Sign up for a KickASS Speeddate
 Sign up for a pitch at Amstelveen Subsidie Speeddate
Sign in to Google to save your progress. Learn more
Email *
First Name (of the contact person) *
Last Name *
Please give us a short description of your idea *
Date of Birth *
MM
/
DD
/
YYYY
Do you live or work in Amstelveen? *
Required
Is your idea something cultural that you want to organize in your freetime? 
(The funding is not for professionals in the Arts)
 *
Required
Which day would you like to pitch your idea? 
(We'll be in touch about the time, but it will be between 19:00-22:00 o'clock.)
 *
Required
I would like to meet with you before the speeddate. (If so, after filling in this form, please also call/app Luc: 06-1661-6951 for an appointment). *
Mobile phone number *
Street Address *
ZIP Code (ie: 1181ZM) *
City *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Kaboem.

Does this form look suspicious? Report

Google Forms