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Home
About us
Venue
Programme
Speakers
Suggest a speaker
Networking
Mexican Pharma Awards
About the Awards
Application for the nomination
Sponsorship
Delegate registration
News
FAQ
Contact us
Mexico:
+52 558 526-60-31
UK:
+44 204 577-36-57
mexico@iventu.co.uk
45 Fitzroy Street, Fitzrovia London, W1T 6EB, United Kingdom
Application for the nomination
Applicant’s details
Details of the person who is submitting the application
Applicant's name and surname
*
Name, Patronymic name
Surname
Company name
*
Applicant’s job title
*
Work phone number
*
(with country and city code)
Mobile phone number
*
(with country and city code)
Email
*
Nominated company details
Сompany’s head
*
Company top manager’s name
Company top manager’s surname
Company name
*
Top manager’s job title
*
Website URL
*
Information about the company
*
(no more than 150 words)
Company logo
Accepted file types: jpg, jpeg, png, gif, pdf, eps, ai, Max. file size: 8 MB.
Application for a nomination
A company can participate in maximum 3 nominations.
I would like to submit application in
*
One nomination
Two nominations
Three nominations
First nomination
Please select the nomination
*
Company of the Year (International)
Company of the Year (local)
Distributor of the Year
Pharmacy Chain of the Year
Leader of the Year
Commercial Director of the Year
Marketing Director of the Year
Medical Director of the Year
Clinical Trials Director of the Year
Human Resources Director of the Year
Innovation of the Year
Exporter of the Year
CSR Project of the Year
Digital Project of the Year
Partnership of the Year
Regulatory Affairs Director of the Year
Nominee’s name and surname
*
Name, Patronymic name
Surname
Company name
*
Job title
*
Work phone number
*
(with country and city code)
Mobile phone number
*
(with country and city code)
Email
*
Please provide information about the results achieved by your company, your representatives and implemented projects
*
Description should include no more than 300 words
Second nomination
Please select the second nomination
*
Company of the Year (International)
Company of the Year (local)
Distributor of the Year
Pharmacy Chain of the Year
Leader of the Year
Commercial Director of the Year
Marketing Director of the Year
Medical Director of the Year
Clinical Trials Director of the Year
Human Resources Director of the Year
Innovation of the Year
Exporter of the Year
CSR Project of the Year
Digital Project of the Year
Partnership of the Year
Regulatory Affairs Director of the Year
Nominee’s name and surname
*
Name
Surname
Company name
*
Job title
*
Work phone number
*
(with country and city code)
Mobile phone number
*
(with country and city code)
Email
*
Please provide information about the results achieved by your company, your representatives and implemented projects
*
Description should include no more than 300 words
Third nomination
Please select the third nomination
*
Company of the Year (International)
Company of the Year (local)
Distributor of the Year
Pharmacy Chain of the Year
Leader of the Year
Commercial Director of the Year
Marketing Director of the Year
Medical Director of the Year
Clinical Trials Director of the Year
Human Resources Director of the Year
Innovation of the Year
Exporter of the Year
CSR Project of the Year
Partnership of the Year
Digital Project of the Year
Regulatory Affairs Director of the Year
Nominee’s name and surname
*
Name, Patronymic name
Surname
Company name
*
Job title
*
Work phone number
*
(with country and city code)
Mobile phone number
*
(with country and city code)
Email
*
Please provide information about the results achieved by your company, your representatives and implemented projects
*
Description should include no more than 300 words
Company representative
Contact details for the company’s representative who is responsible for communication with the “Ukrainian Pharma Inspiration Awards” organising committee
Company representative's name and surname
*
Name, Patronymic name
Surname
Job title
*
Email
*
Work phone number
*
(with country and city code)
Mobile phone number
*
(with country and city code)
Final step
Privacy policy
*
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