Koodam 2018 : Application Form

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We urge you to read the workshop brochure thoroughly and then fill this application form. Your preferred email id is required to send you a copy of your form as well as to enable you to edit or add to the application form at a later date if necessary.

Email *

PERSONAL DETAILS

Name

Address

Mobile / Phone No.

Your engagement with Group Relations (Please let us know in a few lines your experience in the field of group relations - if you have been a member or on the staff in any GRC or workshop based on the Group Relations framework)

We would like to hear what you are looking forward to from participating in Koodam: the GRI Learning Forum

Please also note:

There are some open sessions available as indicated in the brochure. If you are interested in using one to make a presentation on a topic related to furthering group relations work and understanding, do send us a brief proposal to programmes@grouprelationsindia.org and we will revert to you.

ADMINISTRATIVE DETAILS

Indicate meal preferences

Vegetarian

Non-Vegetarian

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Any dietary/health/access related requirements

Accommodation requirements: (note that for single occupancy there is extra payment and you must wait for confirmation from us about availability)

Double Occupancy

Single Occupancy

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How did you hear about this event:

Direct email from us

Social Media

Reference

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Would you like to be included in the regular mailing list of GRI?

Yes

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If yes, do we use the contact details you have given in this form?

Yes

Other:

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If not an associate member already, would you be interested in knowing more about and applying for Associate Membership of GRI Forum?

Yes

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