INFOCOM FUTURE LEADERSHIP AWARDS 2012

REGISTRATION FORM
Name Age B-School Programme Which year of the programme are you in? Contact Details Address Landline Number Mobile Number School e-mail I only
only for all

!Please use this e-mail I communications"

Alternate #-mail id
!$his is your personal mail id %hich is to be used in case your school id is not %or&ing"

S!o"l# $o" %e one o& t!e 'inne(s Will you be able to come to India on ecember '( )*+) to collect the a%ard? !Air tic&et( boarding( lodging e,penses %ill be pro-ided by us" A##itional C(ite(ia $o register for the e-ent( you must ha-e a -alid passport. o you ha-e a -alid passport? !Applicable to International participants only" How to apply: Option 1: Log onto our website to register online at: www.indiainfocom.com PREFERRED Option 2: You could fill out the attached Registration form and email the same to: ifla@abp.in with a copy to ifla.entries@gmail.com Note: Please fill up all fields. Do not leave any field blan