NomiNatioN Form

SN. Particulars Strongly agree agree Undecided Disagree Strongly

Disagree

1. It is your duty to carry out the in-laws’ customs and traditions, even if you don’t believe in them.llqjky ds jhfr&fjokt+ksa dk ikyu djuk vkidk drZO; gS] pkgs vkidks os ilan gksa ;k ughaA

2. You can give work related advice to your husband.

vki vius ifr dks muds vkWfQl @ O;olk; ls tqM+h jk; ns ldrh gaSA

3. Do you think that knowledge of spoken English and Basic Computers is necessary for you?vaxzsth cksyuk vkSj DEI;qVj dk Kku gksuk vkids fy, t:jh gSA

4. You keep your children away from social nuisances like facebook, youtube, videogames etc.vkids cPpksa dks lks’ky usVofd±x osclkbV tSls Qslcqd] ;wVîwc ohfM;ks xsEl vkfn ls nwj jguk pkfg,A

5. It is more important to take part in self development programmes than kitty parties and other socio-enter-tainment activities.fdV~Vh ikVhZ ,oa O;ogkfjd esytksy ls vf/kd t:jh gS O;fDrxr fodkl ds dk;ZØeksa esa “kx ysukA

6. You have a right to spend money for your personal choices and desires, even if it is expensive sometimes.viuh ilanhnk oLrqvksa ij] pkgs og [kphZyh gksa] iSlk [kpZ djuk vkidk gd gSA

7. You do not think it to be appropriate for girls to wear short or revealing clothes as it leads to unnecessary attention from men.yM+fd;ksa dk NksVs vkSj QS’kuscy diM+s iguuk iq#"kksa ds v“nz O;ogkj dk dkj.k curk gSA

8. It is imperative for you to follow the attitudes of forgiving and forgetting.{kek djus vkSj nwljksa dh xyfr;ka “wy tkus dk n`f"Vdks.k vkids fy, vko’;d gSA

9. If a 5 year old girl can be raped then do you think your minors should be educated enough to understand this kind of situation instead of avoiding their curiosity?ik¡p lky dh cPph ds cykRdkj dh ?kVuk ij vki vius cPpksa dh ftKklk dks cus jgus nsaxs ;k mUgsa bl ifjfLFkfr dh tkudkjh nsaxs vkSj blls cpko ds ckjs esa crk,axsA

10. Working women command more respect than you.

dkedkth efgykvksa dks vkils T;knk vknj feyrk gSA

Spare some time and let us have your views...

Empowering women is like empowering our nation. The following statements define different roles played by an Indian woman, whether she is a home maker, a housewife, an enterprising woman, a bread winner. Given below are just view-points and perceptions. There is nothing right or wrong about these statements.

They have been categorised as a multiple choice from “Strongly agree to Strongly Disagree”. Read them carefully and choose the option you agree upon and mark them with a . Express your views and perceptions about these statements freely.

11. Describe yourself in ONE WORD ,d 'kCn esa Lo;a dks of.kZr djsaA

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12. What is your opinion about the present Delhi Government? (2 sentences) orZeku fnYyh ljdkj ds ckjs esa vki D;k dguk pkgsaxhA ¼2 okD;½

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13. Are there any significant achievements you will like to tell us about whether related to the role of a homemaker or in any other interest that you pursue? (3 sentences) ,d x`fg.kh ds :i esa viuh #fp ds fdlh vU; {ks= esa D;k vki viuh fdlh miyfC/k ds ckjs esa crkuk pkgsaxhA ¼3 okD;½

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PC JEWELLEr aDDrESSKaroL BaGH 2708, Bank Street, Karol Bagh Delhi - 110005NoiDa G - 54, Sec - 18, G.B. Nagar , Noida(U.P)- 201305 Ph-0120-2510523FariDaBaD 10-A Nehru Ground, Faridabad (Haryana)-121005 Ph -0121-2413102PitamPUra 162, Kapil Vihar, Pitampura, Delhi-1100034 Ph- 01143005000GUrGaoN 2298, Rajeev Nagar, Gurgaon-122001 Ph- 0124-4114791PrEEt ViHar C-54, Preet Vihar, Delhi-110092 Ph-011-421014310GHaZiaBaD 523, Ambedkar Road,Ghaziabad(U.P) - 201001 Ph-0120-2704372SoUtH-EX F-47, South Ex Part-1, New Delhi-110049 Ph-011-49724972raJoUri GarDEN F-130, Main Market, Rajouri Garden, New Delhi -110027 Ph- 011-45669111GrEatEr KaiLaSH M-64, M Block Market, GK-1, New Delhi-110048 Ph-011-41133333iNDraPUram G-20, Apra Shopping Complex , Opp. Shipra Mall, Indrapuram (Ghaziabad) Ph-0120-4544414KiNGSWaY CamP 2517, Hudson Lane, Kingsway Camp, Delhi -110009 Ph-011-42437014PaSCHim ViHar B-1/12 Paschim Vihar New,Delhi -110063 Ph-011-25258114PaNCHKULa S.C.O. -216, Sec:-14 Panchkula (Haryana) Ph -0172-2584277DEHraDUN 52/15, Rajpur Road,Dehradun (U.K.) -248001 Ph- 0135-2740864CHaNDiGarH SCF -29, Sector-22D, Chandigarh Ph - 0124-4114791LUCKNoW Shop No.-4, West Block, Hazrat Ganj, Lucknow - 226001 Ph - 0522-4109032iNDorE 579, M.G. Road, Indore - 452001 (M.P.) Ph - 0731-4080083BHoPaL 29, New Market, T.T, Market, Bhopal - 462003 (M.P.) Ph - 0755-4002861raiPUr 288, Sadar Bazar, Raipur (Chhatisgarh) - 492001 Ph- 0771-4221730JoDHPUr 644, Residency Road, Jodhpur - 342001 (Rajasthan) Ph -0291 2624032BHiLWara 38, Pech Area, Netaji Subhash Market, Station Road, Bhilwara - 311001 (Rajasthan) Ph- 01482-235901LUDHiaNa B-XIX-128, Rani Jhansi Road, Civil Lines, Ludhiana (Punjab) -141008 Ph - 0161-4567018HariDWar Plot No. 4,Khanna Nagar, Ranipur Mode, Haridwar (U.K.) 249401 Ph - 0133-4220147BiLaSPUr Chattishgarh Plaza, Beside Telephone Exchange Agarsen Chowk, Bilaspur (Chattishgarh) -495001 Ph -07752-434946PaLi Plot No. 54, Maa Plaza, Suraj Pole Road, Pali (Rajasthan) -306401 Ph - 02932-220112amritSar 39, Sardar Hatti, Mall Road, Amritsar - 143001 Ph - 0183-2400065BEaWar 2/229, Kundan Bhawan Gali Mahaveer Bazar, Beawar (Rajasthan) -305901 Ph - 0145-2633205aJmEr 13/267, Kothari Bhawan, Naya Bazar, Ajmer (Rajasthan) -305001 Ph - 0145-2633205KaNPUr 26/46, Birhana Road, Kanpur (U.P.) -208001 Ph - 0512-2303477roHtaK Civil Road, Mear Central Bank, Jhajjar Mode , Rohtak, Haryana -124001 Ph-01262-255061JaBaLPUr 1365 - 69, Bhawani Prasad Tiwari Ward (New), Wright Town Extension (Old), Bsnl Ph Exchange, Jabalpur (M.P.) -482001

Ph - 0761-2480111Sri GaNGa NaGar 16, Swami Dayanand Marg, (Gole Market), Sri Ganga Nagar, (Rajasthan) - 335001 Ph - 0154 - 2444151aHmEDaBaD Unit No. 2&3, Turquoise Panchvati Circle, C.G. Road, Ahmedabad (Gujrat) 380006 Ph - 079 - 26401264VaDoDara 1/B - Anand Nagar, Society Jetalpur Road, Vadodara Gujarat - 390007 Ph - 0265-2330404HiSar 135 & 136, C.U.E.-1, Red Square Market, Hisar (Haryana) PH- 01662-235326

NaVBHarat timES, 2nd Floor, Express Building, 9-10, Bahadurshah Zafar Marg, ITO, New Delhi 110002

NomiNatioN Form CoLLECtioN CENtrES

NomiNatioN Form

In support of CervICal CanCer awareness

Name of the Applicant : .....................................................................................................................

Husband’s Name : .....................................................................................................................

Age : .....................................................................................................................

Address : .....................................................................................................................

......................................................................................................................

......................................................................................................................

CoNtaCt DEtaiLS:

Telephone/ Mobile No. : .....................................................................................................................

Email address : ....................................................................................................................

Please affix a recent Passport-size

photograph here

presents

Saturday 13th July, 2013 Siri Fort Auditorium, New Delhi

Winner gets a chance

to act in Madhur

Bhandarkar’s movie

... an educational initiative by AAS

you can also download nomination forms: www.aasngo.org

follow us on

http://www.youtube.com/user/aasnpo https://www.facebook.com/aasnpo

Eminent Jury Members

Madhur Bhandarkar & Satish Kaushik

you can also send your entries directly to C-5, LGF, Lajpat Nagar-III, New Delhi-110 024 (India)

m: +91 98998 59545, 98992 32525 • t : +91 11 2983 0208, 2983 0220 • e : info@aasngo.org

tErmS aND CoNDitioNS:• Applicant should be a resident of India• Applicant should be a full time housewife not working and earning as a professional or an employee• Applicant should be between 25 to 45 years of age• Incomplete Nomination forms shall be summarily rejected• Nomination forms received after 6.00 pm 20th June, 2013 will not be considered for the contest• Nomination forms and their submission is free.• The applications will be shortlisted subject to the questions being answered as per the criteria decided by AAS.• AAS reserves the right to cancel, discontinue, terminate or modify the contest at any time or to accept or reject

any or all entries at their absolute discretion without giving any prior notice and without assigning any reason whatsoever.

• The decision of the judges will be final and binding for all participants. • All disputes shall be subject to Delhi Jurisdiction. • The details of the applicants will be retained by AAS and may be used in the future to contact the applicants to

promote any social cause that AAS undertakes. • I have read the terms and conditions and I hereby agree to the same.

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Eligibility: Housewives in the age group 25-45 yearsEntry Free: Participation through registrationLast Date: 20th June 2013, 6.00 pm

^^'kqfØ;k ^vkl* eq>s ,d lk/kkj.k gkmlokbQ ls celebrated home maker cukus ds fy,A**

- Jyoti Nagpal Winner of AAS Housewives Awards 2012

Live performance by

Sonu Nigam