Nomination form for Award Kindly fill in the form show below to submit your details for the PMFAI-SML Annual Agchem Award Name of the Organization & Year of Establishment Type of Organization Address Telephone Number Fax no Email address Website address Name of Managing Director/ Directors/ Partners/etc Email address Contact details Company Turnover(Last Three Years) Exports Turnover (Last Three years) Names of Exporting Country Efforts made to Increase exports. Product details Key Products Type of Company (Large/Medium/Small/Micro) & Company Registration details Member of any Association/trade body YesNo Please Inform if you are Member of other Association with names Major Achievement & Accolades Received if any Summary Justifying for the Award applied not more than 500 words I (Name in Full), (Designation) hereby confirm having read & understood the Rules & Regulations by the PMFAI for the Awards, and will abide to the same. I also confirm the information provided by me in the Application form is correct to the best of my knowledge. Date I Agree Rules and Regulations Note: An entry form will be considered complete and valid, only if the following are duly completed and couriered to the PMFAI Office FOR EXPORT CATEGORY AWARD: Certificate from CA for Turnover and Export Turnover or Bank Certificate stating the export turnover or CA Certificate certifying the export turnover for crop protection chemicals only Other relevant supporting documents or information deemed appropriate Duly filled Nomination form along with the enclosures as prescribed in the Nomination Form Please read & Regulations before applying to the Award Nomination. Use Separate sheet to fill the details if required.