IPC - Edge Events Application

IPC India Edge Event Application Form

First name

Last name

Gender

Female

Male

Others

Languages Understood

English

Hindi

Telugu

Others

Title of the event

Type of event

Theme

Contact Details

Email ID

Address line 1

Address line 2

City

State/Province

Pin-code/Zip-code

Country code

Mobile number

STD code

Land-line number

Event Details

Title of the Event

Summarize your event concept, the objective(s) of the event, what the participants will learn or take away from the event. Maximum character limit: 2000

Description of the event

Venue location

City

State/Province

Proposed start date and time:

From

Proposed end date and time:

Who is the target audience for this event?

Capacity of the event

Event standard rate - click on "Add more rate" if you offer reduced rate

Currency

Who will facilitate this event?

Please supply one full resolution pic (600x600px min) you want to use for the event. Ensure you own the image or have copyright. Upload

Please supply one full resolution pic you want us to use to promote the event on Facebook. Ensure you own the image or have copyright. Upload

This weblink will be used by the user to know more about the event and register for it. Share Facebook page and Twitter handle if available.

Website/Webpage

"Eg: http://www.yoursite.com"

Facebook Page

Twitter Account

Name of the organisation and name, email address and contact number of the point of contact that will be displayed on IPC website

Name of the Organisation

Name of Contact

Email Address

Country code

Contact Number

You agree to pay to ₹5000 to IPC India 2017 for hosting your Edge event on IPC website. Your money will be treated as contribution to IPC India.

Your contribution will be made through IPC India event's crowdfunding platform. Details will be shared with you once your application is accepted.

Agree

Disagree

Do you need any support from the IPC team? Maximum character limit: 2000