Hindustan Times - Brightest Young Climate Leaders (BYCL) – 2010

APPLICATION FORM 2010

Select your Category in the application form:

Group A - Creators: We invite young corporate leaders and professionals, entrepreneurs and youth
leaders to apply by choosing any ONE of the categories below:

 Category 1: Have initiated a climate change mitigation idea or business plan within a

corporate or public sector role for a minimum period of 12 months

 Category 2: Early stage start up (existing company, team etc) in the field of climate

change with an existing business plan or a business idea at the planning stage without a

business plan

 Category 3: Youth leaders/Students from Community/Not for profit with climate change

mitigation ideas or projects

Please complete:

1. Name of Applicant : Ashweenikumar Singh

2. Select the Group & Category – A3

3. Age : 22

4. Gender : Male

5. Date of Birth : 14/11/1987

6. Address : 11-Shantinagar, Near Himmat High School No-2, Dist : Sabarkantha, Gujarat

7. City : Himmatnagar

8. Contact Number : 09016258089

9. Email Address : ashweeni_kr@yahoo.com

10. You are b ) Professional

11. If you are a Student – Current degree and year : Graduated in Aug 2009 From V.N.S.G.U - Surat

12. If you are a Professional – Qualification : BE ( Electrical )

13. If you are a Student - Name of the School/College/ University..................................................

Organised by Arctic Holdings

 14. If you are a Professional - Name of your company/ organization : Unemployed

15. How did you hear about BYCL?

• Online campaign (Please mention which website) :

http://www.hindustantimes.com/Be-a-climate-leader-it-s-time/H1-Article1-
483685.aspx

16. Please attach an executive summary of 500 words OR send a video pitch for 3 minutes
on “Your big climate change mitigation idea or initiative that you have
implemented or want to implement”

Checklist

1. Fill out and attach Application Form

2. Attach Resume

3. Attach Video or Executive summary

4. Application Form, Resume and the Executive Summary have to be sent in PDF format.

5. Please make sure your Video is running on Windows Media Player or VLC player before you
send it.

6. Deadline for the submission of application to bycl@sacredfig.com - 5PM IST December 31,
2009

Declaration by the applicant

I have read and understood the official guidelines of the contest in its entirety. I agree to abide by and
be bound by it and the decisions of the judges, and organisers of Hindustan Times – Brightest Young
Climate Leaders which is final and binding in all respects.

All information contained herein is true and accurate. By submitting this application form, I grant to the
organisation and sponsors all the rights to use my name, address, photographs, video tape or
likeness of me and statements made by or attributed to me relating to the project, for any legal
purpose including, without limitation to, advertising, publicity and other commercial purposes in any
and all forms of media including the internet, without further compensation. I hereby assign all the
rights, title and interest to this submitted form and my article to the organisers of Hindustan Times –
Brightest Young Climate Leaders

(No signature of the applicant is required because this is an online submission. By submitting this
form you agree to be bound by terms & conditions mentioned above)

Organised by Arctic Holdings