Questionnaire

Name
State
District
Contact Number
Email id
Selected for
Session Year (F.Y.)
Reference Number
(INSPIRE-MANAK):
DOB

Highest Education Qualification



The Organization where you are working

Organization Name
Designation
contact number
Professional Achievements (if any)
Residential Address (with pin code):
School Name
Schhool Address
Title of Idea/Innovation
(selected under INSPIRE – MANAK)
Impact of INSPIRE programme in your
scientific journey/education journey/ benefit
in higher education (story, if any wish to share)
If any appreciation/rewards
after INSPIRE recognition:
Future plan in general (which
stream of education, which occupation
looking at (if applicable)):
How would you rate INSPIRE-MANAK and
do you think it motivates school students to
pursue careers in science and technology further?
Your Message for the INSPIRE-MANAK scheme.
Certificate of INSPIRE Award (if available)
(Photo should be in jpg,pnj,gif,bmp or jpeg format
and size should not be more than 1MB.)
Photo copy of documents (Education, Recognition, Achievements, etc.) (if available)
(Photo copy of documents should be in jpg,pnj,gif,bmp or jpeg format
and size should not be more than 1MB.)
NLEPC Award function photos. (if available)
(NLEPC Award function photos should be in jpg,pnj,gif,bmp or jpeg format
and size should not be more than 1MB.)