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Charter Membership Application Form
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Email *
Membership type *
Salutation *
First Name *
Last Name *
Gender *
Date of Birth *
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Email ID *
Phone Number *
LinkedIn Link *
Company Name *
Title/ Position *
Mailing Address *
  Total Number of On-roll Employees in the Company  

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Total Number of Contract Employees in the Company 

 *

Average Annual Revenue of Your Company (Past 3 Financial Years)

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Short Profile *
Select Domain *
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Select Functional Area: *
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Have you or your company been facing any criminal or insolvency related proceedings during the last 10 years?
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Mention your other associations, if any: *
Would you like to be an Angel Investor?

*
Have you invested in startups in past? *
How do you propose to contribute to TiE? 

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Share any references (2 Names) *
Have you been associated with TiE before? *
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