IITMAA Social Impact Survey
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Full Name: *
Batch: *
Email Id: *
Contact Number: *
Current Country of Residence: *
Current City of Residence: *
Which themes do you think are most relevant for IITMAA’s Social Impact efforts: *
Please select your top 3 preferences
Required
In what way would you like to contribute to IITMAA’s Social Impact projects? *
Select multiple options if applicable
Required
Do you have any preference on the geographical location of IITMAA’s Social Impact projects? *
Have you ever been involved in volunteer/charity projects? If yes, please share (a) Location (b) Description (c) Nature of your involvement (d) Whether the model should be replicated & scaled by IITMAA:                                                                     *
Can you trace your roots back to a village in India? *
If yes, please share the Village, District & State name:
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