoday.com.

For more details and e-brochure please contact us on 011 23076664, 011 23073042.

     

Modality for 

spending the 

amount Direct  

or through 

implementing 

agengy*.

Name of the 

agency, if any

Name of the CSR 

project 

nominated for 

the BT-CSR 

award entry

Amount  

spent for  

the award  

nominated 

CSR Project  

(in lakhs)

Category 

Code 

under 

which

entry is 

filed
(Please 

refer to 

the  

brochure)

Particulars of project

Specify the 

name of the 

State,district(s) and 

village(s) where 

project was 

undertaken.

(Please 

check 

the box)

Ground 

location of

the award 

nominated  

project.

  (i)

Name of the Director/ Chairman CSR Committee:

  (ii)

  DIN Number (If any):

  (iii)

  Designation:

  (iv)

Total CSR spending during FY 2015- 2016 (in lakhs):

p

 BuREAuCRACY TODAY,  AgENCY 18 MARkETiNg (P) LTD

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