Application Form

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Apply for the DMN Netra Puraskar

Honouring Excellence in Vision and Service

The Dr. M.C. Nahata Netra Suraksha Puraskar recognizes outstanding contributions in Social Work, Research, and Innovation in the field of Ophthalmology, Blindness Prevention, Low Vision Aids, and Optometry.
If you or your organization is making a difference, we want to hear your story!

Applicant Information

Full Name

Email ID

Phone Number

Website / Social Media

Award Category

Select Area of Contribution:

Years of Involvement in the Field

Describe Your Work and Impact (Max 1000 words)

Measurable Impact (if any)

Supporting Documents

Upload Resume / Organization Profile

Upload Certificates, Testimonials, Research Papers or Proof of Work

Referred By (if any)

Declaration

I confirm that the information provided is true and I agree to the terms and conditions.