AFI Forum 2017: Influencer Profile
Please confirm your interest to be an Influencer by sharing these details by 17th January, 2017. The details will help us make the Forum and interactions thereof fruitful for all.
First Name *
Last Name *
Organization *
Designation *
Email address *
Contact Number *
Please provide mobile numbers as it will greatly help in logistics and during emergencies
City travelling from *
AFI Forum Attendance
Have you attended an Action For India Forum before? *
If you answered "Yes" to the previous question, which year did you attend the AFI Forum?
I would be attending the AFI Forum 2017 on: *
The following information will help us to understand your profile better:
Have you worked with social entrepreneurs before? *
If you have worked with social entrepreneurs (SEs) earlier, how many SEs have you worked with? *
What is your area of expertise? *
If you chose "Other," please provide specific details
Please indicate the area(s) where you can help the social entrepreneurs. *
If you can help social entrepreneurs in any "Other" way, please provide details
Would you be interested in engaging with AFI & the social entrepreneurs you meet, beyond the Forum? *
Please share your brief profile. *
Less than 100 words
Please share the link to your Linked-In profile
Please share your Twitter handle
Please indicate any other website link
Forum 2017
List additional Influencers *
Please support our efforts in building a stronger ecosystem by referring influencers who may want to participate. Please include their name, organization, e-mail id and phone number of influencers in your network. (Please try to share at least 3, thanks!)
List of Keynote Speakers you would like to listen to at the AFI Forum 2017
Past Keynote Speakers at AFI Annual Forums have included distinguished people such as Rajiv Pratap Rudy, Sam Pitroda, Desh Deshpande, R Chandrashekhar among other eminent thought leaders. (Please try to share at least 3 Keynote Speaker names, thanks!)
List Social Enterprises
Please suggest 3-5 Social Enterprises you believe should be at the AFI Forum 2017
If you have attended a previous AFI Forum, please share what you liked and what we can do to improve your experience.
Please explain in 100 words
Which similar conference has impressed you and what did you like about it?
Based on similar social entrepreneurship conferences you attended in the past 2 years, please explain in 100 words.
Which 'Influencer category' would you associate yourself to? *
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